Nishikawa Hiroki, Nakamura Shiro, Miyazaki Takako, Kakimoto Kazuki, Fukunishi Shinya, Asai Akira, Nishiguchi Shuhei, Higuchi Kazuhide
The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.
The Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.
J Clin Med. 2021 Sep 17;10(18):4214. doi: 10.3390/jcm10184214.
Malnutrition is a major contributor to muscle loss and muscle dysfunction, known as sarcopenia. Malnutrition is common in patients with inflammatory bowel disease (IBD). IBD includes ulcerative colitis (UC) and Crohn's disease (CD). The number of patients with IBD has recently been increasing. More severe malnutrition is often seen in CD compared to UC, probably due to CD affecting the main site of nutrient absorption, extensive mucosal lesions, fistulas, short bowel syndrome after resection, or obstruction of the gastrointestinal tract. A recent meta-analysis showed the high prevalence of sarcopenia in patients with IBD, and thus sarcopenia is a very important problem for IBD. Although IBD is more common in younger patients, sarcopenia can develop through a variety of mechanisms, including malnutrition, chronic inflammation, increased inflammatory status in adipose tissue, vitamin deficiency, and imbalance of the muscle-gut axis. In addition, sarcopenia has a negative impact on postoperative complications and hospital stay in patients with IBD. Appropriate intervention for sarcopenia may be important, in addition to clinical remission and endoscopic mucosal healing in patients with IBD. Much more attention will thus be paid to sarcopenia in patients with IBD. In this review, we outline IBD and sarcopenia, based on the current evidence.
营养不良是肌肉减少和肌肉功能障碍（即肌肉减少症）的主要促成因素。营养不良在炎症性肠病（IBD）患者中很常见。IBD包括溃疡性结肠炎（UC）和克罗恩病（CD）。IBD患者的数量最近一直在增加。与UC相比，CD患者中往往可见更严重的营养不良，这可能是由于CD影响营养吸收的主要部位、广泛的黏膜病变、瘘管、切除术后的短肠综合征或胃肠道梗阻。最近的一项荟萃分析表明，IBD患者中肌肉减少症的患病率很高，因此肌肉减少症是IBD的一个非常重要的问题。尽管IBD在年轻患者中更常见，但肌肉减少症可通过多种机制发展，包括营养不良、慢性炎症、脂肪组织炎症状态增加、维生素缺乏以及肌肉-肠道轴失衡。此外，肌肉减少症对IBD患者的术后并发症和住院时间有负面影响。除了IBD患者的临床缓解和内镜下黏膜愈合外，对肌肉减少症进行适当干预可能也很重要。因此，IBD患者的肌肉减少症将受到更多关注。在本综述中，我们根据现有证据概述了IBD和肌肉减少症。
