Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia; Translational Medical Sciences and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK.
MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
Clin Nutr ESPEN. 2023 Oct;57:647-654. doi: 10.1016/j.clnesp.2023.08.009. Epub 2023 Aug 21.
Low skeletal muscle mass (MM) and deteriorated function (sarcopenia) can be a frequent complication in paediatric inflammatory bowel disease (IBD).
To conduct a systematic review of the paediatric IBD literature on skeletal muscle function and mass and identify interventions that could affect them.
Systematic searches (EMBASE, Medline, Cochrane library central for registered control trials and Web of Science) were conducted using the terms 'lean body mass' (LM), 'fat free mass' (FFM) or 'MM' and 'IBD'.
Fourteenth studies were included, presenting data from 439 Crohn's disease (CD), 139 ulcerative colitis (UC) and 2 IBD-unclassified participants compared with healthy matched or unmatched groups or reference populations. Six out of 14 studies reported lower LM, whilst 7 studies observed lower MM and FFM in CD patients compared to healthy controls. Research in UC patients reported lower LM in 3 studies, lower MM in 3 studies and lower FFM in 4 studies. Three prospective studies measured the impact of enteral feeding and showed improvement on disease activity and LM or FFM, while one retrospective study did not show any impact on LM.
Despite the variety of experimental approaches and methods used to assess sarcopenia, most studies showed reduction in MM, LM and FFM in IBD. Nutritional intervention may have a positive effect on LM and FFM. Future research should focus on standardizing the terminology and methodologies used in assessing body composition and investigating sarcopenia in diseased and matched healthy control cohorts in adequately powered studies with a longitudinal design.
低骨骼肌量（MM）和功能恶化（肌少症）可能是儿科炎症性肠病（IBD）的常见并发症。
对儿科 IBD 文献中关于骨骼肌功能和量的内容进行系统回顾，并确定可能影响这些内容的干预措施。
系统检索（EMBASE、Medline、Cochrane 图书馆对照试验注册中心和 Web of Science）使用了“瘦体重（LM）”、“无脂肪体重（FFM）”或“MM”和“IBD”等术语。
纳入了 14 项研究，这些研究提供了 439 名克罗恩病（CD）、139 名溃疡性结肠炎（UC）和 2 名 IBD 未分类参与者的数据，与健康匹配或不匹配的对照组或参考人群进行了比较。14 项研究中的 6 项报告了较低的 LM，而 7 项研究观察到 CD 患者的 MM 和 FFM 低于健康对照组。3 项 UC 患者的研究报告了较低的 LM，3 项研究报告了较低的 MM，4 项研究报告了较低的 FFM。3 项前瞻性研究测量了肠内喂养的影响，发现其对疾病活动和 LM 或 FFM 有改善作用，而 1 项回顾性研究未发现其对 LM 有任何影响。
尽管用于评估肌少症的实验方法和方法多种多样，但大多数研究显示 IBD 患者的 MM、LM 和 FFM 减少。营养干预可能对 LM 和 FFM 有积极影响。未来的研究应集中于标准化评估身体成分的术语和方法，并在设计合理、具有纵向研究的充分效能的研究中，调查疾病和匹配健康对照组中肌少症的情况。
