Prevalence of sarcopenia in patients with chronic intestinal failure—how are SARC‐F and the EWGSOP algorithm associated before and after a physical exercise intervention

Abstract

Introduction Patients with chronic intestinal failure (IF) have a low degree of physical activity, decreased muscle mass, and decreased muscle strength, leading to a high risk of sarcopenia. We aimed to test the prevalence of sarcopenia by the use of SARC‐F and EWGSOP and to investigate the association between the two at baseline and after 12 weeks of an exercise intervention. Methods Thirty‐one patients with chronic IF completed 12 weeks of three weekly home‐based individualized exercise sessions. Body composition was measured by bioimpedance analysis and physical function by handgrip strength (HGS) and timed up‐and‐go (TUG). Sarcopenia was assessed by SARC‐F and EWGSOP. Multiple regression analysis was used to test for the association between the two tools. Results The prevalence of sarcopenia measured by EWGSOP was 59%. This prevalence did not change after the intervention. At baseline, 38.8% of patients were screened as at risk for sarcopenia by SARC‐F. This decreased to 29.0% after the intervention (P < 0.001). A statistically significant increase was achieved in muscle mass (P = 0.017) and muscle mass index (P = 0.016). Furthermore, both TUG (P = 0.033) and HGS (P = 0.019) improved. Conclusions Sarcopenia is prevalent in patients with chronic IF. EWGSOP finds more patients to be at risk of sarcopenia than SARC‐F but was not sufficiently sensitive to measure changes induced by the physical intervention. The significant change in SARC‐F may illustrate that patients, themselves, find an improvement in self‐perceived health.

Body composition of adults with chronic intestinal failure receiving home parenteral nutrition: A descriptive cohort study

“…The disadvantageous body composition of our cohort is in line with outcomes reported by Køhler et al, who also found a normal mean BMI (20.0 kg/m 2 ), low FFMI (14.8 kg/m 2 ), and 64% FFMI below reference 9 . Two other studies evaluated the prevalence of sarcopenia in patients with CIF 20,21 . Sarcopenia is a progressive skeletal muscle disorder associated with impaired clinical outcomes, for example, lower quality of life and higher morbidity and mortality 3 .…”

“…For example, the persistent inflammatory state in patients with inflammatory bowel diseases can contribute to metabolic alterations and disruptions in nutrient absorption, ultimately affecting body composition 30 . In addition, we suppose that in line with previous reports in the CIF setting, most patients receiving treatment at our center have a suboptimal body composition because of insufficient exercise 20,31 . However, we could not demonstrate this assumption because our center has only recently implemented accelerometry measurements.…”

“…According to the European consensus, sarcopenia is diagnosed by the presence of low muscle quantity or quality 3,22 . Skallerup et al 21 reported a sarcopenia prevalence of 73%, slightly higher than the result presented by Graungaard et al 20 (59%). During the study period, muscle function was not yet routinely measured; therefore, sarcopenia could not be assessed.…”

“…9 Two other studies evaluated the prevalence of sarcopenia in patients with CIF. 20,21 Sarcopenia is a progressive skeletal muscle disorder associated with impaired clinical outcomes, for example, lower quality of life and higher morbidity and mortality. 3 According to the European consensus, sarcopenia is diagnosed by the presence of low muscle quantity or quality.…”

“…20,31 However, we could not demonstrate this assumption because our center has only recently implemented accelerometry measurements. Besides adequate nutrition support, which the PN formulation can provide, improving body composition requires exercise.…”