DOP118 Correlation between psoasic index and diaphragmatic index ultrasound in the evaluation of sarcopenia in a cohort of patients with inflammatory bowel disease: a study in a tertiary referral center
Authors: Palmisano C M , Dell'Aquila P , Cormio S , Borraccino A V , Squeo F , Savino F , Forastiere D , Novielli D , Moschetta A , Principi M R D 
Published: January 2025

Abstract

Background
Sarcopenia is prevalent in patients with inflammatory bowel disease(IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in IBD population.The ileo-psoas muscle(IP) muscle has already been used in the literature for the assessment of sarcopenia, however, as it is a deep muscle and it needs experienced operators for a proper measurement. Therefore, diaphragm muscle (DM) more superficial and easily assessed, was examined to check its correlation with IP. The aim of this work was to evaluated the correlation of positivity SARC-F score with ultrasound (US) measure of the IP and DM.

Methods
A total of 57 IBD patients with significant suspected sarcopenia with SARC-F score positive ≥4, were enrolled. IP and DM US were detected in the enrolled patients. The transverse diameter of the IP was evaluated. Moreover, we calculated the US psoas/height ratio as the average of the psoas diameter divided by the patient's height (mm/m). For DM, diameters during expiration and during inspiration were assessed, then diaphragmatic expansion was calculated. We calculated the diaphragm/height ratio (mm/m) as well. The correlation between IP and DM ratio was researched by using the Pearson correlation test. Age and sex were taken into consideration as confounders in a linear regression model, using the psoas/height ratio and these confounders as independent variables and the diaphragm index as dependent variable.

Results
The mean of the three US IP measured diameters was 28.40 mm, the psoas/height ratio was 16,62 mm/m. The mean maximum inspiration DM diameter was 20.4 mm (± 5 mm), the mean minimum expiration MD diameter was 10.7 mm (± 3,5 mm). The mean difference between the two diameters was 9.7 mm (± 3,4 mm). The diaphragm/height ratio was 0.59 mm/m (±0.21 mm/m). A significant correlation was identified between IP and DM ratio, with a Pearson coefficient r = 0.3568 (p-value &lt;0.05). A consistent association was found between the two indices, with diaphragm/height ratio increasing linearly with the psoas/height ratio (OR: 0.018; p-value: 0.008). Multivariate analysis showed that age and sex were not significantly associated with the diaphragm/height ratio (p-value &gt;0.05).

Conclusion
The findings of this study emphasize the potential of muscle US as a reliable diagnostic tool for assessing sarcopenia in IBD patients.IP US is confirmed to correlate with sarcopenia.DM can be used more easily and correlates with IP.This research could take a significant implications for disease management in IBD patients.

References
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