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Abstract
Patients with inflammatory bowel disease (IBD) are at risk of sarcopenia, which is associated with poor clinical outcomes. We conducted this study to assess whether sarcopenia predicts the need for surgery and postoperative complications in patients with IBD. We performed a systematic search of four electronic databases, last updated in March, 2019. Data from studies comparing rates of surgery and postoperative complications in sarcopenic IBD patients versus non-sarcopenic IBD patients were pooled with the random-effects models. We calculated the odds ratios (OR) with a 95% confidence interval (CI). Ten studies with a collective total of 885 IBD patients were included in our meta-analysis. Although the analysis of raw data did not reveal significant differences between the two groups with respect to the rate of surgery and postoperative complications (OR = 1.826; 95% CI 0.913–3.654; p = 0.089 and OR = 3.265; 95% CI 0.575–18.557; p = 0.182, respectively), the analysis of adjusted data identified sarcopenia as an independent predictor for both of the undesirable outcomes (OR = 2.655; 95% CI 1.121–6.336; p = 0.027 and OR = 6.097; 95% CI 1.756–21.175; p = 0.004, respectively). Thus, early detection of sarcopenia in patients with IBD is important to prevent undesirable outcomes.
Highlights
The term ‘sarcopenia’ was introduced by Rosenberg in 1997 to describe an age-related decrease in skeletal muscle mass [1]
Sarcopenia is relevant for patients with inflammatory bowel disease (IBD) as it can lead to poor outcomes, such as bone demineralization with consequential pathological fractures, hospitalization, reduced mobility, and compromised quality of life [31]
Our meta-analysis found only seven studies with controversial results on surgical interventions for sarcopenic patients with IBD
Summary
The term ‘sarcopenia’ was introduced by Rosenberg in 1997 to describe an age-related decrease in skeletal muscle mass [1]. According to the recent recommendation of the European Working Group on Sarcopenia in Older People (EWGSOP), sarcopenia can be diagnosed if low lean muscle mass stands together with either low muscle strength or low physical performance [2]. Several studies have shown that BMI does not predict low lean muscle mass accurately and the entity of sarcopenic obesity exists [3,4,5]. A variety of methods and measures are used to evaluate muscle mass, including computed tomography (CT), magnetic resonance imaging (MRI), bioelectrical impedance analysis (BIA), dual-energy X-ray absorptiometry (DXA) and skeletal muscle index (SMI), appendicular SMI (ASMI), and total psoas muscle area (TPA) [2]. Sarcopenia was implicated as a prognostic factor in a wide range of diseases, such as cancer [9, 10], chronic liver diseases [11], chronic pancreatitis [12], rheumatic diseases [13] and inflammatory bowel disease (IBD) [14]
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