Dermine Solène, Bazin Thomas, Hassan Fatimé Adam, Bettolo Johanna, Billiauws Lore, Bourdillel Justine, Bresteau Clément, Corcos Olivier, El Khatib Myriam, Gouse Ashiq Mohamed, Hutinet Coralie, Nuzzo Alexandre, Joly Francisca
Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre for Rare Disease MarDI, AP-HP Beaujon Hospital, University Paris, France.
Department of Gastroenterology and Nutritional Support, Center for Intestinal Failure, Reference Centre for Rare Disease MarDI, AP-HP Beaujon Hospital, University Paris, France; Infection & Inflammation, UMR 1173, Inserm, UVSQ/Université Paris Saclay, Montigny-le-Bretonneux, France.
Clin Res Hepatol Gastroenterol. 2025 Apr;49(4):102555. doi: 10.1016/j.clinre.2025.102555. Epub 2025 Feb 26.
Inflammatory bowel disease (IBD) patients with sarcopenia are at increased morbidity risk. The aim of this study was to assess the prevalence of sarcopenia in IBD outpatients using both morphological and functional criteria.
In this prospective cohort study, all IBD patients admitted to the day hospital unit between March 01 and 31, 2023 were included. Muscle mass and function were evaluated using bioelectrical impedance analysis and handgrip strength measurement, respectively. Probable sarcopenia was defined as reduced handgrip strength (<16-27 kg). Myopenia was defined by a low appendicular muscle mass index (<5.5-7 kg/m²). Sarcopenia was diagnosed based on the coexistence of reduced muscle strength and muscle mass. Disease activity, therapeutic changes, hospitalizations, and IBD-related surgeries were assessed at month 6.
Sixty patients with either Crohn's disease (CD, 52 %) or ulcerative colitis (48 %), with a median age of 37 years (interquartile range [IQR]: 28-54), were included. Fifty-five percent were women. Most patients were in remission (67 %, n = 40). In CD patients, the involvement was ileocolic (48 %), ileal (35 %), or colonic (16 %). A history of IBD-related digestive surgery was noted in 30 % of cases. The median body mass index [BMI] was 24 (IQR: 21-27). The prevalence of sarcopenia, probable sarcopenia, and myopenia was 10 %, 18 %, and 20 %, respectively. Sarcopenic patients were significantly older (59 vs 36 years, p = 0.01), had a longer disease duration (20 vs 8 years, p = 0.003), were more likely to have associated joint inflammation (27 % vs 6 %, p = 0.01) and CD (80 % vs 49 %, p = 0.36). Myopenia was significantly associated with a history of surgery (67 % vs 21 %, p = 0.004) and a lower BMI (21 vs 24, p = 0.001).
In this prospective cohort of IBD outpatients, 10 % and 20 % of patients had sarcopenia and myopenia, respectively. Screening for sarcopenia therefore seems essential in this population, including in stable outpatients in remission who do not meet malnutrition criteria and in overweight patients, as according to the literature, sarcopenia is associated with poorer clinical outcomes and increased postoperative complications. Interventional studies are needed to assess the impact of multidisciplinary treatment of sarcopenia on quality of life and disease progression.
患有肌肉减少症的炎症性肠病（IBD）患者发病风险增加。本研究的目的是使用形态学和功能标准评估IBD门诊患者中肌肉减少症的患病率。
在这项前瞻性队列研究中，纳入了2023年3月1日至31日入住日间医院病房的所有IBD患者。分别使用生物电阻抗分析和握力测量评估肌肉质量和功能。可能的肌肉减少症定义为握力降低（<16 - 27千克）。肌少症定义为四肢肌肉质量指数低（<5.5 - 7千克/平方米）。根据肌肉力量和肌肉质量同时降低来诊断肌肉减少症。在第6个月评估疾病活动度、治疗变化、住院情况和IBD相关手术。
纳入了60例克罗恩病（CD，52%）或溃疡性结肠炎（48%）患者，中位年龄为37岁（四分位间距[IQR]：28 - 54），55%为女性。大多数患者处于缓解期（67%，n = 40）。在CD患者中，病变累及回结肠（48%）、回肠（35%）或结肠（16%）。30%的病例有IBD相关消化手术史。中位体重指数[BMI]为24（IQR：21 - 27）。肌肉减少症、可能的肌肉减少症和肌少症的患病率分别为10%、18%和20%。肌肉减少症患者年龄显著更大（59岁对36岁，p = 0.01），病程更长（20年对8年，p = 0.003），更可能伴有关节炎症（27%对6%，p = 0.01）和CD（80%对49%，p = 0.36）。肌少症与手术史（67%对21%，p = 0.004）和较低的BMI（21对24，p = 0.001）显著相关。
在这个IBD门诊患者的前瞻性队列中，分别有10%和20%的患者患有肌肉减少症和肌少症。因此，在这一人群中筛查肌肉减少症似乎至关重要，包括那些不符合营养不良标准的缓解期稳定门诊患者以及超重患者，因为根据文献，肌肉减少症与较差的临床结局和术后并发症增加有关。需要进行干预性研究来评估肌肉减少症的多学科治疗对生活质量和疾病进展的影响。
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