Sarcopaenia-high visceral fat combo predicts poor outcomes in Crohn’s disease

27 Oct 2021
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The combination of sarcopaenia and high visceral fat, rather than individually, is associated with worse outcomes in patients with Crohn’s disease (CD), suggests a recent study.

A team of investigators conducted this retrospective study to assess 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 to December 2015). Patients were followed until December 2019.

Sarcopaenia was defined as SMI <36.5 cm2/m2 for males and 30.2 cm2/m2 for females. The investigators then compared disease severity, behaviour, and long-term outcomes (surgery and disease course) with respect to sarcopaenia and VF/SC ratio.

Forty-four patients (age at onset 34.4 years, median disease duration 48 months, follow-up duration 32 months, males 63.6 percent) were enrolled in the study.

Sarcopaenia had a 43-percent prevalence in females, independent of age, disease severity, behaviour, and location. More patients with sarcopaenia had surgery (31.6 percent vs 4 percent; p=0.01). Those who underwent surgery had significantly higher VF/SC (1.76 vs 0.9; p=0.002); a cutoff of 0.88 was predictive of surgery, with sensitivity of 71 percent and specificity of 65 percent.

Survival analysis revealed a lower probability of remaining surgery-free among patients with sarcopaenia (59.6 percent vs 94.1 percent; p=0.01) and those with VF/SC >0.88 (66.1 percent vs 91.1 percent; p=0.1). This probability remained lower in patients with both sarcopaenia and VF/SC >0.88 than those with either or none (38 percent vs 82 percent vs 100 percent; p=0.01).

“Sarcopenia and visceral fat independently predict poor outcomes in CD,” the investigators said.

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