Terapevticheskii arkhiv · 2025
[Ultrasound of muscles for the diagnosis of sarcopenia in patients with inflammatory bowel diseases].
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Akchurina O E, Mukhametova D D, Odintsova A K, Abdulganieva D I
Аннотация
AIM: To assess the muscle mass of patients with inflammatory bowel disease (IBD) using ultrasound.
MATERIALS AND METHODS: 102 IBD patients hospitalized in gastroenterology department of Republican Clinical Hospital (Kazan) were involved in the study. Among them, 49% of patients with ulcerative colitis, 51% with Crohn's disease, 10 people made up the control group (CG). The median age in the IBD group was 39.5 [28.5; 50] years, in the CG - 37 [26; 38] years. There were 52 (51%) women in the IBD group and 5 (50%) in the CG group. Patients were examined to assess body mass index (BMI), mid-upper arm circumference (MUAC, cm) and mid-thigh circumference (MTC, cm) of the dominant side; bioimpedance analysis of body composition using the ABC-02 "MEDASS" device; ultrasound examination of muscle thickness at two points on the leading side: ultrasound thickness of the middle of the shoulder (US-MUAC), ultrasound thickness of the middle of the thigh (US-MTC), dynamometry using a wrist dynamometer, assessment of nutritional status.
RESULTS: According to BMI, patients were distributed as follows: normal in 57 (55.9%) patients; deficiency - in 12 (11.8%); overweight - 25 (24.5%); obesity - 8 (7.8%). Median MUAC in women with IBD was 28 [24.9; 31] cm, in CG - 28 [27; 28.5] cm (p>0.05); in men with IBD 29.8 [27; 32] cm, in CG - 33 [31; 34] cm (p<0.05). The median MTC in women with IBD was 54.25 [48.15; 58.10] cm, in CG - 61.5 [56; 67] cm (p<0.05); in men with IBD 48 [46; 51.4] cm, in GC - 54 [53; 54] cm (p<0.05). The median US-MUAC in women with IBD was 19.60 [18.23; 22.84] mm, CG 22.49 [20.41; 22.66] (p>0.05); in men with IBD 26.45 [22.87; 29.24] mm, in CG 21.54 [21.18; 25.13] mm (p>0.05). Median US-MTC in women with IBD was 31.05 [23.21; 37.11] mm, CG 41.30 [35.55; 41.74] mm (p<0.05), in men with IBD 30.90 [25.64; 39.99] mm, in CG 40.67 [39.10; 41.84] (p<0.05). According to the results of bioimpedansometry, the skeletal muscle mass index (SMI) was low in 32% of patients, normal in 65%, and above normal in 3%. US-MUAC correlated with MUAC (r=0.557; p<0.05), with BMI (r=0.448; p<0.05), with SMI (r=0.666; p<0.05). US-MTC correlated with MTC (r=0.505; p<0.05), with BMI (r=0.376; p<0.05), with SMI (r=0.373; p<0.05).
CONCLUSION: In patients with IBD, MTC was lower than in CG. US-MTC in women and men with IBD was lower than in CG, which correlated with MTC, BMI, skeletal muscle mass according to bioimpedance measurements and grip strength according to dynamometry.
MATERIALS AND METHODS: 102 IBD patients hospitalized in gastroenterology department of Republican Clinical Hospital (Kazan) were involved in the study. Among them, 49% of patients with ulcerative colitis, 51% with Crohn's disease, 10 people made up the control group (CG). The median age in the IBD group was 39.5 [28.5; 50] years, in the CG - 37 [26; 38] years. There were 52 (51%) women in the IBD group and 5 (50%) in the CG group. Patients were examined to assess body mass index (BMI), mid-upper arm circumference (MUAC, cm) and mid-thigh circumference (MTC, cm) of the dominant side; bioimpedance analysis of body composition using the ABC-02 "MEDASS" device; ultrasound examination of muscle thickness at two points on the leading side: ultrasound thickness of the middle of the shoulder (US-MUAC), ultrasound thickness of the middle of the thigh (US-MTC), dynamometry using a wrist dynamometer, assessment of nutritional status.
RESULTS: According to BMI, patients were distributed as follows: normal in 57 (55.9%) patients; deficiency - in 12 (11.8%); overweight - 25 (24.5%); obesity - 8 (7.8%). Median MUAC in women with IBD was 28 [24.9; 31] cm, in CG - 28 [27; 28.5] cm (p>0.05); in men with IBD 29.8 [27; 32] cm, in CG - 33 [31; 34] cm (p<0.05). The median MTC in women with IBD was 54.25 [48.15; 58.10] cm, in CG - 61.5 [56; 67] cm (p<0.05); in men with IBD 48 [46; 51.4] cm, in GC - 54 [53; 54] cm (p<0.05). The median US-MUAC in women with IBD was 19.60 [18.23; 22.84] mm, CG 22.49 [20.41; 22.66] (p>0.05); in men with IBD 26.45 [22.87; 29.24] mm, in CG 21.54 [21.18; 25.13] mm (p>0.05). Median US-MTC in women with IBD was 31.05 [23.21; 37.11] mm, CG 41.30 [35.55; 41.74] mm (p<0.05), in men with IBD 30.90 [25.64; 39.99] mm, in CG 40.67 [39.10; 41.84] (p<0.05). According to the results of bioimpedansometry, the skeletal muscle mass index (SMI) was low in 32% of patients, normal in 65%, and above normal in 3%. US-MUAC correlated with MUAC (r=0.557; p<0.05), with BMI (r=0.448; p<0.05), with SMI (r=0.666; p<0.05). US-MTC correlated with MTC (r=0.505; p<0.05), with BMI (r=0.376; p<0.05), with SMI (r=0.373; p<0.05).
CONCLUSION: In patients with IBD, MTC was lower than in CG. US-MTC in women and men with IBD was lower than in CG, which correlated with MTC, BMI, skeletal muscle mass according to bioimpedance measurements and grip strength according to dynamometry.