Intest Res.  2020 Jan;18(1):79-84. 10.5217/ir.2019.00107.

The prevalence of sarcopenia and its effect on prognosis in patients with Crohn’s disease

• Lee CH
• Yoon H
• Oh DJ
• Lee JM
• Choi YJ
• Shin CM
• Park YS
• Kim N
• Lee DH
• Kim JS

• KMID: 2501369
• DOI: http://doi.org/10.5217/ir.2019.00107

Abstract

Background/Aims
Crohn’s disease is associated with altered body composition, such as low muscle mass, which can affect clinical outcomes. However, there are few studies regarding the effect of sarcopenia on prognosis of Crohn’s disease. In this study, we evaluated the body composition at the initial diagnosis of Crohn’s disease and analyzed the clinical meaning of sarcopenia.
Methods
We conducted a retrospective review of medical records of patients who were diagnosed as Crohn’s disease and underwent computed tomography within 3 months after diagnosis. Sarcopenia was defined as an L3 skeletal muscle index (SMI) of < 49 cm²/m² for men and < 31 cm²/m² for women. Outcomes such as need for hospitalization, surgery, use of steroids, immunomodulators and biologics were analyzed.
Results
A total of 79 patients (male, 73.4%; mean age, 29.9 years) were included and 40 patients (51%) were diagnosed as sarcopenia. C-reactive protein (CRP) level was correlated with sarcopenia (P= 0.044). Erythrocyte sedimentation rate (ESR) showed a tendency to decrease inversely with SMI (r = –0.320, P= 0.008) and hemoglobin and albumin tended to increase in proportion to SMI (hemoglobin: r = 0.271, P= 0.016 and albumin: r = 0.350, P= 0.002). However, there was no statistically significance in time-to-first-event analysis in aspects of sarcopenia.
Conclusions
Approximately 50% of patients with newly diagnosed as Crohn’s disease had sarcopenia. CRP levels were higher in the sarcopenia group and SMI correlated with ESR, hemoglobin, and albumin. However, none of prognostic values were demonstrated.

Keyword

Crohn disease; Prevalence; Sarcopenia; Prognosis

Figure

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  Fig. 1. The skeletal muscle area (SMA) measured at the L3 vertebral level. The skeletal muscle index, which defines sarcopenia, is the SMA divided by the height squared. Purple is SMA measured in patients with CD without sarcopenia and blue is SMA measured in patients with CD with sarcopenia.

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  Fig. 2. Time-to-first-event analysis by Kaplan-Meier methods in patients with or without sarcopenia: cumulative operation-free survival rate (A), hospitalization-free survival rate (B), biologics-free survival rate (C), immunomodulators-free survival rate (D), and corticosteroid-free survival rate (E).

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