Ultrasound muscle assessment for sarcopenia detection in inflammatory bowel disease: A prospective study.

Crohn's disease USMI bioelectrical impedance analysis diagnostic tools disease activity magnetic resonance imaging malnutrition ulcerative colitis ultrasound muscle index

Journal

United European gastroenterology journal
ISSN: 2050-6414
Titre abrégé: United European Gastroenterol J
Pays: England
ID NLM: 101606807

Informations de publication

Date de publication:
28 Mar 2024
Historique:
received: 10 12 2023
accepted: 08 03 2024
medline: 29 3 2024
pubmed: 29 3 2024
entrez: 29 3 2024
Statut: aheadofprint

Résumé

Sarcopenia is prevalent in patients with inflammatory bowel disease (IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in this population. 153 consecutive patients were included, 100 in the training cohort and 53 in the study cohort. Three superficial muscles (rectus femoris = RF, rectus abdominis = RA, and biceps brachii = BB) were selected for the detection of sarcopenia using muscle ultrasound (US). The training cohort consisted of consecutive patients with or without IBD and was used to evaluate the feasibility and inter- and intra-observer variability of the US measurement. The study cohort consisted of only IBD patients and served to test US diagnostic accuracy. In the latter, muscle US, bioelectrical impedance analysis (BIA), and magnetic resonance imaging (MRI) were used to measure muscle parameters. Sarcopenia prevalence in IBD patients was 50%. Muscle US showed excellent inter-rater and intra-rater reliability (ICC >0.95) and a good diagnostic accuracy in detecting sarcopenia compared to BIA with area under the receiver operating characteristic curve (AUROC) values of 80% and 85% for RA and BB thickness, respectively. Moreover, an Ultrasound Muscle Index (USMI) was defined as the sum of the RA, BB, and RF thickness divided by the square of the patient's height, resulting in an AUROC of 81%. Muscle thresholds for sarcopenia were detected, with RA and USMI values correlated with the highest positive (84.3%) and negative (99%) predictive values, respectively. Additionally, the agreement between the US and MRI measurements of RA was excellent (ICC 0.96). The findings of this study emphasize the potential of muscle US as a reliable diagnostic tool for assessing sarcopenia in IBD patients. This research has significant implications for disease management in IBD patients and underscores the need for further investigations to validate these findings in larger cohorts.

Sections du résumé

BACKGROUND BACKGROUND
Sarcopenia is prevalent in patients with inflammatory bowel disease (IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in this population.
METHODS METHODS
153 consecutive patients were included, 100 in the training cohort and 53 in the study cohort. Three superficial muscles (rectus femoris = RF, rectus abdominis = RA, and biceps brachii = BB) were selected for the detection of sarcopenia using muscle ultrasound (US). The training cohort consisted of consecutive patients with or without IBD and was used to evaluate the feasibility and inter- and intra-observer variability of the US measurement. The study cohort consisted of only IBD patients and served to test US diagnostic accuracy. In the latter, muscle US, bioelectrical impedance analysis (BIA), and magnetic resonance imaging (MRI) were used to measure muscle parameters.
RESULTS RESULTS
Sarcopenia prevalence in IBD patients was 50%. Muscle US showed excellent inter-rater and intra-rater reliability (ICC >0.95) and a good diagnostic accuracy in detecting sarcopenia compared to BIA with area under the receiver operating characteristic curve (AUROC) values of 80% and 85% for RA and BB thickness, respectively. Moreover, an Ultrasound Muscle Index (USMI) was defined as the sum of the RA, BB, and RF thickness divided by the square of the patient's height, resulting in an AUROC of 81%. Muscle thresholds for sarcopenia were detected, with RA and USMI values correlated with the highest positive (84.3%) and negative (99%) predictive values, respectively. Additionally, the agreement between the US and MRI measurements of RA was excellent (ICC 0.96).
CONCLUSIONS CONCLUSIONS
The findings of this study emphasize the potential of muscle US as a reliable diagnostic tool for assessing sarcopenia in IBD patients. This research has significant implications for disease management in IBD patients and underscores the need for further investigations to validate these findings in larger cohorts.

Identifiants

pubmed: 38549182
doi: 10.1002/ueg2.12566
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.

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Auteurs

Giacomo Mulinacci (G)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.

Lorena Pirola (L)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.

Davide Gandola (D)

Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
Division of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.

Davide Ippolito (D)

Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
Division of Radiology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.

Chiara Viganò (C)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.

Alice Laffusa (A)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.

Camilla Gallo (C)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.

Pietro Invernizzi (P)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.

Silvio Danese (S)

Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, Milan, Italy.
Vita-Salute San Raffaele University, Milan, Italy.

Sara Massironi (S)

Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.

Classifications MeSH