Akchurina O E, Mukhametova D D, Odintsova A K, Abdulganieva D I
Kazan State Medical University.
Republican Clinical Hospital.
Ter Arkh. 2025 Mar 26;97(2):157-162. doi: 10.26442/00403660.2025.02.203204.
To assess the muscle mass of patients with inflammatory bowel disease (IBD) using ultrasound.
102 IBD patients hospitalized in gastroenterology department of Republican Clinical Hospital (Kazan) were involved in the study. Among them, 49% of patients with ulcerative colitis, 51% with Crohn's disease, 10 people made up the control group (CG). The median age in the IBD group was 39.5 [28.5; 50] years, in the CG - 37 [26; 38] years. There were 52 (51%) women in the IBD group and 5 (50%) in the CG group. Patients were examined to assess body mass index (BMI), mid-upper arm circumference (MUAC, cm) and mid-thigh circumference (MTC, cm) of the dominant side; bioimpedance analysis of body composition using the ABC-02 "MEDASS" device; ultrasound examination of muscle thickness at two points on the leading side: ultrasound thickness of the middle of the shoulder (US-MUAC), ultrasound thickness of the middle of the thigh (US-MTC), dynamometry using a wrist dynamometer, assessment of nutritional status.
According to BMI, patients were distributed as follows: normal in 57 (55.9%) patients; deficiency - in 12 (11.8%); overweight - 25 (24.5%); obesity - 8 (7.8%). Median MUAC in women with IBD was 28 [24.9; 31] cm, in CG - 28 [27; 28.5] cm (>0.05); in men with IBD 29.8 [27; 32] cm, in CG - 33 [31; 34] cm (<0.05). The median MTC in women with IBD was 54.25 [48.15; 58.10] cm, in CG - 61.5 [56; 67] cm (<0.05); in men with IBD 48 [46; 51.4] cm, in GC - 54 [53; 54] cm (<0.05). The median US-MUAC in women with IBD was 19.60 [18.23; 22.84] mm, CG 22.49 [20.41; 22.66] (>0.05); in men with IBD 26.45 [22.87; 29.24] mm, in CG 21.54 [21.18; 25.13] mm (>0.05). Median US-MTC in women with IBD was 31.05 [23.21; 37.11] mm, CG 41.30 [35.55; 41.74] mm (<0.05), in men with IBD 30.90 [25.64; 39.99] mm, in CG 40.67 [39.10; 41.84] (<0.05). According to the results of bioimpedansometry, the skeletal muscle mass index (SMI) was low in 32% of patients, normal in 65%, and above normal in 3%. US-MUAC correlated with MUAC (=0.557; <0.05), with BMI (=0.448; <0.05), with SMI (=0.666; <0.05). US-MTC correlated with MTC (=0.505; <0.05), with BMI (=0.376; <0.05), with SMI (=0.373; <0.05).
In patients with IBD, MTC was lower than in CG. US-MTC in women and men with IBD was lower than in CG, which correlated with MTC, BMI, skeletal muscle mass according to bioimpedance measurements and grip strength according to dynamometry.
使用超声评估炎症性肠病（IBD）患者的肌肉量。
共和临床医院（喀山）胃肠病科收治的102例IBD患者参与了本研究。其中，溃疡性结肠炎患者占49%，克罗恩病患者占51%，10人组成对照组（CG）。IBD组的中位年龄为39.5[28.5；50]岁，对照组为37[26；38]岁。IBD组有52名（51%）女性，对照组有5名（50%）女性。对患者进行检查以评估体重指数（BMI）、优势侧上臂中部周长（MUAC，厘米）和大腿中部周长（MTC，厘米）；使用ABC - 02“MEDASS”设备对身体成分进行生物电阻抗分析；在优势侧两点进行肌肉厚度的超声检查：肩部中部的超声厚度（US - MUAC）、大腿中部的超声厚度（US - MTC），使用腕部测力计进行握力测量，评估营养状况。
根据BMI，患者分布如下：57例（55.9%）患者正常；12例（11.8%）患者不足；25例（24.5%）患者超重；8例（7.8%）患者肥胖。IBD女性患者的中位MUAC为28[24.9；31]厘米，对照组为28[27；28.5]厘米（>0.05）；IBD男性患者为29.8[27；32]厘米，对照组为33[31；34]厘米（<0.05）。IBD女性患者的中位MTC为54.25[48.15；58.10]厘米，对照组为61.5[56；67]厘米（<0.05）；IBD男性患者为48[46；51.4]厘米，对照组为54[53；54]厘米（<0.05）。IBD女性患者的中位US - MUAC为19.60[18.23；22.84]毫米，对照组为22.49[20.41；22.66]（>0.05）；IBD男性患者为26.45[22.87；29.24]毫米，对照组为21.54[21.18；25.13]毫米（>0.05）。IBD女性患者的中位US - MTC为31.05[23.21；37.11]毫米，对照组为41.30[35.55；41.74]毫米（<0.05），IBD男性患者为30.90[25.64；39.99]毫米，对照组为40.67[39.10；41.84]（<0.05）。根据生物电阻抗测量结果，32%的患者骨骼肌质量指数（SMI）较低，65%的患者正常，3%的患者高于正常。US - MUAC与MUAC相关（=0.557；<0.05），与BMI相关（=0.448；<0.05），与SMI相关（=0.666；<0.05）。US - MTC与MTC相关（=0.505；<0.05），与BMI相关（=0.376；<0.05），与SMI相关（=0.373；<0.05）。
IBD患者的MTC低于对照组。IBD女性和男性的US - MTC低于对照组，这与MTC、BMI、生物电阻抗测量的骨骼肌质量以及握力测量的握力相关。
