Diagnosis of sarcopenia with magnetic resonance imaging of newly diagnosed pediatric inflammatory bowel disease


Annals of Clinical and Analitycal Medicine, 2023 (ESCI) identifier


Aim: Patients with inflammatory bowel disease (IBD) are at a high risk of sarcopenia. This study aimed to evaluate sarcopenia by estimating muscle mass with magnetic resonance imaging of newly diagnosed IBD. Material and Methods: Pediatric IBD patients, who underwent magnetic resonance enterography (MRE) from 2019 to 2022, were enrolled. Demographic, anthropometric, laboratory and clinical data were retrospectively obtained from medical records. The total Psoas Muscle Area (tPMA) and Skeletal Muscle Area (SMA) were calculated by scanning the psoas muscle areas at the upper level of the L4 vertebra and all muscle areas in the same section on axial T2-weighted images. Sarcopenia diagnosis was made according to Pediatric Reference Analytic Morphomics Population (PRAMP) growth charts. Results: We enrolled 26 IBD patients, 11 (42.3%) with Crohn's disease (CD) and 15 (57.7%) with ulcerative colitis (UC) (median age 15, IQR=4.25 years). Among patients, 14 (54%) cases had sarcopenia. IBD patients treated with biologics had a lower tPMA index (p=0.036) than those treated with 5-ASA and steroids. tPMA and tPMA indexes were significantly lower in the group with vitamin D levels below 20 ng/ml (p=0.018, p=0.015, respectively). A significant correlation was also found between the tPMA index and serum vitamin D levels (r=0.429, p=0.029). Discussion: This study demonstrated a high prevalence of sarcopenia with 54% and lower SMA in newly diagnosed pediatric IBD patients. Muscle mass measurement in MRE studies highlighted that sarcopenia should be considered in vitamin D deficiency and in the case of normal anthropometric measurements.