P0063 Prevalence of sarcopenia in a cohort of patients with inflammatory bowel disease: observational study in a tertiary care centre
Authors: Palmisano C M , Dell'Aquila P , Cormio S , Boraccino V , Novielli D , Savino F , Squeo F , Forastiere D , Moschetta A , Principi M R D 
Published: January 2025

Abstract

Background
Malnutrition is a common condition of patients with inflammatory bowel disease (IBD) and could be associated with sarcopenia i.e. a reduced muscle mass and strength. It is well demonstrated that sarcopenic IBD patients have two to three times higher risk of lost of response to biotechnology drugs than non-sarcopenic patients.

Methods
A prospective observational study was conducted.Consecutive IBD patients were enrolled. Data were collected on disease characteristics, therapy and disease activity. We collected data about the frequency(none, low,high) and the kind (aerobic or anaerobic) of the physical activity of patients.At the enrolment, nutritional assessments were performed by body mass index(BMI) and the global subjective assessment by the MUST(Malnutrition Universal Screening Tool) index.Moreover, the SARC-F questionnaire, recommended by the scientific consensus EWGSOP 2 to identify individuals at risk for sarcopenia was administrated.A SARC-F value≥4 was significant of sarcopenia. The quality of life was assessed using the inflammatory bowel disease questionnaire (IBDQ). Univariate and multivariate analysis was conducted between BMI, MUST,SARC-F and IBDQ values and patient characteristics(age, current therapy, disease activity and physical activity).

Results
A total of 353 IBD patients (170 CD, 183 UC),54,55% male, with a mean age of 44.78 years were enrolled. A mean BMI of 24,35 kg/m2, was calculated. Regarding malnutrition, 210 patients (59.66%) were considered at low risk (MUST=0), 88 subjects (25%) at medium risk (MUST=1), 53(15,34%) at high risk (MUST ≥2).A SARC-F value ≥4 was evaluated in 57 patients (16.19%). A reduction in quality of life, understood as IBDQ &lt;209, was found in 124(35.23%) patients. Univariate analysis shows a protective role of male sex(OR vs. female sex: 0.33; p-value:0.018) in the risk of sarcopenia; older subjects had a higher sarcopenic risk (OR 1.04; p.&lt;0.001). The risk was associated with a severe disease activity (OR 9.46,p.&lt;0.001), increasing MUST(OR 1,65, p.&lt;0.001) and with the IBDQ decreases (OR 5.9,p.&lt;0.001). Multivariate analysis confirmed an higher incidence of sarcopenia in women of advanced age with active-stage disease (R2 0.88), furthermore female patients with active-stage disease who did not engage in physical activity had a greater impairment in quality of life (R2: 0.75, p.&lt;0.0001). Physical activity played a protective role in the onset of sarcopenia regardless of sex and age (R2: 0.82, p.&lt;0.0001).

Conclusion
In our cohort, sarcopenia was present in only 16.19%.Male sex was found to be a protective factor for sarcopenia. Disease status is linked to the risk of sarcopenia. Regular physical activity has been shown to have a protective was related with a lower risk of sarcopenia.

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