Imaging-based assessment of body composition in patients with Crohn’s disease: a systematic review

Background and aims Body composition changes in patients with Crohn’s disease (CD) have received increasing attention in recent years. This review aims to describe the changes in body composition in patients with CD on imaging and to analyze and summarize the prognostic value of body composition. Methods We systematically searched Web of Science, PubMed, Embase, Cochrane Library, and Medline via OVID for literature published before November 2022, and two researchers independently evaluated the quality of the retrieved literature. Results A total of 39 publications (32 cohort studies and 7 cross-sectional studies) involving 4219 patients with CD were retrieved. Imaging methods for body composition assessment, including dual-energy X-ray absorptiometry (DXA), computed tomography (CT) and magnetic resonance imaging (MRI), were included in this review. The study found that patients with CD typically have more visceral adipose tissue and less skeletal muscle mass, and the prevalence of sarcopenia and visceral obesity was significantly different in different studies (sarcopenia: 16–100%; visceral obesity: 5.3–30.5%). Available studies suggest that changes in the body composition of CD patients are significantly related to inflammatory status, disease behavior, poor outcomes, and drug efficacy. Conclusion Altered body composition can be a significant predictor of poor outcomes for CD patients. Therefore, the body composition of CD patients may serve as a potential therapeutic target to help optimize disease management strategies in clinical practice.