Short-Term Changes in Body Composition and the Development of Sarcopenia Following Acute Pancreatitis: An Observational Study.

OBJECTIVE

Malnutrition is a common complication of acute pancreatitis (AP), and it may adversely affect outcomes. This study aimed to evaluate short-term changes in body composition and the development of sarcopenia in patients with moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP).

METHODS

This single-center, prospective observational study evaluated patients with MSAP and SAP at admission and after eight weeks. Body composition was measured using bioelectrical impedance analysis (BIA). Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People (EWGSOP2) guidelines, with handgrip strength (HGS) used to identify probable sarcopenia and computed tomography (CT)-derived skeletal muscle index (SMI) used to confirm the diagnosis. The primary endpoint was the prevalence of probable and confirmed sarcopenia based on EWGSOP2 criteria. Secondary endpoints included changes in body composition parameters during 8 weeks follow up.

RESULTS

Forty patients (22 MSAP, 18 SAP) were included. The mean age was 39.4 ± 14.8 years, and 75% were male. Patients with SAP had significantly higher Bedside Index of Severity in Acute Pancreatitis (BISAP) scores (2.16 vs. 1.04) and rates of organ failure compared to the MSAP group. Over eight weeks, both groups experienced significant reductions in body mass index (BMI), body fat, and visceral fat. SMI declined significantly in both MSAP (47.5 to 41.5 cm2/m2, p < 0.001) and SAP (48.9 to 41.2 cm2/m2, p < 0.001). At the eight-week follow-up, the prevalence of confirmed sarcopenia was 31.8% in the MSAP group and 22.2% in the SAP group. HGS did not change significantly in either group; therefore, the rise in confirmed sarcopenia was driven primarily by a progressive decline in SMI crossing the diagnostic threshold in patients with pre-existing low HGS.

CONCLUSION

Moderately severe and severe AP lead to rapid, detrimental changes in body composition and a high incidence of sarcopenia within eight weeks. These findings highlight the need for systematic screening and targeted nutritional and physical rehabilitation to mitigate muscle loss in recovering patients.