Ultrasound Assessment of the Muscles for Sarcopenia Diagnosis in Patients With Inflammatory Bowel Disease
Background:
Sarcopenia is a progressive pathological condition which can present in inflammatory bowel disease (IBD) together with changes in body composition. Aim. To provide ultrasound assessment of muscle mass and bioimpedance analysis of body composition in patients with IBD.
Methods:
The study included 77 patients with IBD, 34 (44%) with ulcerative colitis (UC) and 43 (56%) with Crohn’s disease (CD), 10 persons formed the control group (CG). The average age of patients with IBD was 39 [28; 50] year, in the CG – 37 [26.5; 38.5] years. There were 10 (50%) women in the IBD group and 5 (50%) in CG. Patients underwent an examination with assessment of BMI, mid-upper arm circumference (MUAC, cutoffs in the range of ≤23.0 to ≤25.5 cm) and mid-thigh circumference (MTC) of dominant side; analysis of bioimpedance metabolic processes and body composition using the ABC-02 “MEDASS” apparatus, analysis of hand grip strength was determined using a dynamometer.
Results:
According to BMI, patients were distributed as follows: normal body weight was observed in 45 (58%) patients; deficiency – in 6 (8%); overweight 19 (24%); obesity – 7 (10%). The average MUAC values of the dominant hand in women were 29 [25; 31] cm, in men 29.8 [27.4; 32] cm. In the CG the average MUAC in women were 28 [27; 28.5] cm (p>0.05), in men 31 [26.5; 34] cm (p>0.05). MUAC in IBD women was normal in 28 (71%) and lower in 11 (29%); for men normal MUAC in 34 (89%) and lower in 4 (11%). The average MTC in women with IBD were 35 [33; 37.5] cm, in men 35 [32; 36] cm. In the CG the average MTC values in women were 38.5 [36; 40] cm (p>0.05), in men 35 [34; 38] cm (p>0.05). The average ultrasound value of the muscles of the shoulder of the leading arm in women with IBD was 19,68 [18,26; 23,86] mm, CG 22,49 [20,41; 22,66] (p>0.05); in men with IBD 27,03 [22,41; 29,17] mm, in the CG 25,13 [21,18; 31,19] mm (p>0.05). The average ultrasound value of the thigh muscles on the leading side in women with IBD was 30,7 [24,51; 34,69] mm, CG 41.3 41,3 [35,55; 41,74] mm (<italic>P<</italic> 0.05), in men with IBD 32,23 [25,78; 39,99] mm, in the control group 40,67 [37,68; 41,84] (<italic>P<</italic> 0.05). The average absolute values of dynamometry of the leading hand in women were 25.7 [22.6; 28.2] kg, in men 46.2 [39.7; 51.4]. Hand strength of the dominant hand was lower in 5 (12%) women, in 1 (10%) men. The thickness of the shoulder muscles according to ultrasound correlated with skeletal muscle mass according to BMI (r=0.61; <italic>P<</italic> 0.05) and with grip strength (r=0.50; <italic>P<</italic> 0.05). The ultrasound thickness of the thigh muscles according correlated with BMI (r=0.44; <italic>P<</italic> 0.05), with skeletal muscle mass according to BMI (r=0.33; <italic>P<</italic> 0.05) and with the thickness of the shoulder muscles according to ultrasound (r=0.47; <italic>P<</italic> 0.05) and with grip strength (r=0.25; <italic>P<</italic> 0.05).
Conclusions:
Patients with IBD have a significant decrease in thigh muscles by ultrasound compared with the control group. Ultrasound thickness of the muscles correlated with grip strength.
