Combination of sarcopenia and high visceral fat predict poor outcomes in patients with Crohn's disease.
Eur J Clin Nutr
; 75(10): 1491-1498, 2021 10.
Article
em En
| MEDLINE
| ID: mdl-33531636
ABSTRACT
BACKGROUND:
Sarcopenia and visceral fat independently predict poor outcomes in Crohn's disease (CD). However, combined influence of these parameters on outcomes is unknown, and was investigated in the present study.METHODS:
This retrospective study evaluated skeletal muscle index (SMI-cross-sectional area of five skeletal muscles normalized for height), visceral and subcutaneous fat area and their ratio (VF/SC) on single-slice computed tomography (CT) images at L3 vertebrae in CD patients (CT done January 2012-December 2015, patients followed till December 2019). Sarcopenia was defined as SMI < 36.5 cm2/m2 and 30.2 cm2/m2 for males and females, respectively. Disease severity, behavior, and long-term outcomes (surgery and disease course) were compared with respect to sarcopenia and VF/SC ratio.RESULTS:
Forty-four patients [age at onset 34.4 ± 14.1 years, median disease duration 48 (24-95) months, follow-up duration 32 (12-53.5) months, males 63.6%] were included. Prevalence of sarcopenia was 43%, more in females, but independent of age, disease severity, behavior and location. More patients with sarcopenia underwent surgery (31.6% vs 4%, p = 0.01). VF/SC was significantly higher in patients who underwent surgery (1.76 + 1.31 vs 0.9 + 0.41, p = 0.002), and a cutoff of 0.88 could predict surgery with sensitivity and specificity of 71% and 65% respectively. On survival analysis, probability of remaining free of surgery was lower in patients with sarcopenia (59.6% vs 94.1% p = 0.01) and those with VF/SC > 0.88 (66.1% vs 91.1%, p = 0.1), and still lower in those with both sarcopenia and VF/SC > 0.88 than those with either or none (38% vs 82% vs 100%, p = 0.01).CONCLUSIONS:
Combination of sarcopenia and high visceral fat predict worse outcomes in CD than either.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença de Crohn
/
Sarcopenia
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article