Premium
Low muscle mass and sarcopenia: common and predictive of osteopenia in inflammatory bowel disease
Author(s) -
Bryant R. V.,
Ooi S.,
Schultz C. G.,
Goess C.,
Grafton R.,
Hughes J.,
Lim A.,
Bartholomeusz F. D.,
Andrews J. M.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13156
Subject(s) - sarcopenia , medicine , osteopenia , grip strength , osteoporosis , lean body mass , body mass index , population , short bowel syndrome , hand strength , cohort , inflammatory bowel disease , gastroenterology , physical therapy , bone mineral , disease , body weight , parenteral nutrition , environmental health
Summary Background Body composition is poorly studied in inflammatory bowel disease ( IBD ). Sarcopenia describes a loss of muscle mass and strength. Aim To assess the prevalence of low lean mass ( LM ), sarcopenia and associated morbidity in an adult IBD cohort. Methods Cross‐sectional data were gathered on pre‐menopausal 18‐ to 50‐year‐old patients with IBD . Whole‐body dual‐energy X ‐ray absorptiometry, anthropometric assessment and grip strength were performed. Low LM was defined as ≥1 s.d. below the population mean for appendicular skeletal muscle index [ ASMI (kg)/height (m)²], and sarcopenia as both ASMI and grip strength ≥1 s.d. below population mean. Multivariate regression analyses were performed. Results Of 137 participants (median age 31 years, BMI 24.8 kg/m 2 ), 56% were male and 69% had Crohn's disease ( CD ). Low LM and sarcopenia were observed in 21% and 12% of patients, respectively, and osteopenia/osteoporosis in 38% of patients (mean lumbar spine t ‐score −0.3 ± s.d. 1.1). Grip strength predicted low LM and sarcopenia better than did body mass index ( BMI ) ( OR 4.8 vs. OR 0.7 for low‐ LM , P < 0.05 both). Normal BMI was falsely reassuring in 72% and 76% of patients with low ASMI and sarcopenia, respectively. Low LM and sarcopenia ( OR = 3.6, P = 0.03; OR = 6.3, P = 0.02; respectively), but not BMI nor fat mass, predicted osteopenia/osteoporosis. Conclusions Low lean mass and sarcopenia are common in patients with IBD, and important to recognise as they predict osteopenia/osteoporosis. Grip strength testing should be incorporated into routine clinical practice to detect low lean mass deficits, which may go unrecognised using BMI alone.