Julienne Grillot1, Christelle D'Engremont1, Anne-Laure Parmentier2, Zaher Lakkis3, Gaël Piton4, Diane Cazaux1, Claire Gay1, Marjolaine De Billy5, Stéphane Koch1, Sophie Borot6, Lucine Vuitton7. 1. Department of Gastroenterology and Nutrition, University Hospital of Besançon, University Bourgogne Franche-Comté, 25030 Besançon, France. 2. Centre de Méthodologie Clinique, University Hospital of Besançon, Besançon, France. 3. Department of Digestive and Oncologic Surgery - Liver Transplantation Unit, University Hospital of Besançon, University Bourgogne Franche-Comté, 25030 Besançon, France. 4. Intensive Care Unit, University Hospital of Besançon, University Bourgogne Franche-Comté, 25030 Besançon, France. 5. Department of Radiology, University Hospital of Besançon, University Bourgogne Franche-Comté, 25030 Besançon, France. 6. Department of Endocrinology and Nutrition, University Hospital of Besançon, University Bourgogne Franche-Comté, 25030 Besançon, France. 7. Department of Gastroenterology and Nutrition, University Hospital of Besançon, University Bourgogne Franche-Comté, 25030 Besançon, France. Electronic address: lvuitton@chu-besancon.fr.
Abstract
BACKGROUND: Altered body composition may impact on the clinical course of Crohn's disease (CD) but is not detected by the simple body mass index (BMI) assessment. AIM: To assess the prevalence of sarcopenia and visceral obesity by a single computed tomography (CT) slice, and its association with adverse events in an adult hospitalized CD cohort. METHODS: 88 CD patients who had abdominal CT scans during hospitalization were retrospectively enrolled. The skeletal muscle index (SMI) at the third lumbar vertebra level was used to assess sarcopenia. Sarcopenia was defined as a SMI <38.5 cm2/m2 in women, <52.4 cm2/m2 in men and visceral obesity as a visceral fat area ≥130 cm2. Clinical malnutrition was defined by a BMI <18.5 kg/m2. Univariate analysis was performed, and predictors for surgery in the follow-up were entered in a stepwise logistic regression model for multivariate analysis. RESULTS: The prevalence of sarcopenia was 58%, malnutrition 21.6%, and visceral obesity 19.3%. Among sarcopenic patients, 49% had a normal BMI, 13.7% were overweight, and 1(2%) was obese. Sarcopenic CD patients had significantly more abscesses (51% vs 16.7%, p = 0.001), hospitalizations (61.2% vs 36.1%, p = 0.022) and digestive surgery (63.3% vs 27.8%, p = 0.001) than non-sarcopenic patients during the follow-up, whereas usual malnutrition assessment was not correlated with disease outcomes. In multivariate analysis, both sarcopenia and visceral obesity were associated with further occurrence of digestive surgery. CONCLUSION: Both sarcopenia and visceral obesity were associated with adverse outcomes in severe CD patients whereas usual nutritional assessment was not.
BACKGROUND: Altered body composition may impact on the clinical course of Crohn's disease (CD) but is not detected by the simple body mass index (BMI) assessment. AIM: To assess the prevalence of sarcopenia and visceral obesity by a single computed tomography (CT) slice, and its association with adverse events in an adult hospitalized CD cohort. METHODS: 88 CDpatients who had abdominal CT scans during hospitalization were retrospectively enrolled. The skeletal muscle index (SMI) at the third lumbar vertebra level was used to assess sarcopenia. Sarcopenia was defined as a SMI <38.5 cm2/m2 in women, <52.4 cm2/m2 in men and visceral obesity as a visceral fat area ≥130 cm2. Clinical malnutrition was defined by a BMI <18.5 kg/m2. Univariate analysis was performed, and predictors for surgery in the follow-up were entered in a stepwise logistic regression model for multivariate analysis. RESULTS: The prevalence of sarcopenia was 58%, malnutrition 21.6%, and visceral obesity 19.3%. Among sarcopenic patients, 49% had a normal BMI, 13.7% were overweight, and 1(2%) was obese. Sarcopenic CDpatients had significantly more abscesses (51% vs 16.7%, p = 0.001), hospitalizations (61.2% vs 36.1%, p = 0.022) and digestive surgery (63.3% vs 27.8%, p = 0.001) than non-sarcopenicpatients during the follow-up, whereas usual malnutrition assessment was not correlated with disease outcomes. In multivariate analysis, both sarcopenia and visceral obesity were associated with further occurrence of digestive surgery. CONCLUSION: Both sarcopenia and visceral obesity were associated with adverse outcomes in severe CDpatients whereas usual nutritional assessment was not.
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