da Silva Vieira Ana Margarida Duarte, Pais Sandra, Martins Viviana, Castelo Barbara, Mascarenhas Saraiva Miguel
Unidade Local de Saúde do Algarve, Unidade de Portimão de Gastrenterologia, 8500-338 Portimão, Portugal.
Faculdade de Medicina e Ciências Biomédicas, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal.
J Clin Med. 2024 Nov 29;13(23):7273. doi: 10.3390/jcm13237273.
Anorectal dysfunctions (ARDs) include fecal incontinence (FI) and functional defecation disorders (FDDs). The pelvic floor muscles play a central role in the physiology of continence and defecation. We aimed to investigate the prevalence of sarcopenia in a female group with anorectal dysfunctions and compare them with a healthy female age-matched group. As secondary objectives, the relationship between anorectal dysfunction outcomes and sarcopenia was analyzed. We conducted a single-center cross-sectional, interventional, controlled, and double-blind study involving female adults admitted to an ARD outpatient clinic assessed for FI and/or FDD. A control group was also included of age-matched women without ARD. Sarcopenia was evaluated in the entire cohort, according to the latest criteria. Statistical analysis was performed using SPSS software v.29, considering a confidence interval of 95%. A total of 130 participants were included, equally divided by the two groups. The median age was 64 years. Both groups were also similar regarding body mass index (BMI), physical activity index values, and dietary patterns. Among the 130 investigated women, there were no cases of confirmed sarcopenia or severe sarcopenia, but 15 women (11.5%) had probable sarcopenia or dynapenia. The case group had significantly more probable sarcopenia than women in the control group (14 (21.5%) vs. 1 (1.5%), < 0.001). The presence of relevant comorbidities, such as irritable bowel syndrome (IBS), urinary incontinence (UI), and meat dietary pattern (MDP), was a risk factor for probable sarcopenia. The binomial logistic regression analysis showed that probable sarcopenia (OR 3.9; CI 1.1-14.1, = 0.039) was associated with a worse treatment response. Probable sarcopenia or dynapenia was significantly more prevalent in women with ARD and was a predictive factor of a worse treatment response, regardless of the ARD severity. Concomitant UI, MDP, IBS, and psychiatric conditions were significantly associated with dynapenia. The inclusion of the evaluation of sarcopenia in these patients should be considered.
肛肠功能障碍(ARDs)包括大便失禁(FI)和功能性排便障碍(FDDs)。盆底肌肉在控便和排便生理过程中起核心作用。我们旨在调查患有肛肠功能障碍的女性群体中肌肉减少症的患病率,并将她们与年龄匹配的健康女性群体进行比较。作为次要目标,分析了肛肠功能障碍结果与肌肉减少症之间的关系。我们进行了一项单中心横断面、干预性、对照性和双盲研究,纳入了因FI和/或FDD在ARD门诊接受评估的成年女性。还纳入了一个无ARD的年龄匹配女性对照组。根据最新标准对整个队列进行肌肉减少症评估。使用SPSS软件v.29进行统计分析,置信区间为95%。总共纳入了130名参与者,两组人数相等。中位年龄为64岁。两组在体重指数(BMI)、身体活动指数值和饮食模式方面也相似。在130名接受调查的女性中,没有确诊的肌肉减少症或严重肌肉减少症病例,但有15名女性(11.5%)可能患有肌肉减少症或肌肉功能减退。病例组中可能患有肌肉减少症的女性明显多于对照组(14例(21.5%)对1例(1.5%),<0.001)。存在相关合并症,如肠易激综合征(IBS)、尿失禁(UI)和肉类饮食模式(MDP),是可能患有肌肉减少症的危险因素。二项式逻辑回归分析表明,可能患有肌肉减少症(比值比3.9;置信区间1.1 - 14.1,=0.039)与较差的治疗反应相关。无论ARD严重程度如何,可能患有肌肉减少症或肌肉功能减退在患有ARD的女性中明显更为普遍,并且是较差治疗反应的预测因素。合并UI、MDP、IBS和精神疾病与肌肉功能减退显著相关。应考虑对这些患者进行肌肉减少症评估。