P858 Prevalence of sarcopenia in patients with inflammatory bowel disease and factors associated with it
Dharap, V.(1)*;Abraham, P.(2);Desai, D.(2);Gupta, T.(2);Dhoble, P.(2);Mehta, N.(3);Modhe, J.(3);
(1)P D Hinduja National Hospital and Medical Research Centre- Mahim- Mumbai- India, Department of Gastroenterology, Mumbai, India;(2)P D Hinduja National Hospital and Medical Research Centre- Mumbai, Department of Gastroenterology, Mumbai, India;(3)P D Hinduja National Hospital and Medical Research Centre- Mumbai, Department of Radiology, Mumbai, India; Inflammatory bowel disease
Sarcopenia is a progressive and generalized skeletal muscle disorder with significant reduction in skeletal muscle mass associated with low muscle strength and physical performance. Multiple factors contribute to sarcopenia in active as well as quiescent inflammatory bowel disease (IBD). It has been implicated in disease complications and surgical outcomes
Inclusion criteria: Consecutive consenting patients > 18 years old with IBD attending the division of Gastroenterology between June 2021 and June 2022
Exclusion criteria: Associated systemic diseases, patient with prior surgery for IBD, that could contribute to sarcopenia were excluded
All patients had anthropometric measurements, calculation of body mass index (BMI), and measurement of mid-arm muscle circumference. The muscle strength was measured by hand-grip strength by hand-held dynamometer. The physical performance was measured by gait speed by 4-meters walk test. The muscle mass was calculated by measuring skeletal muscle index (SMI) with single slice of CT scan at the level 3rd Lumbar vertebra.Patients were categorized according to the European Working Group on Sarcopenia in Older People, 2018 definition, into probable sarcopenia (low muscle strength), sarcopenia (low muscle strength and low muscle mass), and severe sarcopenia (low muscle strength, low muscle mass, and low physical performance1. Factors evaluated for association with sarcopenia were age, gender, disease subtype (Crohn’s disease [CD], ulcerative colitis [UC] or IBD-U (unclassified), activity and nutrition. SMI value of <42 cm2/m2 for men and <38 cm2/m2 for women were taken as per a recent Indian study2.
Of 117 patients, 73 had ulcerative colitis (UC), 42 Crohn’s disease (CD), and 2 IBD- unclassified (IBD-U). Forty (34.2%) patients had probable sarcopenia; 47 (40.2%) patients had sarcopenia (29 UC, 18 CD) including 10 with severe sarcopenia. Ten (21.3%) patients with sarcopenia were in disease remission. On univariate analysis BMI, disease activity, low hemoglobin, and biologic use were significantly associated with sarcopenia (Table1); on multivariate analysis, only BMI showed significant association with sarcopenia. (Table 2)
Sarcopenia was detected in over 40% of patients with IBD and a fifth had severe sarcopenia. One-fifth of them were in clinical remission. Low BMI significantly correlated with sarcopenia. Screening for sarcopenia should be considered in all patients with IBD.
1. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis.Age Ageing.2019;48:16-31
2. Sidhu S, Saggar K, Goyal O, Kishore H, Sidhu SS. Normative values of sarcopenia in the Indian population. Indian J Gastroenterol. 2018;37(suppl 1): A1–A137