Imaging-based assessment of body composition in patients with Crohn’s disease: a systematic review

Tang, Wuli; Xie, Gang; Wang, Danni; Li, Ting; Ren, Yitao; Li, Junlin; Deng, Jiaxing; Li, Kang

doi:10.1007/s00384-023-04413-w

Cited by 8 publications

(7 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of this study showed a high prevalence of decreased skeletal muscle mass in patients with CD (75%), which is consistent with the results of our recently published systematic review ( 30 ). This systematic review included 39 studies for analysis, and more than half of them reported a prevalence of sarcopenia >50% in patients with CD.…”

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.

Self Cite

View full text Add to dashboard Cite

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.

show abstract

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.

Self Cite

View full text Add to dashboard Cite

show abstract

“…and Tang et al . reported the incidence of sarcopaenia in approximately 52% of CD, which influenced the inflammatory status, disease behaviour, prognostic outcome, and the effectiveness of drug therapy [ 6 , 25 ]. According to the current “gut-muscle axis” hypothesis, there is a need to study intramuscular changes, which appear due to the systemic influence of low-grade inflammation in CD patients, to detect earlier the CD forms with poor prognosis [ 6 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent systemic review by Tang et al . in 2023, body composition parameters were shown to predict poor outcomes for CD patients [ 6 ]. Sarcopaenia was associated with longer disease duration, more complex phenotype, and disease activity [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…in 2023, body composition parameters were shown to predict poor outcomes for CD patients [ 6 ]. Sarcopaenia was associated with longer disease duration, more complex phenotype, and disease activity [ 6 ]. Additionally, sarcopaenia was revealed as a risk factor for the requirement of surgical intervention (hazard ratio (HR) = 4.31, 95% CI: 1.36–13.7) and for postoperative complications (HR = 3.84, 95% CI: 1.48–9.974) [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Melekh,

Ordonez,

Melekh

et al. 2024

View full text Add to dashboard Cite

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.

show abstract

“…Therefore, body composition assessment tools should be always used during nutritional assessment to identify patients with limited skeletal mass, despite normal BMI or total body weight. Notably, altered body composition is a key predictor of poor outcomes and surgical complications for CD patients [ 17 , 31 ].…”

Section: Nutritional Optimizationmentioning

confidence: 99%

Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review

Fiorindi,

Giudici,

Testa

et al. 2024

Nutrients

View full text Add to dashboard Cite

Approximately 15–50% of patients with Crohn’s disease (CD) will require surgery within ten years following the diagnosis. The management of modifiable risk factors before surgery is essential to reduce postoperative complications and to promote a better postoperative recovery. Preoperative malnutrition reduced functional capacity, sarcopenia, immunosuppressive medications, anemia, and psychological distress are frequently present in CD patients. Multimodal prehabilitation consists of nutritional, functional, medical, and psychological interventions implemented before surgery, aiming at optimizing preoperative status and improve postoperative recovery. Currently, studies evaluating the effect of multimodal prehabilitation on postoperative outcomes specifically in CD are lacking. Some studies have investigated the effect of a single prehabilitation intervention, of which nutritional optimization is the most investigated. The aim of this narrative review is to present the physiologic rationale supporting multimodal surgical prehabilitation in CD patients waiting for surgery, and to describe its main components to facilitate their adoption in the preoperative standard of care.

show abstract

Imaging-based assessment of body composition in patients with Crohn’s disease: a systematic review

Cited by 8 publications

References 73 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

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

Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review

Contact Info

Product

Resources

About