Sarcopenia and Dinapenia in Patients with Ulcerative Colitis (Cross-Sectional Observational Study)

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Abstract

Background. Sarcopenia is a generalised, progressive decline in skeletal muscle mass, strength and performance leading to reduced quality of life, increased risk of falls, hospitalisation and mortality. Primary sarcopenia results from age-related changes in muscle tissue. In certain cases, sarcopenia develops secondary as a consequence of diseases including ulcerative colitis (UC), which is associated with a systemic inflammatory process, malabsorption syndrome, restriction of patients’ physical activity and nutrient deficiencies. The term “dynapenia” or “probable sarcopenia” has been proposed to describe the decrease in muscle strength. Studies have demonstrated that muscle strength is a more relevant marker for predicting adverse outcomes because its measurement is more practical, whereas muscle mass is technically difficult to measure.

Aims — to increase the effectiveness of the diagnosis of dinapenia, to assess the prevalence and risk factors of its formation in patients with UC.

Methods. A single-centre, observational cross-sectional study included 80 UC patients. To identify factors associated with the development of dinapenia, patients with dinapenia were compared with patients without dinapenia. The investigated parameters in patients: sex, age, body mass index, peculiarities of the course of the disease, ongoing treatment, concomitant pathology, peculiarities of nutrition, nutritional deficiency, malabsorption syndrome, bad habits, psychological stress and sleep duration, physical activity, laboratory indicators of inflammation, myokine-adipokine profile. Statistical parameters were calculated using Statistica 10.0.1011.0 programme.

Results. Dinapenia is present in 32.5% of UC patients. Risk factors for the formation of dinapenia in UC patients include female sex (p = 0.0003); nutritional insufficiency (p = 0.021); low physical activity (p = 0.010); artificial feeding in infancy (p = 0.024); inflammation, namely C-reactive protein, autoantibodies of class G against double-stranded DNA (p = 0.006; p = 0.002 respectively). Patients with UC with dinapenia significantly more often gave a positive answer to the questionnaire question “Does daily activity cause you a lot of stress?” (p = 0.048). In the group of UC patients with dinapenia, the level of cortisol in evening saliva was significantly higher than in the comparison group (p = 0.005).

Conclusions. Sarcopenia and UC are multifactorial conditions with common developmental mechanisms that can burden each other. Dynamometry is not technically difficult and is justified from an economic point of view. The timely detection of dinapenia and its correction will additionally affect the mechanisms of UC pathogenesis in order to improve the quality of life and prognosis of patients.

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About the authors

Galiya R. Bicbavova

Omsk State Medical University

Author for correspondence.
Email: galiya1976@mail.ru
ORCID iD: 0000-0001-9252-9152
SPIN-code: 6103-6690

MD, PhD, Associate Professor

Russian Federation, Omsk

Maria A. Livzan

Omsk State Medical University

Email: mlivzan@yandex.ru
ORCID iD: 0000-0002-6581-7017
SPIN-code: 1961-4082

MD, PhD, Professor, Corresponding Member of the RAS

Russian Federation, Omsk

Oksana M. Drapkina

National Medical Research Center for Therapy and Preventive Medicine

Email: drapkina@bk.ru
ORCID iD: 0000-0002-4453-8430
SPIN-code: 4456-1297

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow

Natalia S. Lisyutenko

Omsk State Medical University

Email: n.labuzina@mail.ru
ORCID iD: 0000-0003-4088-240X
SPIN-code: 1964-5202

MD, PhD, Assistant of the Department

Russian Federation, Omsk

Alisa E. Romanyuk

Omsk State Medical University

Email: romalisa00@mail.ru
ORCID iD: 0000-0001-6308-4377
SPIN-code: 6833-4986

Student

Russian Federation, Omsk

References

  1. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. doi: https://doi.org/10.1093/ageing/afy169
  2. Studenski SA, Peters KW, Alley DE, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69(5):547–558. doi: https://doi.org/10.1093/gerona/glu010
  3. Chumlea WMC, Cesari M, Evans WJ, et al. International working group on Sarcopenia. The Journal of Nutrition, Health & Aging. 2011;15:450–455. doi: https://doi.org/10.1007/s12603-011-0092-7
  4. Seene T, Kaasik P. Muscle weakness in the elderly: role of sarcopenia, dynapenia, and possibilities for rehabilitation. Eur Rev Aging Phys Act. 2012;9(2):109–117. doi: https://doi.org/10.1007/s11556-012-0102-8
  5. Schaap LA, van Schoor NM, Lips P, Visser M. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the longitudinal aging study Amsterdam. J Gerontol A Biol Sci Med Sci. 2018;73(9): 1199–1204. doi: https://doi.org/10.1093/gerona/glx245
  6. Ibrahim K, May C, Patel HP, et al. A feasibility study of implementing grip strength measurement into routine hospital practice (GRImP): study protocol. Pilot Feasibility Stud. 2016;2:27. doi: https://doi.org/10.1186/s40814-016-0067-x
  7. Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266–273. doi: https://doi.org/10.1016/S0140-6736(14)62000-6
  8. Nishikawa H, Nakamura S, Miyazaki T., et al. Inflammatory bowel disease and sarcopenia: its mechanism and clinical importance. J Clin Med. 2021;10(18):4214. doi: https://doi.org/10.3390/jcm10184214
  9. Ryan E, McNicholas D, Creavin B, et al. Sarcopenia and inflammatory bowel disease: a systematic review. Inflamm Bowel Dis. 2019;25(1):67–73. doi: https://doi.org/10.1093/ibd/izy212
  10. Peyrin-Biroulet L, Sandborn W, Sands BE, et al. Selecting therapeutic targets in inflammatory bowel disease (STRIDE): Determining therapeutic goals for treat-to-target. Am J Gastroenterol. 2015;110(9):1324–1338. doi: https://doi.org/10.1038/ajg.2015.233
  11. Turner D, Ricciuto A, Lewis A, et al. STRIDE-II: an update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the International Organization for the Study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology. 2021;160(5):1570–1583. doi: https://doi.org/10.1053/j.gastro.2020.12.031
  12. Ge X, Jiang L, Yu W, et al. The importance of sarcopenia as a prognostic predictor of the clinical course in acute severe ulcerative colitis patients. Dig Liver Dis. 2021;53(8):965–971. doi: https://doi.org/10.1016/j.dld.2021.03.031
  13. Pedersen M, Cromwell J, Nau P. Sarcopenia is a predictor of surgical morbidity in inflammatory bowel disease. Inflamm Bowel Dis. 2017;23(10):1867–1872. doi: https://doi.org/10.1097/MIB.0000000000001166
  14. Cushing KC, Kordbacheh H, Gee MS, et al. Sarcopenia is a novel predictor of the need for rescue therapy in hospitalized ulcerative colitis patients. J Crohns Colitis. 2018;12(9):1036–1041. doi: https://doi.org/10.1093/ecco-jcc/jjy064
  15. Ивашкин В.Т., Шелыгин Ю.А., Белоусова Е.А., и др. Проект клинических рекомендаций по диагностике и лечению язвенного колита // Колопроктология. — 2019. — Т. 18. — № 4. — С. 7–36. [Ivashkin VT, Shelygin YuA, Belousova EA, et al. Project: Clinical guidelines for the diagnostics and treatment of ulcerative colitis. Koloproktologiya. 2019;18(4):7–36. (In Russ.)] doi: https://doi.org/10.33878/2073-7556-2019-18-4-7-36
  16. CINDI dietary guide. Document EUR/00/5018028, E70041R. Copenhagen, WHO Regional Office for Europe; 2003. 42 p.
  17. Haskey N, Peña-Sánchez JN, Jones JL, et al. Development of a screening tool to detect nutrition risk in patients with inflammatory bowel disease. Asia Pac J Clin Nutr. 2018;27(4):756–762. doi: https://doi.org/10.6133/apjcn.112017.01
  18. Fiorindi C, Dragoni G, Scaringi S, et al. Relationship between nutritional screening tools and GLIM in complicated IBD requiring surgery. Nutrients. 2021;13(11):3899. doi: https://doi.org/10.3390/nu13113899
  19. Ерофеев Ю.В., Болдырева М.С., Турчанинов Д.В. Организация и методика проведения социологических исследований здоровья сельского населения для информационного обеспечения системы социально-гигиенического мониторинга. Методические рекомендации. — Омск: Изд-во ФГУ ЦГСЭН Омской области, 2004. — 52 с. [Erofeev YuV, Boldyreva MS, Turchaninov DV. Organizatsiya i metodika provedeniya sotsiologicheskikh issledovanii zdorov’ya sel’skogo naseleniya dlya informatsionnogo obespecheniya sistemy sotsial’no-gigienicheskogo monitoringa. Metodicheskie rekomendatsii. Omsk: Izdatel’stvo FGU TsGSEN Omskoi oblasti; 2004. 52 s. (In Russ.)]
  20. Reeder LG, Chapman JM, Coulson AH. Socioenvironmental stress, tranquilizers and cardiovascular disease. Proceedings of the Excerpta Medica International Congress Series. 1968;182:226–238
  21. Rom O, Kaisari S, Aizenbud D, Reznick AZ. Lifestyle and sarcopenia-etiology, prevention, and treatment. Rambam Maimonides Med J. 2012;3(4):e0024. doi: https://doi.org/10.5041/RMMJ.10091
  22. Dhaliwal A, Quinlan JI, Overthrow K, et al. Sarcopenia in inflammatory bowel disease: a narrative overview. Nutrients. 2021;13(2):656. doi: https://doi.org/10.3390/nu13020656
  23. Yuan S, Larsson SC. Epidemiology of sarcopenia: Prevalence, risk factors, and consequences. Metabolism. 2023;144:155533. doi: https://doi.org/10.1016/j.metabol.2023.155533
  24. Mawdsley JE, Rampton DS. Psychological stress in IBD: New insights into pathogenic and therapeutic implications. Gut. 2005;54(10):1481–1491. doi: https://doi.org/10.1136/gut.2005.064261
  25. Vanuytsel T, van Wanrooy S, Vanheel H, et al. Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism. Gut. 2014;63(8):1293–1299. doi: https://doi.org/10.1136/gutjnl-2013-305690
  26. Miller R, Wojtyniak JG, Weckesser LJ, et al. How to disentangle psychobiological stress reactivity and recovery: a comparison of model-based and non-compartmental analyses of cortisol concentrations. Psychoneuroendocrinology. 2018;90:194–210. doi: https://doi.org/10.1016/j.psyneuen.2017.12.019

Supplementary files

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2. Fig. 1. Nutritional deficiency in patients with ulcerative colitis with and without dynapenia, according to the SaskIBD-NR Tool questionnaire

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3. Fig. 2. Distribution of study participants by the degree of risk of nutritional deficiency, according to the SaskIBD-NR Tool questionnaire, %

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4. Fig. 3. Evening cortisol levels in patients with ulcerative colitis with and without dynapenia

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5. Fig. 4. The content of C-reactive protein in the blood of patients with ulcerative colitis with and without dynapenia

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6. Fig. 5. Titer of class G autoantibodies against double-stranded DNA in patients with ulcerative colitis with and without dynapenia

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7. Fig. 6. Correlation of serum C-reactive protein levels with the risk of developing nutritional deficiency assessed using the SaskIBD-NR Tool questionnaire

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8. Fig. 7. Factors contributing to the development of sarcopenia

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