Naruse Takumi, Sato Hiroki, Takahashi Kazuya, Sato Chihiro, Kojima Yuichi, Kawata Yuzo, Tominaga Kentaro, Mizuno Ken-Ichi, Terai Shuji
Division of Gastroenterology & Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan.
Intern Med. 2025 May 15;64(10):1451-1458. doi: 10.2169/internalmedicine.4420-24. Epub 2024 Oct 18.
Objective Crohn's disease (CD) is a chronic inflammatory bowel disease that is associated with malnutrition. Sarcopenia is a malnutrition condition characterized by skeletal muscle loss that impairs the physical function. We investigated the clinical characteristics of patients with CD with sarcopenia and sarcopenic obesity (sarcopenic-o). Methods The body composition of patients with CD was evaluated using a bioelectrical impedance analysis. The clinical characteristics of patients with sarcopenia and sarcopenic-o were analyzed, and a predictive model for sarcopenia was developed. Patients Patients with CD recruited from 2019 to 2021 were included. Results Among the 104 patients, 35 (33.7%) and 10 (9.6%) had sarcopenia and sarcopenic-o, respectively. In the sarcopenia group, the skeletal muscle index (SMI) and body mass index (BMI) were lower than those in the control group (SMI, 6.3 kg/m vs. 7.7 kg/m, p<0.01; BMI, 18.8 kg/m vs. 22.6 kg/m, p<0.01), whereas the Crohn's disease activity index (CDAI) was higher than in the control group (114.2 vs. 42.0, p<0.01). The predictive models of sarcopenia using the BMI and CDAI revealed high performance with areas under the receiver operating characteristic curve (AUC) of 0.87 and 0.72, respectively, and high specificity (0.94) and sensitivity (0.71), respectively. Sarcopenic-o patients could not be screened using the BMI (25 kg/m), and the SMI and body fat percentage were negatively correlated in patients with sarcopenia (p<0.01). Conclusion Sarcopenia and sarcopenic-o are relatively common conditions among patients with CD. Sarcopenia can be predicted using the clinical parameters of BMI and CDAI. Sarcopenic-o can be a severe form of sarcopenia.
目的 克罗恩病(CD)是一种与营养不良相关的慢性炎症性肠病。肌肉减少症是一种以骨骼肌流失为特征的营养不良状况,会损害身体功能。我们研究了患有肌肉减少症和肌肉减少性肥胖(肌少肥)的CD患者的临床特征。方法 使用生物电阻抗分析评估CD患者的身体成分。分析了肌肉减少症和肌少肥患者的临床特征,并建立了肌肉减少症的预测模型。患者 纳入2019年至2021年招募的CD患者。结果 在104例患者中,分别有35例(33.7%)和10例(9.6%)患有肌肉减少症和肌少肥。在肌肉减少症组中,骨骼肌指数(SMI)和体重指数(BMI)低于对照组(SMI,6.3kg/m对7.7kg/m,p<0.01;BMI,18.8kg/m对22.6kg/m,p<0.01),而克罗恩病活动指数(CDAI)高于对照组(114.2对42.0,p<0.01)。使用BMI和CDAI建立的肌肉减少症预测模型显示出高性能,受试者操作特征曲线(AUC)下面积分别为0.87和0.72,特异性分别为0.94和敏感性分别为0.71。无法使用BMI(25kg/m)筛查肌少肥患者,且肌肉减少症患者的SMI与体脂百分比呈负相关(p<0.01)。结论 肌肉减少症和肌少肥在CD患者中相对常见。可以使用BMI和CDAI的临床参数预测肌肉减少症。肌少肥可能是肌肉减少症的一种严重形式。