Intest Res.  2024 Apr;22(2):162-171. 10.5217/ir.2023.00090.

Sarcopenia is common in ulcerative colitis and correlates with disease activity

• Neelam PB
• Pal R
• Gupta P
• Singh AK
• Shah J
• Mandavdhare HS
• Singh H
• Sekar A
• Bhadada SK
• Dutta U
• Sharma V

• KMID: 2554660
• DOI: http://doi.org/10.5217/ir.2023.00090

Abstract

Background/Aims
Association of sarcopenia with disease severity in ulcerative colitis (UC) is not clearly defined. We planned to estimate the prevalence of sarcopenia in patients with UC as per the revised definition and its relation with the disease severity.
Methods
A cross-sectional assessment of sarcopenia in patients with UC was performed. Disease activity was graded according to complete Mayo score. Hand grip strength was assessed with Jamar hand dynamometer, muscle mass using a dual energy X-ray absorptiometry scan, and physical performance with 4-m walk test. Sarcopenia was defined as a reduction of both muscle mass and strength. Severe sarcopenia was defined as reduced gait speed in presence of sarcopenia.
Results
Of 114 patients (62 males, mean age: 36.49±12.41 years), 32 (28%) were in remission, 46 (40.4%) had mild-moderate activity, and 36 (31.6%) had severe UC. Forty-three patients (37.7%) had probable sarcopenia, 25 (21.9%) had sarcopenia, and 14 (12.2%) had severe sarcopenia. Prevalence of sarcopenia was higher in active disease (2 in remission, 6 in active, and 17 in severe, P<0.001). Of 14 with severe sarcopenia, 13 had severe UC while 1 had moderate UC. On multivariate analysis, lower body mass index and higher Mayo score were associated with sarcopenia. Of 37 patients with acute severe colitis, 16 had sarcopenia. Requirement of second-line therapy was similar between patients with and without sarcopenia. On follow-up (median: 18 months), there was a non-significant higher rate of major adverse events in those with sarcopenia (47.4% vs. 33.8%, P=0.273).
Conclusions
Sarcopenia and severe sarcopenia in UC correlate with the disease activity.

Keyword

Inflammatory bowel diseases; Ulcerative colitis; Sarcopenia; Absorptiometry, photon; Grip strength

Figure

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  Fig. 1. Summary of the study flow and salient findings (STROBE flow). HGS, hand grip strength; DEXA, dual energy X-ray absorptiometry; ASMI, appendicular skeletal muscle index.

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  Fig. 2. Correlation of HGS (A), ASMI (B), and gait speed (C) with disease activity (complete Mayo score). HGS, hand grip strength; ASMI, appendicular skeletal muscle index.

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