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肌肉减少症对接受多排 CT 肠造影的白种活动性克罗恩病患者队列临床结局的影响。

Impact of Sarcopenia on Clinical Outcomes in a Cohort of Caucasian Active Crohn's Disease Patients Undergoing Multidetector CT-Enterography.

机构信息

Gastroenterology, Department of Public Health, University of Naples Federico II, 80131 Naples, Italy.

Department of Advanced Biomedical Sciences-Section of Diagnostic Imaging, University Federico II of Naples, 80131 Naples, Italy.

出版信息

Nutrients. 2022 Aug 23;14(17):3460. doi: 10.3390/nu14173460.

Abstract

(1) Background: Sarcopenia has a high incidence in Crohn’s disease (CD) with considerable heterogeneity among ethnicities and variable impact on clinical outcomes. Aim: to assess the impact of sarcopenia on clinical outcomes in a cohort of Caucasian patients with active CD undergoing CT-enterography (CTE) for clinical assessment. We further investigated the prevalence of sarcopenia and its predictors. (2) Methods: Caucasian CD patients with moderate−severe clinical activity, who underwent CTE in an emergency setting, were retrospectively recruited. The skeletal muscle index (SMI) at the third lumbar vertebra was used to detect sarcopenia in the early stages. Clinical malnutrition was defined according to global clinical nutrition criteria. Clinical outcomes included the rate of surgery and infections within one year. (3) Results: A total of 63 CD patients (34 M; aged 44 ± 17 years) were recruited, and 48 patients (68.3%) were sarcopenic. Malnutrition occurred in 28 patients (44.4%) with a significant correlation between body mass index (BMI) and sarcopenia (r = 0.5, p < 0.001). The overall rate of surgery was 33%, without a significant difference between sarcopenic and non-sarcopenic (p = 0.41). The rate of infection in patients with sarcopenia was significantly higher than in non-sarcopenic (42%vs15%, p = 0.03). BMI (OR 0.73,95%, CI 0.57−0.93) and extraintestinal manifestations (EIM) (OR 19.2 95%, CI 1.05−349.1) were predictive of sarcopenia (p < 0.05). (4) Conclusions: Sarcopenia was associated with an increased rate of infections, and it was observed in 68.3% of the Caucasian cohort with active CD.

摘要

(1) 背景:肌少症在克罗恩病(CD)中的发病率很高,不同种族之间存在很大的异质性,对临床结局的影响也各不相同。目的:评估肌少症对接受 CT 肠造影术(CTE)进行临床评估的活动期 CD 白种人群队列的临床结局的影响。我们进一步研究了肌少症的患病率及其预测因素。(2)方法:回顾性招募了中重度临床活动期接受 CTE 的白种人 CD 患者。第三腰椎处的骨骼肌指数(SMI)用于早期检测肌少症。根据全球临床营养标准定义临床营养不良。临床结局包括一年内手术和感染的发生率。(3)结果:共纳入 63 例 CD 患者(34 例男性;年龄 44±17 岁),其中 48 例(68.3%)为肌少症。28 例(44.4%)存在营养不良,且 BMI 与肌少症呈显著相关(r=0.5,p<0.001)。总的手术率为 33%,肌少症与非肌少症之间无显著差异(p=0.41)。肌少症患者的感染率明显高于非肌少症患者(42%比 15%,p=0.03)。BMI(OR 0.73,95%CI 0.57-0.93)和肠外表现(EIM)(OR 19.2 95%CI 1.05-349.1)是肌少症的预测因素(p<0.05)。(4)结论:肌少症与感染率增加有关,在活动期 CD 的白种人队列中,68.3%的患者存在肌少症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a651/9458031/8681a698ad95/nutrients-14-03460-g001.jpg

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