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P635 Assessment of sarcopenia and nutritional status in a cohort of patients with Crohn’s disease

Nardone, O.M.(1);de Sire, R.(1);Ponsiglione, A.(2);Rispo, A.(1);Testa, A.(1);Villani, G.(1);Camera, L.(2);Castiglione, F.(1);

(1)University of Naples Federico II, Department of Clinical Medicine and Surgery, Naples, Italy;(2)University of Naples Federico II, Department of Advanced Biomedical Science, Naples, Italy

Background

Altered body composition may negatively impact on the clinical outcome and quality of life of patients with IBD. Sarcopenia, defined as a progressive loss of skeletal muscle mass and function, is commonly observed in patients with IBD and can be reliably assessed by computed tomography (CT) which allows accurate and reproducibile quantification of both abdominal adipose tissues (subcutaneous and visceral), as well as skeletal muscles. We aimed to assess the prevalence of sarcopenia in Crohn's disease (CD) patients undergoing contrast-enhanced CT(CECT). We further investigated the associations of sarcopenia with visceral fat parameters, disease severity and surgery

Methods

40 CD patients (22F, aged 44±16 yrs; BMI 20.8±3.7) who underwent CE­CT for clinical assessment were retrospectively enrolled. CECT was performed using a 64-rows multi-detector equipment after i.v. injection of non ionic iodinated contrast media with a tailored scan delay.
Demographic and clinical data were collected at the date of abdominal CT. Clinical outcome included the rate of surgery within one year. The skeletal muscle index (SMI) at the level of third lumbar vertebra was used to assess sarcopenia defined as a SMI<38.5cm2/m2 in women and <42cm2/m2 in men (Fig1).Clinical malnutrition was defined by a BMI<18.5 kg/m2, while visceral obesity as a visceral fat area ≥130cm

Results

Mean duration of disease was 117 months ± 84. Most patients 60% had a moderate-severe clinical activity based on Harvey Bradshaw index (HBI) >8, whereas 35%  had a mild activity (HBI 5-7) and 5% were in remission (HBI<5). Overall, 17(42.5%) patients were sarcopenic. In detail, 14 out of 22 (63.6%) females and only 3 out of 18 (16.6%) males (p=0.04). The majority (65%) had moderate activity of inflammation with a mean of HBI 9.2 ± 1.6. Malnutrition occurred in 41,2% sarcopenic patients with a mean BMI of 16.5±3.75. A significant correlation was observed between BMI and sarcopenia (r=0.4,p<0.001).  A total of 25 (62.5%) patients underwent surgery within one year. Among them, 40% patients were sarcopenic, while 60% non sarcopenic (p=0.7). In the total population the mean of visceral fat was 48,03±58.04 and only 4 patients had a visceral fat area ≥104 cm2. The ratio between visceral fat and subcutaneous fat area (VFA/SFA) was 0,57±0.5. The correlation between SMI and visceral fat was significant (r=0.4,p=0.02),while it was not significant with VFA/SFA (p=0.7). For all IBD patients, univariate analysis revealed that female sex (p=0.002) and low BMI (p=0.003) were significantly associated with sarcopenia

Conclusion

Approximately 42.5%CD patients were sarcopenic. Female sex and low BMI were significantly associated with sarcopenia but this latter did not correlate with the clinical outcome

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