Characterization of Sarcopenia in an IBD Population Attending an Italian Gastroenterology Tertiary Center
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Population
2.3. Assessment of Asthenia Degree
2.4. Assessment of Body Composition
2.5. Quality of Life Evaluation
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
- Cruz-Jentoft, A.J.; Bahat, G.; Bauer, J.; Boirie, Y.; Bruyère, O.; Cederholm, T.; Cooper, C.; Landi, F.; Rolland, Y.; Sayer, A.A.; et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), Extended Group for EWGSOP2. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing 2019, 48, 16–31. [Google Scholar] [CrossRef] [PubMed]
- Roberts, H.C.; Denison, H.J.; Martin, H.J.; Patel, H.P.; Syddall, H.; Cooper, C.; Sayer, A.A. A review of the measurement of grip strength in clinical and epidemiological studies: Towards a standardised approach. Age Ageing 2011, 40, 423–429. [Google Scholar] [CrossRef] [PubMed]
- Beaudart, C.; McCloskey, E.; Bruyère, O.; Cesari, M.; Rolland, Y.; Rizzoli, R.; Araujo de Carvalho, I.; Thiyagarajan, J.A.; Bautmans, I.; Bertière, M.C.; et al. Sarcopenia in daily practice: Assessment and management. BMC Geriatr. 2016, 16, 170. [Google Scholar] [CrossRef] [PubMed]
- Hartman, C.; Eliakim, R.; Shamir, R. Nutritional status and nutritional therapy in inflammatory bowel diseases. World J. Gastroenterol 2009, 21, 2570–2578. [Google Scholar] [CrossRef] [PubMed]
- Valentini, L.; Schaper, L.; Buning, C.; Hengstermann, S.; Koernicke, T.; Tillinger, W.; Guglielmi, F.W.; Norman, K.; Buhner, S.; Ockenga, J.; et al. Malnutrition and impaired muscle strength in patients with Crohn’s disease and ulcerative colitis in remission. Nutrition 2008, 24, 694–702. [Google Scholar] [CrossRef] [PubMed]
- Scaldaferri, F.; Pizzoferrato, M.; Lopetuso, L.R.; Musca, T.; Ingravalle, F.; Sicignano, L.L.; Mentella, M.; Miggiano, G.; Mele, M.C.; Gaetani, E.; et al. Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide. Gastroenterol. Res. Pract. 2017. [Google Scholar] [CrossRef] [PubMed]
- Rocha, R.; Santana, G.O.; Almeida, N.; Lyra, A.C. Analysis of fat and muscle mass in patients with inflammatory bowel disease during remission and active phase. Br. J. Nutr. 2009, 101, 676–679. [Google Scholar] [CrossRef] [PubMed]
- Bilski, J.; Mazur-Bialy, A.I.; Wierdak, M.; Brzozowski, T. The impact of physical activity and nutrition on inflammatory bowel disease: The potential role of cross talk between adipose tissue and skeletal muscle. J. Physiol. Pharmacol. 2013, 64, 143–155. [Google Scholar] [PubMed]
- Ryan, E.; McNicholas, D.; Creavin, B.; Kelly, M.; Walsh, T.; Beddy, D. Sarcopenia and Inflammatory Bowel Disease: A Systematic Review. Inflamm. Bowel Dis. 2019, 25, 67–73. [Google Scholar] [CrossRef] [PubMed]
- Zhang, T.; Cao, L.; Cao, T.; Yang, J.; Gong, J.; Zhu, W.; Li, N.; Li, J. Prevalence of Sarcopenia and Its Impact on Postoperative Outcome in Patients With Crohn’s Disease Undergoing Bowel Resection. JPEN. J. Parenter. Enteral Nutr. 2017, 41, 592–600. [Google Scholar] [CrossRef] [PubMed]
- Adams, D.W.; Gurwara, S.; Silver, H.J.; Horst, S.N.; Beaulieu, D.B.; Schwartz, D.A.; Seidner, D.L. Sarcopenia Is Common in Overweight Patients with Inflammatory Bowel Disease and May Predict Need for Surgery. Inflamm. Bowel Dis. 2017, 23, 1182–1186. [Google Scholar] [CrossRef] [PubMed]
- de Sire, R.; Rizzatti, G.; Ingravalle, F.; Pizzoferrato, M.; Petito, V.; Lopetuso, L.; Graziani, C.; de Sire, A.; Mentella, M.C.; Mele, M.C.; et al. Skeletal muscle-gut axis: Emerging mechanisms of sarcopenia for intestinal and extra intestinal diseases. Minerva Gastroenterol. Dietol. 2018, 64, 351–362. [Google Scholar] [CrossRef] [PubMed]
- Cruz-Jentoft, A.J.; Baeyens, J.P.; Bauer, J.M.; Boirie, Y.; Cederholm, T.; Landi, F.; Martin, F.C.; Michel, J.P.; Rolland, Y.; Schneider, S.M.; et al. European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010, 4, 412–423. [Google Scholar] [CrossRef] [PubMed]
- Argilés, J.M.; Busquets, S.; Stemmler, B.; López-Soriano, F.J. Cachexia and sarcopenia: Mechanisms and potential targets for intervention. Curr. Opin. Pharmacol. 2015, 22, 100–106. [Google Scholar] [CrossRef]
- Iannuzzi-Sucich, M.; Prestwood, K.M.; Kenny, A.M. Prevalence of sarcopenia and predictors of skeletal muscle mass in healthy, older men and women. J. Gerontol. A Biol. Sci. Med. Sci. 2002, 57, 772–777. [Google Scholar] [CrossRef] [PubMed]
- Bamba, S.; Sasaki, M.; Takaoka, A.; Takahashi, K.; Imaeda, H.; Nishida, A.; Inatomi, O.; Sugimoto, M.; Andoh, A. Sarcopenia is a predictive factor for intestinal resection in admitted patients with Crohn’s disease. PLoS ONE 2017, 12, e0180036. [Google Scholar] [CrossRef] [PubMed]
- Borren, N.Z.; van der Woude, C.J.; Ananthakrishnan, A.N. Fatigue in IBD: Epidemiology, pathophysiology and management. Nat. Rev. Gastroenterol. Hepatol. 2019, 16, 247–259. [Google Scholar] [CrossRef] [PubMed]
IBD Patients | UC Patients | CD Patients | Healthy Controls | Getriac Controls | Geriatric Sarcopenic Controls | |
---|---|---|---|---|---|---|
Patient Demographics | ||||||
Cases, No. | 127 (100%) | 58 (46%) | 69 (54%) | 89 (100%) | 14 (100%) | 5 (100%) |
Age, y | 41.60 ± 13.76 | 43.47 ± 12.57 | 40.11 ± 14.44 | 37.45 ± 12.86 | 79.86 ± 4.37 | 78.80 ± 4.76 |
Sex, F/M | 39%/61% | 17%/26% | 22%/35% | 55%/44% | 79%/21% | 80%/20% |
BMI, kg/m2 | 24.63 ± 4.38 | 23.94 ± 4.74 | 25.2 ± 4.01 | 25.10 ± 3.50 | 25.74 ± 3.36 | 23.55 ± 3.71 |
Extent of Disease | ||||||
Ileal | 29% | - | 29% | - | - | - |
Ileo-Colonic | 27% | - | 27% | - | - | - |
Pancolitis | 25% | 25% | - | - | - | - |
Descending Colon | 12% | 12% | - | - | - | - |
Rectal | 7% | 7% | - | - | - | - |
Clinical Score | ||||||
Clinical Mayo | - | 4.8 | - | - | - | - |
Harvey Bradshaw | - | - | 4.64 | - | - | - |
Disease Activity | ||||||
Remission | 55% | 22% | 33% | - | - | - |
Mild | 24% | 11% | 13% | - | - | - |
Moderate | 17% | 8% | 9% | - | - | - |
Severe | 4% | 2% | 2% | - | - | - |
Resection, No. | ||||||
34% | 8% | 26% | - | - | - | |
Therapy | ||||||
Steroids | 43% | 20% | 23% | - | - | - |
Anti-TNFα | 80% | 33% | 47% | - | - | - |
Skeletal Muscle Mass Evaluation | ||||||
DEXA | 38% | 19% | 19% | 56% | 100% | 100% |
BIA | 62% | 25% | 37% | 44% | 29% | 20% |
Measurement Device | Mean Whole Population (Std.Dev) | Mean UC Patients (Std.Dev) | Mean CD Patients (Std.Dev) | Mean Healthy Controls (Std.Dev) | Mean Geriatric Controls (Std.Dev) | Mean Geriatric Sarcopenic Controls (Std.Dev) | p | Male | Female | p | |
---|---|---|---|---|---|---|---|---|---|---|---|
Phase Angle | BIA | 5.568 (1.019) | 5.491 (1.138) | 5.618 (1.014) | 5.712 (0.880) | 4.340 (0.629) | 4.770 (0.001) | 0.1024 | 5.926 (0.132) | 5.206 (0.094) | 0.00001 |
Skeletal Muscle Mass | BIA | 28.076 (7.613) | 28.169 (7.587) | 29.77 (6.463) | 27.608 (7.957) | 15.945 (1.388) | 14.300 (0.00001) | 0.0023 | 34.394 (0.517) | 21.664 (0.486) | 0.00001 |
SMI | BIA | 9.587 (7.613) | 9.600 (1.951) | 10.005 (1.811) | 9.444 (1.838) | 6.992 (0.607) | 6.270 (0.0001) | 0.0101 | 11.045 (0.146) | 8.108 (0.148) | 0.00001 |
Appendicular Lean Mass | DEXA | 19.403 (7.613) | 19.936 (4.591) | 19.463 (4.714) | 20.402 (4.782) | 15.745 (3.242) | 14.888 (2.855) | 0.0027 | 23.370 (0.399) | 15.494 (0.227) | 0.00001 |
ASMI | DEXA | 6.886 (1.133) | 6.885 (1.188) | 6.622 (1.051) | 7.201 (1.148) | 6.529 (0.892) | 5.959 (0.772) | 0.0296 | 7.678 (0.115) | 6.106 (0.080) | 0.00001 |
Phase Angle | Coeff. | Std. Err. | t | p | 95% Conf. Interval | |
---|---|---|---|---|---|---|
Age | −0.029 | 0.007 | −3.780 | 0.000 | −0.045 | −0.014 |
BMI | 0.076 | 0.220 | 3.430 | 0.001 | 0.032 | 0.121 |
Genre | 0.510 | 0.210 | 2.430 | 0.017 | 0.092 | 0.928 |
Type | 0.043 | 0.148 | 0.290 | 0.772 | −0.252 | 0.338 |
SMI | Coeff. | Std. Err. | t | p | 95% Conf. Interval | |
Age | −0.017 | 0.006 | −2.940 | 0.004 | −0.029 | −0.006 |
BMI | 0.244 | 0.017 | 14.730 | 0.000 | 0.211 | 0.277 |
Genre | 2.449 | 0.155 | 15.760 | 0 | 2.140 | 2.759 |
Type | 0.043 | 0.148 | 0.290 | 0.772 | −0.252 | 0.338 |
ASMI | Coeff. | Std. Err. | t | p | 95% Conf. Interval | |
Age | −0.014 | 0.008 | −1.700 | 0.095 | −0.032 | 0.002 |
BMI | 0.166 | 0.031 | 5.310 | 0.000 | 0.103 | 0.229 |
Genre | 1.248 | 0.214 | 5.830 | 0 | 0.818 | 1.677 |
Type | −0.075 | 0.191 | −0.390 | 0.697 | −0.459 | 0.309 |
Measurement Device | Mean IBD Patients in Remission (Std.Dev) | Mean IBD Patients in Mild Activity (Std.Dev) | Mean IBD Patients in Moderate Activity (Std.Dev) | Mean IBD Patients in Severe Activity (Std.Dev) | p | |
---|---|---|---|---|---|---|
Phase Angle | BIA | 5.919 (0.720) | 5.535 (1.254) | 5.244 (1.178) | 4.719 (1.080) | 0.0213 |
Skeletal Muscle Mass | BIA | 30.706 (7.010) | 29.305 (5.750) | 27.216 (7.167) | 25.354 (9.131) | 0.1565 |
SMI | BIA | 10.080 (1.620) | 10.041 (1.712) | 9.298 (2.165) | 9.759 (2.628) | 0.3993 |
Appendicular Lean Mass | DEXA | 20.893 (4.716) | 17.400 (3.187) | 18.883 (4.174) | 11.768 (0.0001) | 0.0221 |
ASMI | DEXA | 6.976 (1.142) | 6.252 (0.957) | 6.732 (1.117) | 5.636 (0.0001) | 0.1489 |
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Pizzoferrato, M.; de Sire, R.; Ingravalle, F.; Mentella, M.C.; Petito, V.; Martone, A.M.; Landi, F.; Miggiano, G.A.D.; Mele, M.C.; Lopetuso, L.R.; et al. Characterization of Sarcopenia in an IBD Population Attending an Italian Gastroenterology Tertiary Center. Nutrients 2019, 11, 2281. https://doi.org/10.3390/nu11102281
Pizzoferrato M, de Sire R, Ingravalle F, Mentella MC, Petito V, Martone AM, Landi F, Miggiano GAD, Mele MC, Lopetuso LR, et al. Characterization of Sarcopenia in an IBD Population Attending an Italian Gastroenterology Tertiary Center. Nutrients. 2019; 11(10):2281. https://doi.org/10.3390/nu11102281
Chicago/Turabian StylePizzoferrato, Marco, Roberto de Sire, Fabio Ingravalle, Maria Chiara Mentella, Valentina Petito, Anna Maria Martone, Francesco Landi, Giacinto Abele Donato Miggiano, Maria Cristina Mele, Loris Riccardo Lopetuso, and et al. 2019. "Characterization of Sarcopenia in an IBD Population Attending an Italian Gastroenterology Tertiary Center" Nutrients 11, no. 10: 2281. https://doi.org/10.3390/nu11102281