Body composition parameters correlate with the endoscopic severity in Crohn's disease patients treated with infliximab

Wuli Tang; Gang Xie; Junlin Li; Wei Tan; Rongqi Yi; Ling Yang; Lingqin Zhang; Jiaxing Deng; Yue Zhang; Kang Li

doi:10.3389/fnut.2023.1251448

Body composition parameters correlate with the endoscopic severity in Crohn's disease patients treated with infliximab

Front Nutr. 2023 Aug 21:10:1251448. doi: 10.3389/fnut.2023.1251448. eCollection 2023.

Authors

Wuli Tang^{1

2

3

4}, Gang Xie⁵, Junlin Li⁴, Wei Tan⁶, Rongqi Yi⁴, Ling Yang⁴, Lingqin Zhang⁴, Jiaxing Deng⁷, Yue Zhang⁴, Kang Li^{1

2

3

4}

Affiliations

¹ Chongqing Medical University, Chongqing, China.
² Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences, Chongqing, China.
³ Chongqing School, University of Chinese Academy of Science, Chongqing, China.
⁴ Department of Radiology, Chongqing General Hospital, Chongqing, China.
⁵ Department of Radiology, The Third People's Hospital of Chengdu, Chengdu, China.
⁶ Department of Gastroenterology, Chongqing General Hospital, Chongqing, China.
⁷ Department of General Medicine, Chongqing General Hospital, Chongqing, China.

Abstract

Background: The disease activity status and behavior of Crohn's disease (CD) can reflect the severity of the disease, and changes in body composition are common in CD patients.

Aims: The aim of this study was to investigate the relationship between body composition parameters and disease severity in CD patients treated with infliximab (IFX).

Methods: Patients with CD assessed with the simple endoscopic score (SES-CD) and were treated with IFX were retrospectively collected, and body composition parameters at the level of the 3rd lumbar vertebrae were calculated from computed tomography (CT) scans of the patients. The correlation of patients' body composition parameters with disease activity status and disease behavior was analyzed, and the diagnostic value of the relevant parameters was assessed using receiver operating characteristic (ROC) curves.

Results: A total of 106 patients were included in this study. There were significant differences in the subcutaneous adiposity index (SAI) (p = 0.010), the visceral adiposity index (VAI) (p < 0.001), the skeletal muscle mass index (SMI) (p < 0.001), and decreased skeletal muscle mass (p < 0.001) among patients with different activity status. After Spearman and multivariate regression analysis, SAI (p = 0.006 and p = 0.001), VAI (p < 0.001 and p < 0.001), and SMI (p < 0.001and p = 0.007) were identified as independent correlates of disease activity status (both disease activity and moderate-to-severe activity), with disease activity status independently positively correlated with SAI and SMI and independently negatively correlated with VAI. In determining the disease activity and moderate-to-severe activity status, SMI performed best relative to SAI and VAI, with areas under the ROC curve of 0.865 and 0.801, respectively. SAI (p = 0.015), SMI (p = 0.011) and decreased skeletal muscle mass (p = 0.027) were significantly different between different disease behavior groups (inflammatory disease behavior group, complex disease behavior group) but were not independent correlates (p > 0.05).

Conclusion: Body composition parameters of CD patients treated with IFX correlate with the endoscopic disease severity, and SMI can be used as a reliable indicator of disease activity status.

Keywords: Crohn’s disease; body composition; disease activity status; disease behavior; malnutrition.