Division of Clinical Nutrition, Shiga University of Medical Science, Otsu, Shiga, Japan.
Division of Gastroenterology, Shiga University of Medical Science, Otsu, Shiga, Japan.
Inflamm Bowel Dis. 2021 Aug 19;27(9):1435-1442. doi: 10.1093/ibd/izaa306.
Although there are several reports of associations between body composition parameters and outcomes in patients with inflammatory bowel disease (IBD), it is not clear which muscle tissue parameters and/or adipose tissue parameters most strongly affect outcomes. Therefore, this study sought to determine the associations of such parameters determined at the level of the third lumbar vertebra (L3) on computed tomography (CT) images with outcomes in IBD patients.
Subjects were IBD patients who were admitted to our hospital and underwent abdominal CT. The following parameters were assessed: skeletal muscle index, psoas muscle index, visceral adipose tissue/height index, visceral to subcutaneous adipose tissue area ratio, and intramuscular adipose tissue content. In this study, short- and long-term outcomes were defined as prolonged length of stay (≥30 days) and intestinal resection during the overall period of observation, respectively.
In total, 187 patients were enrolled, 99 with Crohn's disease and 88 with ulcerative colitis. For all IBD patients, multivariate logistic regression analysis revealed that low albumin level and low psoas muscle index on admission were associated with prolonged length of stay. Multivariate Cox regression analysis revealed that male sex, Crohn's disease (not ulcerative colitis), low psoas muscle index, and high visceral to subcutaneous adipose tissue area ratio were associated with intestinal resection.
This study revealed that muscle volume is associated with the short-term outcome of prolonged length of stay, whereas muscle volume and visceral adipose tissue volume (relative to subcutaneous adipose tissue volume) are associated with the long-term outcome of intestinal resection.
虽然有几项关于身体成分参数与炎症性肠病（IBD）患者结局之间关联的报告，但尚不清楚哪些肌肉组织参数和/或脂肪组织参数对结局的影响最大。因此，本研究旨在确定 CT 图像第 3 腰椎（L3）水平的这些参数与 IBD 患者结局的关系。
本研究纳入了因患 IBD 而到我院就诊并行腹部 CT 检查的患者。评估了以下参数：骨骼肌指数、腰大肌指数、内脏脂肪/身高指数、内脏脂肪与皮下脂肪面积比、肌内脂肪含量。本研究中，短期和长期结局分别定义为住院时间延长（≥30 天）和整个观察期间的肠切除术。
共纳入 187 例患者，其中克罗恩病 99 例，溃疡性结肠炎 88 例。多变量逻辑回归分析显示，入院时低白蛋白水平和低腰大肌指数与住院时间延长有关。多变量 Cox 回归分析显示，男性、克罗恩病（非溃疡性结肠炎）、低腰大肌指数和高内脏脂肪与皮下脂肪面积比与肠切除术有关。
本研究表明，肌肉量与住院时间延长的短期结局有关，而肌肉量和内脏脂肪量（相对于皮下脂肪量）与肠切除术的长期结局有关。
