Body Composition Predictors of Complicated Crohn’s Disease

Ordonez, Felix Barajas; Melekh, B. Ya.; Rodríguez-Feria, Pablo; Melekh, Oksana; Thormann, Maximilian; Damm, Robert; Omari, Jazan; Pech, Maciej; Surov, Alexey

doi:10.1159/000529426

Cited by 5 publications

(4 citation statements)

References 48 publications

(93 reference statements)

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“…*p < 0.05, ns p > 0.05 (not significant). although our study revealed variability in some body composition parameters among CD patients with different disease behaviors, it was not their independent correlate, which is consistent with the results of a recent study (50). This may be because intestinal complications such as stricture or penetration are a further progression of poorly controlled disease activity and are influenced by a combination of factors such as altered body composition, poor drug therapy and an active intestinal inflammatory response; therefore, altered body composition is not an independent correlate of complex disease behavior.…”

Section: Discussionsupporting

confidence: 92%

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Tang,

Xie,

et al. 2023

Front. Nutr.

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BackgroundThe disease activity status and behavior of Crohn’s disease (CD) can reflect the severity of the disease, and changes in body composition are common in CD patients.AimsThe aim of this study was to investigate the relationship between body composition parameters and disease severity in CD patients treated with infliximab (IFX).MethodsPatients with CD assessed with the simple endoscopic score (SES-CD) and were treated with IFX were retrospectively collected, and body composition parameters at the level of the 3rd lumbar vertebrae were calculated from computed tomography (CT) scans of the patients. The correlation of patients’ body composition parameters with disease activity status and disease behavior was analyzed, and the diagnostic value of the relevant parameters was assessed using receiver operating characteristic (ROC) curves.ResultsA total of 106 patients were included in this study. There were significant differences in the subcutaneous adiposity index (SAI) (p = 0.010), the visceral adiposity index (VAI) (p < 0.001), the skeletal muscle mass index (SMI) (p < 0.001), and decreased skeletal muscle mass (p < 0.001) among patients with different activity status. After Spearman and multivariate regression analysis, SAI (p = 0.006 and p = 0.001), VAI (p < 0.001 and p < 0.001), and SMI (p < 0.001and p = 0.007) were identified as independent correlates of disease activity status (both disease activity and moderate-to-severe activity), with disease activity status independently positively correlated with SAI and SMI and independently negatively correlated with VAI. In determining the disease activity and moderate-to-severe activity status, SMI performed best relative to SAI and VAI, with areas under the ROC curve of 0.865 and 0.801, respectively. SAI (p = 0.015), SMI (p = 0.011) and decreased skeletal muscle mass (p = 0.027) were significantly different between different disease behavior groups (inflammatory disease behavior group, complex disease behavior group) but were not independent correlates (p > 0.05).ConclusionBody composition parameters of CD patients treated with IFX correlate with the endoscopic disease severity, and SMI can be used as a reliable indicator of disease activity status.

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Section: Discussionsupporting

confidence: 92%

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Tang,

Xie,

et al. 2023

Front. Nutr.

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“…Our MRE technique has been previously described, the MRI sequences are depicted in the Table S1 27,28 . All CT examinations were performed on a multidetector CT scanner (Siemens Somatom Definition AS+, Siemens Healthineers, Germany; Canon Aquilion Prime, Canon Medical Systems Corporation, Japan).…”

Section: Methodsmentioning

confidence: 99%

“…Our MRE technique has been previously described, the MRI sequences are depicted in the Table S1. 27,28 All CT examinations were performed on a multidetector CT scanner (Siemens Somatom Definition AS+, Siemens Healthineers, Germany; Canon Aquilion Prime, Canon Medical Systems Corporation, Japan). The CT protocol was as follows: acquisition slice thickness of ≤2 mm; tube voltage, 120 kV; automatic tube current modulation; pitch factor, 1.2.…”

Section: Ct and Mre Techniquementioning

confidence: 99%

Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease

Melekh,

Barajas Ordonez,

Melekh

et al. 2024

Int J of Rheum Dis

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AimTo assess the relationship between anatomical variants of sacroiliac joint (SIJ) and subchondral changes detected in magnetic resonance enterography (MRE) in patients with Crohn's disease (CD).MethodsThis was a retrospective study of 60 CD patients, who were divided into two groups: with (n = 16) and without SIJ (n = 44) involvement, depending on the presence of inflammatory (bone marrow edema) and structural changes (sclerosis and erosions) in MRE. Anatomical variants of SIJ were assessed in CT of the abdomen and/or pelvis, distinguishing typical form with convex iliac surface and atypical forms. Univariate and multivariate analyses were performed to reveal an association between joint changes and forms.ResultsOur study included 60 patients (38 males; mean age 38.72 years ± 13.33). Patients with SIJ changes were older (p = .044). No significant differences in CD localization and behavior were found. The most common SIJ lesions were structural changes (in 75% of patients); the main atypical form was the iliosacral complex. The univariate and multivariate analyses showed a significant association of atypical forms with total subchondral changes (odds ratio [OR]: 3.429, 95% confidence interval [CI] 1.043–11.268; p = .042; OR: 5.066, 95% CI: 1.273–20.167; p = .021, respectively), and with structural changes (OR: 4.185, 95% CI: 1.155–15.160; p = .029; OR: 5.986, 95% CI: 1.293–27.700; p = .022, respectively).ConclusionAtypical forms of SIJ are a risk factor for the occurrence of structural joint changes in CD patients. An association between bone marrow edema and atypical forms was not found.

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“…Each MRE was performed on a 1.5 Tesla MR scanner (Intera, Philips Healthcare, Best, Netherlands) in a supine position using a whole-body surface coil system. Our MRE protocol has been previously reported, and the MRI sequences are summarized in Supplementary Table SI [ 17 , 18 ].…”

Section: Methodsmentioning

confidence: 99%

Diagnostic value of apparent diffusion coefficient of psoas muscles for evaluating complications in patients with Crohn’s disease

Melekh,

Ordonez,

Melekh

et al. 2024

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Aim To assess the association of the apparent diffusion coefficient (ADC) of the psoas muscles and psoas muscle index (PMI) with the activity and behaviour of Crohn’s disease (CD). Material and methods This was a retrospective study of 88 CD patients who underwent magnetic resonance enterography. Patients were classified according to the Montreal Classification in uncomplicated (non-stricturing, non-penetrating, B1), and complicated (structuring [B2] and penetrating disease [B3]). At the level of the third lumbar vertebra, the ADC and PMI were estimated. CD activity was analysed using the Magnetic Resonance Index of Activity (MaRIA), and depending on its values patients were categorized as high or low activity. Additionally, the presence of creeping fat (CrF) was used to evaluate activity. ADC and PMI were using Student’s t -test. Results Our study included 47 males and 41 females (mean age of 38.69 ±14.4 years). The ADC in uncomplicated (B1, n = 45) and complicated disease (B2 + B3, n = 43) were 1.11 ±0.19 and 1.03 ±0.10 (10 –3 *mm 2 /s), respectively, ( p = 0.02). ADC was significantly lower in patients with stricturing disease than in patients without strictures (1.02 ±0.11 and 1.10 ±0.18 [10 –3 mm 2 /s], respectively, p = 0.01). The group with non-penetrating disease showed higher PMI than those with penetrating disease (5.71 ±1.88 vs. 4.42 ±1.55 cm 2 /m 2 , respectively, p = 0.10). There was no significant difference in PMI and ADC between patients with low and high MaRIA or positive and negative CrF. Conclusions The ADC of the psoas muscles is significantly lower in CD patients with uncomplicated disease, particularly those with stricturing disease. Therefore, ADC can be considered as an imaging biomarker of myopathic changes in CD patients.

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Body Composition Predictors of Complicated Crohn’s Disease

Cited by 5 publications

References 48 publications

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Association between sacroiliac joint forms and subchondral changes in patients with Crohn's disease

Diagnostic value of apparent diffusion coefficient of psoas muscles for evaluating complications in patients with Crohn’s disease

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