Sarcopenia hinders the decline in disease activity after surgery for people with Crohn's disease: Preliminary results

Abstract

Objectives: Surgical treatment is an important option for inducing remission in Crohn's disease (CD); indeed, the longer the disease duration, the higher the cumulative surgical rate. Previous studies have shown that the pathogenesis of Crohn's disease is associated with sarcopenia, a condition of reduced skeletal muscle mass. Here, we investigated the effect of preoperative sarcopenia on postoperative disease activity.

Methods: This retrospective study included 56 patients with CD with medical records who met our inclusion criteria. Sarcopenia was diagnosed based on the psoas muscle mass index derived from computed tomography images, with predetermined cutoff values of <6.36 cm²/m² for men and <3.92 cm²/m² for women. We performed univariate and multivariate analyses to identify factors associated with sarcopenia.

Results: Of the 56 participants, nine (16%) had sarcopenia. The rate of preoperative treatment with biological drugs was significantly lower in the sarcopenia group than the non-sarcopenia group. In addition, the operation time was significantly longer, and hemorrhage occurred more often, in the sarcopenia group than in the non-sarcopenia group. Postoperatively, the CD activity index at 6 mo had significantly decreased in the non-sarcopenia group (P = 0.01) but not in the sarcopenia group (P = 0.20). Univariate and multivariate analyses showed that a low total serum protein level was significantly associated with sarcopenia.

Conclusion: Our results suggest that to maximize the effect of surgical treatment for CD, an appropriate nutritional intervention should be performed before surgery, or surgery should be postponed until after the patient recovers from sarcopenia.

Keywords: CDAI; Crohn's disease; IBD; Sarcopenia.