Abstract
(1) Background: There is growing interest in the assessment of muscular mass in inflammatory bowel disease (IBD) as sarcopenia is associated with important outcomes. The aim of the study was to evaluate the percentage of sarcopenia in IBD patients, characterizing methods for assessment and clinical symptoms associated to it. (2) Methods: Consecutive IBD patients accessing the Fondazione Policlinico Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) were enrolled. Healthy patients, elderly or elderly sarcopenic patients, were enrolled as controls. Skeletal muscle mass was evaluated by Dual Energy X-ray Absorptiometry (DEXA) or Bio-Impedensometric Analysis (BIA). Asthenia degree was assessed by subjective visual analogue scales (VAS). Quality of life was measured by the EQ-5D questionnaire. (3) Results: Patients with IBD showed a significant reduction in skeletal muscle mass than healthy controls with lower DEXA and BIA parameters. Moreover, IBD patients presented a lower perception of muscle strength with a higher incidence of asthenia and reduction in quality of life when compared with healthy controls. A significant association between loss in skeletal muscle mass and high asthenia degree was found, configuring a condition of sarcopenia in about one third of patients with IBD. (4) Conclusions: Sarcopenia is common in IBD patients and it is associated with fatigue perception as well as a reduction in quality of life. Therefore, routine assessment of nutritional status and body composition should be a cornerstone in clinical practice, bringing gastroenterologists and nutritionists closer together for a compact, defined picture.
Highlights
Sarcopenia is defined as a progressive and generalized skeletal muscle disorder characterized by a significant reduction in skeletal muscle mass associated with low muscle strength and low physical performance
Four cohorts were enrolled in the study: A first cohort was composed of patients with confirmed diagnosis of Crohn’s disease (CD) and ulcerative colitis (UC), attending the Digestive Disease Center (CEMAD) at Fondazione Policlinico Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS); healthy controls were enrolled in the second cohort; a third cohort was composed of healthy elderly; and a fourth cohort was composed of elderly with primary sarcopenia, attending the Center of Aging Medicine (CEMI) at Fondazione Policlinico Agostino Gemelli IRCCS
A reduction in skeletal muscle mass and an increase in sarcopenia were observed in inflammatory bowel disease (IBD) patients
Summary
Sarcopenia is defined as a progressive and generalized skeletal muscle disorder characterized by a significant reduction in skeletal muscle mass associated with low muscle strength and low physical performance. The diagnosis of sarcopenia requires the demonstration of a significant reduction in muscle mass associated with a reduction of muscle function. Muscular mass can be studied with radiologic methods, in particular magnetic resonance imaging (MRI) and computed tomography (CT), which are considered the gold standard for non-invasive assessment. Dual Energy X-ray Absorptiometry (DEXA) and Bio-Impedensometric analysis (BIA) are considered punctual, affordable, widely available and portable techniques to assess skeletal muscle mass. Muscular function can be studied with a specific test evaluating hand grip or chain stand [2,3]
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