Lower skeletal muscle attenuation and high visceral fat index are associated with complicated disease in patients with Crohn's disease: An exploratory study

Lower skeletal muscle attenuation and high visceral fat index are associated with complicated disease in patients with Crohn's disease: An exploratory study

Summary Background and aims The prognostic value of body composition analysis in patients with Crohn's disease (CD) is poorly explored. The aims of the present study were to assess fat and skeletal muscle compartments including muscle radiation attenuation (MA) in patients with CD, and to analy...

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Veröffentlicht in:Clinical nutrition ESPEN 2017-10, Vol.21, p.79-85
Hauptverfasser: Cravo, Marília L, Velho, Sónia, Torres, Joana, Costa Santos, Maria Pia, Palmela, Carolina, Cruz, Rita, Strecht, João, Maio, Rui, Baracos, Vickie
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Gastroenterology and Hepatology
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container_end_page 85
container_issue
container_start_page 79
container_title Clinical nutrition ESPEN
container_volume 21
creator Cravo, Marília L
Velho, Sónia
Torres, Joana
Costa Santos, Maria Pia
Palmela, Carolina
Cruz, Rita
Strecht, João
Maio, Rui
Baracos, Vickie
description Summary Background and aims The prognostic value of body composition analysis in patients with Crohn's disease (CD) is poorly explored. The aims of the present study were to assess fat and skeletal muscle compartments including muscle radiation attenuation (MA) in patients with CD, and to analyze its predictive value to identify complicated phenotypes. Methods Seventy one patients with CD who have had an abdominal CT within one month of clinical, laboratory, and endoscopic evaluation were included. Skeletal muscle area (SMA) and index (SMI), visceral fat area (VFA) and index (VFI), subcutaneous fat area (SFA), and mean MA were measured using appropriate software. Sarcopenia, as defined by Martin's criteria was assessed. Montreal classification was used to characterize disease phenotype. Results Mean MA was lower in patients >40 years ( p  = 0.001), L2 ( p  = 0.09) and stricturing/penetrating disease ( p  = 0.03) whereas SMA and SMI were significantly lower in patients with positive C-reactive protein and previous hospital admissions ( p  
doi_str_mv 10.1016/j.clnesp.2017.04.005
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The aims of the present study were to assess fat and skeletal muscle compartments including muscle radiation attenuation (MA) in patients with CD, and to analyze its predictive value to identify complicated phenotypes. Methods Seventy one patients with CD who have had an abdominal CT within one month of clinical, laboratory, and endoscopic evaluation were included. Skeletal muscle area (SMA) and index (SMI), visceral fat area (VFA) and index (VFI), subcutaneous fat area (SFA), and mean MA were measured using appropriate software. Sarcopenia, as defined by Martin's criteria was assessed. Montreal classification was used to characterize disease phenotype. Results Mean MA was lower in patients &gt;40 years ( p  = 0.001), L2 ( p  = 0.09) and stricturing/penetrating disease ( p  = 0.03) whereas SMA and SMI were significantly lower in patients with positive C-reactive protein and previous hospital admissions ( p  &lt; 0.01). On multivariate analysis, higher MA was protective against the complicated disease phenotype (stricturing/penetrating disease and/or previous surgeries) (OR 0.81; p  = 0.002) whereas a high visceral fat index increased such risk (OR 26.1; p  = 0.02). A ROC curve showed a 82.4% sensibility, 90.3% specificity, 17.6% positive predictive value, 9.7% negative predictive value and an area under the curve (AUC) of 0.91 for body composition analysis to predict complicated disease. Conclusions A lower muscle attenuation and a high visceral fat index seem to be associated with more severe phenotypes in patients with CD.</description><identifier>ISSN: 2405-4577</identifier><identifier>EISSN: 2405-4577</identifier><identifier>DOI: 10.1016/j.clnesp.2017.04.005</identifier><identifier>PMID: 30014873</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Gastroenterology and Hepatology</subject><ispartof>Clinical nutrition ESPEN, 2017-10, Vol.21, p.79-85</ispartof><rights>European Society for Clinical Nutrition and Metabolism</rights><rights>2017 European Society for Clinical Nutrition and Metabolism</rights><rights>Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. 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The aims of the present study were to assess fat and skeletal muscle compartments including muscle radiation attenuation (MA) in patients with CD, and to analyze its predictive value to identify complicated phenotypes. Methods Seventy one patients with CD who have had an abdominal CT within one month of clinical, laboratory, and endoscopic evaluation were included. Skeletal muscle area (SMA) and index (SMI), visceral fat area (VFA) and index (VFI), subcutaneous fat area (SFA), and mean MA were measured using appropriate software. Sarcopenia, as defined by Martin's criteria was assessed. Montreal classification was used to characterize disease phenotype. Results Mean MA was lower in patients &gt;40 years ( p  = 0.001), L2 ( p  = 0.09) and stricturing/penetrating disease ( p  = 0.03) whereas SMA and SMI were significantly lower in patients with positive C-reactive protein and previous hospital admissions ( p  &lt; 0.01). On multivariate analysis, higher MA was protective against the complicated disease phenotype (stricturing/penetrating disease and/or previous surgeries) (OR 0.81; p  = 0.002) whereas a high visceral fat index increased such risk (OR 26.1; p  = 0.02). A ROC curve showed a 82.4% sensibility, 90.3% specificity, 17.6% positive predictive value, 9.7% negative predictive value and an area under the curve (AUC) of 0.91 for body composition analysis to predict complicated disease. 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The aims of the present study were to assess fat and skeletal muscle compartments including muscle radiation attenuation (MA) in patients with CD, and to analyze its predictive value to identify complicated phenotypes. Methods Seventy one patients with CD who have had an abdominal CT within one month of clinical, laboratory, and endoscopic evaluation were included. Skeletal muscle area (SMA) and index (SMI), visceral fat area (VFA) and index (VFI), subcutaneous fat area (SFA), and mean MA were measured using appropriate software. Sarcopenia, as defined by Martin's criteria was assessed. Montreal classification was used to characterize disease phenotype. Results Mean MA was lower in patients &gt;40 years ( p  = 0.001), L2 ( p  = 0.09) and stricturing/penetrating disease ( p  = 0.03) whereas SMA and SMI were significantly lower in patients with positive C-reactive protein and previous hospital admissions ( p  &lt; 0.01). On multivariate analysis, higher MA was protective against the complicated disease phenotype (stricturing/penetrating disease and/or previous surgeries) (OR 0.81; p  = 0.002) whereas a high visceral fat index increased such risk (OR 26.1; p  = 0.02). A ROC curve showed a 82.4% sensibility, 90.3% specificity, 17.6% positive predictive value, 9.7% negative predictive value and an area under the curve (AUC) of 0.91 for body composition analysis to predict complicated disease. Conclusions A lower muscle attenuation and a high visceral fat index seem to be associated with more severe phenotypes in patients with CD.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30014873</pmid><doi>10.1016/j.clnesp.2017.04.005</doi><tpages>7</tpages></addata></record>
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title Lower skeletal muscle attenuation and high visceral fat index are associated with complicated disease in patients with Crohn's disease: An exploratory study
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