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P159 The creatinine / cystatin C ratio is a surrogate marker of low skeletal muscle mass in patients with inflammatory bowel disease

Y. Ohta*1, T. Nakagawa1, Y. Imai1, T. Ooike1, Y. Yokoyama1, N. Akizue1, K. Ishikawa1, T. Taida1, K. Okimoto1, K. Saito1, D. Maruoka1, T. Matsumura1, M. Arai2, N. Kato1

1Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan, 2 Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan

Background

Low skeletal muscle (LSM), which is referred to as sarcopenia, has been shown to be an independent predictor of lower overall survival in various kinds of diseases. Recently, the relation between LSM and disease prognosis is also reported in patients with inflammatory bowel disease (IBD), but the awareness of the relation in Asia is unclear yet comparing with Europe. The aim of this study was to identify the incidence of LSM in IBD patients and evaluate the significance of nutritional therapy. Furthermore, we investigate serum surrogate markers to predict LSM in IBD patient without examination of computed-tomography (CT).

Methods

We evaluated the inpatients with IBD data in our hospital registered between February 2015 and March 2017. Psoas muscle mass index (PMI, cm2/m2) was calculated by manual trace using Image J at the lumber three level on the CT images divided by height squared. The criteria of LSM was determined by PMI for man was lower than 6.36 and PMI for woman was lower than 3.92. We extracted the occurrence of IBD patients with LSM from our database, and assessed the relation between PMI and clinical data.

Results

Of 76 IBD cases including 34 patients with ulcerative colitis (UC) and 42 patients with Crohn’s disease (CD), we assessed in this study. Fifty-seven of 76 patients were men, their mean of age with standard deviation (SD) was 35.0 ± 16.3 (year), and the mean of body mass index (BMI) with SD was 19.6 ± 2.8 g/m2. The PMI for man was 5.1 ± 1.6, and the PMI for women was 3.1 ± 0.6. In terms of the nutritional therapy in CD patients, there was no correlation between PMI and nutritional therapy for 1 year before hospitalisation (p = 0.438). According to our determination of LSM, 64 of 76 cases (84.2%) were IBD patients with LSM, and 31 of 40 cases (77.5%) were IBD patients with LSM even though with normal BMI (BMI range: 18.5–24.9). Moreover, we found the correlation between PMI and Cre/CysC in our data (p < 0.001, r = 0.576).

Conclusion

The most of IBD patients requiring hospitalisation were LSM regardless of their normal weight. It was suggested that the Cre/CysC ratio might be a marker of LSM in IBD patients who need hospitalisation.