Kadavanoor Srijith, Krishnadas P Susruth, Peumpalath Naufal, K Sunil Kumar, Balagopal Sithara K
Department of Gastroenterology, Government Medical College Hospital, Thrissur, IND.
Department of Gastroenterology, Government Medical College Hospital, Kozhikode, IND.
Cureus. 2025 May 6;17(5):e83579. doi: 10.7759/cureus.83579. eCollection 2025 May.
Introduction Crohn's disease (CD) is a chronic inflammatory disorder that can involve any part from mouth to anus but predominantly involves the distal small intestine and proximal colon. Sarcopenia is recognized as muscle failure consequent to loss of skeletal muscle strength, function, and mass. Sarcopenia was found to be prevalent in CD patients. Objectives The primary objective of our study was to assess the prevalence of sarcopenia in CD patients, its correlation with disease activity, and the effect of sarcopenia on the prognosis of CD. The secondary objectives were to find out whether there is any correlation of sarcopenia with C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, and hemoglobin levels. Materials and methods This was a prospective cohort study done on 70 newly diagnosed CD patients in the Department of Gastroenterology, Government Medical College, Kozhikode, Kerala, India. Sarcopenia was assessed with the L3 skeletal muscle index (L3SMI) using a cross-sectional image at the L3 level from a cross-sectional image using Image J software. The cut-off of L3SMI was < 36.5 cm²/m² and 30.2 cm²/m² for male patients and female patients, respectively. The prevalence of sarcopenia was assessed. Its effect on clinical and endoscopic disease severity as well as blood parameters was assessed, and the outcome was measured by clinical remission, response to therapy, and number of disease flares. Results The study included 70 newly diagnosed CD patients above 18 years. Out of 70 patients, 26 were female patients and 44 were male patients. The mean age of the study population was 29.86. Mean L3SMI of the population was 37.35 ± 6.63 cm/m. Prevalence of sarcopenia was 38.6% (n=27). The sarcopenia group had a younger age of disease onset (24.52 ± 8.22). Body mass index (BMI) was lower in the sarcopenia group (15.12 ± 1.33 kg/m). Patients with sarcopenia had higher clinical disease severity according to the Crohn's disease activity index (CDAI) score and higher endoscopic severity according to the simple endoscopic score (SES-CD score). Hemoglobin and albumin were lower, and CRP and ESR were higher in the sarcopenia group. Remission at six-month follow-up was 48.1% in the sarcopenia group and was lower when compared to the group without sarcopenia. The number of disease flares was higher in the sarcopenia group (1.07 ± 1.035). Conclusion Sarcopenia is prevalent in CD patients. Patients with sarcopenia had higher clinical and endoscopic disease severity. There is decreased remission and an increased number of flares in patients with sarcopenia. Sarcopenia correlated with hemoglobin, albumin, CRP, and ESR.
引言
克罗恩病（CD）是一种慢性炎症性疾病，可累及从口腔到肛门的任何部位，但主要累及远端小肠和近端结肠。肌肉减少症被认为是骨骼肌力量、功能和质量丧失导致的肌肉功能衰竭。研究发现肌肉减少症在CD患者中很普遍。
目的
我们研究的主要目的是评估CD患者中肌肉减少症的患病率、其与疾病活动度的相关性以及肌肉减少症对CD预后的影响。次要目的是确定肌肉减少症与C反应蛋白（CRP）、红细胞沉降率（ESR）、白蛋白和血红蛋白水平是否存在任何相关性。
材料和方法
这是一项前瞻性队列研究，对印度喀拉拉邦科泽科德政府医学院胃肠病学系的70例新诊断的CD患者进行。使用Image J软件从L3水平的横断面图像评估L3骨骼肌指数（L3SMI）来评估肌肉减少症。男性患者和女性患者的L3SMI临界值分别为<36.5 cm²/m²和30.2 cm²/m²。评估肌肉减少症的患病率。评估其对临床和内镜疾病严重程度以及血液参数的影响，并通过临床缓解、对治疗的反应和疾病发作次数来衡量结果。
结果
该研究纳入了70例18岁以上新诊断的CD患者。70例患者中，26例为女性患者，44例为男性患者。研究人群的平均年龄为29.86岁。人群的平均L3SMI为37.35±6.63 cm/m。肌肉减少症的患病率为38.6%（n = 27）。肌肉减少症组的疾病发病年龄较轻（24.52±8.22）。肌肉减少症组的体重指数（BMI）较低（15.12±1.33 kg/m）。根据克罗恩病活动指数（CDAI）评分，肌肉减少症患者的临床疾病严重程度较高，根据简单内镜评分（SES-CD评分），内镜严重程度也较高。肌肉减少症组的血红蛋白和白蛋白较低，CRP和ESR较高。肌肉减少症组在6个月随访时的缓解率为48.1%，与无肌肉减少症组相比更低。肌肉减少症组的疾病发作次数更高（1.07±1.035）。
结论
肌肉减少症在CD患者中很普遍。肌肉减少症患者的临床和内镜疾病严重程度较高。肌肉减少症患者的缓解率降低，发作次数增加。肌肉减少症与血红蛋白、白蛋白、CRP和ESR相关。
