Inflammatory Bowel Disease Unit, St Mark's Hospital, Harrow, UK.
Gastroenterology Department, St Vincent's Hospital, Melbourne, Australia.
J Crohns Colitis. 2022 Sep 8;16(9):1475-1492. doi: 10.1093/ecco-jcc/jjac041.
Alterations in body composition are common in inflammatory bowel disease [IBD] and have been associated with differences in patient outcomes. We sought to consolidate knowledge on the impact and importance of body composition in IBD.
We performed a systematic search of MEDLINE, EMBASE and conference proceedings by combining two key research themes: inflammatory bowel disease and body composition.
Fifty-five studies were included in this review. Thirty-one focused on the impact of IBD on body composition with a total of 2279 patients with a mean age 38.4 years. Of these, 1071 [47%] were male. In total, 1470 [64.5%] patients had Crohn's disease and 809 [35.5%] had ulcerative colitis. Notably, fat mass and fat-free mass were reduced, and higher rates of sarcopaenia were observed in those with active IBD compared with those in clinical remission and healthy controls. Twenty-four additional studies focused on the impact of derangements in body composition on IBD outcomes. Alterations in body composition in IBD are associated with poorer prognoses including higher rates of surgical intervention, post-operative complications and reduced muscle strength. In addition, higher rates of early treatment failure and primary non-response are seen in patients with myopaenia.
Patients with IBD have alterations in body composition parameters in active disease and clinical remission. The impacts of body composition on disease outcome and therapy are broad and require further investigation. The augmentation of body composition parameters in the clinical setting has the potential to improve IBD outcomes in the future.
在炎症性肠病（IBD）中，身体成分的改变很常见，并且与患者结局的差异有关。我们旨在综合了解身体成分在 IBD 中的影响和重要性。
我们通过结合两个关键研究主题：炎症性肠病和身体成分，对 MEDLINE、EMBASE 和会议记录进行了系统检索。
本综述共纳入 55 项研究。其中 31 项研究侧重于 IBD 对身体成分的影响，共纳入 2279 例患者，平均年龄为 38.4 岁。其中 1071 例（47%）为男性。共有 1470 例（64.5%）患者患有克罗恩病，809 例（35.5%）患者患有溃疡性结肠炎。值得注意的是，与临床缓解和健康对照组相比，活动期 IBD 患者的脂肪量和去脂量减少，且肌肉减少症的发生率更高。另外 24 项研究侧重于身体成分失调对 IBD 结局的影响。IBD 患者的身体成分改变与预后较差相关，包括手术干预、术后并发症和肌肉力量降低的发生率增加。此外，肌肉减少症患者的早期治疗失败和原发性无应答率更高。
活动期和临床缓解期 IBD 患者的身体成分参数发生改变。身体成分对疾病结局和治疗的影响广泛，需要进一步研究。在临床实践中增加身体成分参数可能会改善未来 IBD 的结局。
