Sarcopenia and Short Bowel Syndrome

Study Overview
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Brief Summary
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Sarcopenia or the loss of skeletal muscle is highly prevalent in many diseases, including short bowel syndrome (SBS). While adaptation is more likely in SBS patients with a colon-in-continuity, the consequences and underlying mechanisms are unclear. An overabundance of fecal Lactobacillus was found but not yet linked to adaptation or sarcopenia. The objectives are to study the evolution of sarcopenia and the link with intestinal adaptation in SBS.

Detailed Description
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Patients with short bowel syndrome (SBS) will be screened and included in longitudinal or cross-sectional studies if eligible. The longitudinal study will follow patients with type 1 SBS (enterostomy) before and every 3 months after continuity surgery for 1 year. Cross-sectional studies will follow patients with type 2 or 3 SBS (jejunocolonic or -ileal anastomosis) for 1 year (every 3 months during the first 2 years after continuity surgery or every 6 months after). Study visits will include clinical examination, nutritional assessment, endoscopy with biopsies and/or intestinal absorption assessment planned as part of routine follow-up. In addition, questionnaires will be completed (GPAQ, SarQoL, EQ-5D -3L, SF36), with collection of stool (for routine and research) and urine samples (for research). The objective are to study the evolution of sarcopenia and the link with intestinal adaptation in SBS. The results may identify metabolic or microbial biomarkers and predictors of nutritional optimisation in SBS, which is a complex and costly orphan disease.

Official Title
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Sarcopenia and Short Bowel Syndrome: the Microbiota-gut-muscle Axis

Conditions
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Short Bowel Syndrome

Intervention / Treatment
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* Other: questionnaires with collection of stool and urine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years old SBS diagnosis validated by small bowel length and either type 1 (enterostomy), type 2 or 3 (jejuno-colic or -ileal anastomosis) Patient not objecting to the collection of personal data as part of the study Exclusion Criteria: Pregnancy Remaining hail length unknown Patient expressing opposition to participating in the cohort Patients who are unable to express themselves

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| SBS patients<br> | Other: questionnaires with collection of stool and urine<br>* questionnaires will be completed (GPAQ, SarQoL, EQ-5D-3L, SF36), with collection of stool (for care and research) and urine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evolution of sarcopenia | Changes in muscle strength (Jamar's dynamometer) | at 12 months | 
| Evolution of sarcopenia | Changes in muscle mass (bioimpedance analysis) | at 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of sarcopenia | Changes in questionnaire of quality of life SarQoL | at 12 months | 
| Impact of sarcopenia | Changes in questionnaire of quality of life EQ-5D-3L | at 12 months | 
| Impact of sarcopenia | Changes in questionnaire of quality of life SF36 | at 12 months | 
| Impact of sarcopenia | Changes in questionnaire of physical activity (GPAQ) | at 12 months | 
| Link with intestinal adaptation | Number of changes in histological markers of adaptation in relation to sarcopenia. Each of these elements can be considered as a chang : crypt depths, villi length, immune cells. | at 12 months | 
| Link with intestinal adaptation | Changes in biological markers of adaptation in relation to sarcopenia: ApoB48, citrulline, leptin, nutrients | at 12 months | 
| Quantification of intestinal adsorption and its link with intestinal adaptation | Changes in intestinal absorption balance markers of adaptation in relation to sarcopenia: digestive losses in fat, proteins, carbohydrates and total energy. These elements will be quantified by biological assessements. | at 12 months | 
| Link with intestinal adaptation | Changes in bacterial fermentation markers of adaptation in relation to sarcopenia: D-lactate, short-chain fatty acids (SCFAs) | at 12 months | 
| Quantification of urinary metabolite linked with sarcopenia | Changes in urinary markers of fermentation in relation to sarcopenia (metagenomic sequencing) | at 12 months | 
| Quantification of fecal metabolite linked with sarcopenia | Changes in fecal markers of fermentation in relation to sarcopenia (mass spectrometry) | at 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sarcopenia, short bowel syndrome, adaptation