Skip to main content
Log in

Sarcopenia in Inflammatory Bowel Diseases: Reviewing Past Work to Pave the Path for the Future

  • Irritable Bowel Diseases (D Adams, Section Editor)
  • Published:
Current Treatment Options in Gastroenterology Aims and scope Submit manuscript

Abstract

Purpose of the Review

Sarcopenia is the loss of muscle quantity and strength. It is highly prevalent in patients with inflammatory bowel disease (IBD) and is associated with periods of ongoing inflammation. This review will summarize the prior work in the field and highlight areas for future research.

Recent Findings

The presence of sarcopenia has been associated with adverse outcomes in different populations. Most recently, sarcopenia has been associated with adverse postoperative outcomes and an increased likelihood of surgery in IBD. Despite this, significant heterogeneity among these studies limits the ability to draw definitive conclusions.

Summary

The importance of sarcopenia in inflammatory bowel disease (IBD) is only beginning to be recognized. Future studies assessing its utility both as a risk stratification tool and a modifiable factor in IBD are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127:990S-991S.

    Article  CAS  PubMed  Google Scholar 

  2. Marcell TJ. Review Article: Sarcopenia: causes, consequences, and preventions. J Gerontol A Biol Sci Med Sci. 2003;58:M911–6.

    Article  PubMed  Google Scholar 

  3. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kochar B, Jylhava J, Soderling J, et al. Prevalence and Implications of frailty in older adults with incident inflammatory bowel diseases: a nationwide cohort study. Clin Gastroenterol Hepatol 2022. [epub ahead of print].

  5. Faye AS, Wen T, Soroush A, et al. Increasing prevalence of frailty and its association with readmission and mortality among hospitalized patients with IBD. Dig Dis Sci 2021;66(12):4178–90.

  6. Faye AS, Colombel J-F. Aging and IBD: a new challenge for clinicians and researchers. Inflamm Bowel Dis 2022;28(1):126–32.

  7. Kochar B, Orkaby AR, Ananthakrishnan AN, et al. Frailty in inflammatory bowel diseases: an emerging concept. Ther Adv Gastroenterol. 2021;14:175628482110254.

    Article  Google Scholar 

  8. Visser M, Schaap LA. Consequences of sarcopenia. Clin Geriatr Med. 2011;27:387–99.

    Article  PubMed  Google Scholar 

  9. Dalle S, Rossmeislova L, Koppo K. The role of inflammation in age-related sarcopenia. Front Physiol. 2017;8:1045.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol. 2018;15:505–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Balage M, Averous J, Remond D, et al. Presence of low-grade inflammation impaired postprandial stimulation of muscle protein synthesis in old rats. J Nutr Biochem. 2010;21:325–31.

    Article  CAS  PubMed  Google Scholar 

  12. Schakman O, Dehoux M, Bouchuari S, et al. Role of IGF-I and the TNFalpha/NF-kappaB pathway in the induction of muscle atrogenes by acute inflammation. Am J Physiol Endocrinol Metab. 2012;303:E729–39.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Sakuma K, Aoi W, Yamaguchi A. Current understanding of sarcopenia: possible candidates modulating muscle mass. Pflugers Arch. 2015;467:213–29.

    Article  CAS  PubMed  Google Scholar 

  14. Bian A-L, Hu H-Y, Rong Y-D, et al. A study on relationship between elderly sarcopenia and inflammatory factors IL-6 and TNF-α. Eur J Med Res 2017;22(1):25.

  15. Beyer I, Bautmans I, Njemini R, et al. Effects on muscle performance of NSAID treatment with piroxicam versus placebo in geriatric patients with acute infection-induced inflammation. A double blind randomized controlled trial. BMC Musculoskel Disord. 2011;12:292.

    Article  CAS  Google Scholar 

  16. Abraham C, Cho JH. Inflammatory bowel disease. N Engl J Med. 2009;361:2066–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Unal NG, Oruc N, Tomey O, et al. Malnutrition and sarcopenia are prevalent among inflammatory bowel disease patients with clinical remission. Eur J Gastroenterol Hepatol 2021;33(11):1367–75.

  18. Atlan L, Cohen S, Shiran S, et al. Sarcopenia is a predictor for adverse clinical outcome in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2021;72:883–8.

    Article  CAS  PubMed  Google Scholar 

  19. Lee CH, Yoon H, Oh DJ, et al. The prevalence of sarcopenia and its effect on prognosis in patients with Crohn’s disease. Intest Res. 2020;18:79–84.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 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):1036–41.

  21. Dhaliwal A, Williams FR, Quinlan JI, et al. Evaluation of the mechanisms of sarcopenia in chronic inflammatory disease: protocol for a prospective cohort study. Skelet Muscle 2021;11(1):27.

  22. Simonsen C, de Heer P, Bjerre ED, et al. Sarcopenia and postoperative complication risk in gastrointestinal surgical oncology: a meta-analysis. Ann Surg. 2018;268:58–69.

    Article  PubMed  Google Scholar 

  23. Pedersen M, Cromwell J, Nau P. Sarcopenia is a predictor of surgical morbidity in inflammatory bowel disease. Inflamm Bowel Dis. 2017;23:1867–72.

    Article  PubMed  Google Scholar 

  24. Carvalho D, Viana C, Marques I, et al. Sarcopenia is associated with postoperative outcome in patients with Crohn’s disease undergoing bowel resection. Gastrointest Disord. 2019;1:201–9.

    Article  Google Scholar 

  25. Fujikawa H, Araki T, Okita Y, et al. Impact of sarcopenia on surgical site infection after restorative proctocolectomy for ulcerative colitis. Surg Today. 2017;47:92–8.

    Article  PubMed  Google Scholar 

  26. Zhang T, Cao L, Cao T, et al. Prevalence of sarcopenia and its impact on postoperative outcome in patients With Crohn’s disease undergoing bowel resection. J Parenter Enter Nutr. 2017;41:592–600.

    Article  Google Scholar 

  27. O’Brien S, Kavanagh RG, Carey BW, et al. The impact of sarcopenia and myosteatosis on postoperative outcomes in patients with inflammatory bowel disease. Euro Radiol Exp 2018;2.

  28. Alipour O, Lee V, Tejura TK, et al. The assessment of sarcopenia using psoas muscle thickness per height is not predictive of post-operative complications in IBD. Scand J Gastroenterol. 2021;56:1175–81.

    Article  CAS  PubMed  Google Scholar 

  29. Ryan E, McNicholas D, Creavin B, et al. Sarcopenia and inflammatory bowel disease: a systematic review. Inflamm Bowel Dis. 2019;25:67–73.

    Article  PubMed  Google Scholar 

  30. Erős A, Soós A, Hegyi P, et al. Sarcopenia as an independent predictor of the surgical outcomes of patients with inflammatory bowel disease: a meta-analysis. Surg Today. 2020;50:1138–50.

    Article  PubMed  Google Scholar 

  31. Bamba S, Sasaki M, Takaoka A, et al. Sarcopenia is a predictive factor for intestinal resection in admitted patients with Crohn’s disease. PLoS ONE. 2017;12:e0180036.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Ge X, Xia J, Wu Y, et al. Sarcopenia assessed by computed tomography is associated with colectomy in patients with acute severe ulcerative colitis. Eur J Clin Nutr 2021.

  33. Stenholm S, Harris TB, Rantanen T, et al. Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care. 2008;11:693–700.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Morley JE. The aging gut: physiology. Clin Geriatr Med. 2007;23:757–67.

    Article  PubMed  Google Scholar 

  35. Baumgartner RN. Body composition in healthy aging. Ann N Y Acad Sci. 2000;904:437–48.

    Article  CAS  PubMed  Google Scholar 

  36. Adams DW, Gurwara S, Silver HJ, et al. Sarcopenia is common in overweight patients with inflammatory bowel disease and may predict need for surgery. Inflamm Bowel Dis. 2017;23:1182–6.

    Article  PubMed  Google Scholar 

  37. Dogan SC, Hizmetli S, Hayta E, et al. Sarcopenia in women with rheumatoid arthritis. Eur J Rheumatol. 2015;2:57–61.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Beckwee D, Delaere A, Aelbrecht S, et al. Exercise interventions for the prevention and treatment of sarcopenia. A systematic umbrella review. J Nutr Health Aging. 2019;23:494–502.

    Article  CAS  PubMed  Google Scholar 

  39. Beaudart C, Dawson A, Shaw SC, et al. Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporos Int. 2017;28:1817–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Cruz-Jentoft AJ, Landi F, Schneider SM, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014;43:748–59.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Cruz-Jentoft AJ, Romero-Yuste S, Chamizo Carmona E, et al. Sarcopenia, immune-mediated rheumatic diseases, and nutritional interventions. Aging Clin Exp Res 2021;33(11):2929–39.

  42. Dhaliwal A, Quinlan JI, Overthrow K, et al. Sarcopenia in inflammatory bowel disease: a narrative overview. Nutrients. 2021;13:656.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Zhang T, Ding C, Xie T, et al. Skeletal muscle depletion correlates with disease activity in ulcerative colitis and is reversed after colectomy. Clin Nutr. 2017;36:1586–92.

    Article  PubMed  Google Scholar 

  44. Subramaniam K, Fallon K, Ruut T, et al. Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn’s disease. Aliment Pharmacol Ther. 2015;41:419–28.

    Article  CAS  PubMed  Google Scholar 

  45. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16–31.

    Article  PubMed  Google Scholar 

  46. Studenski SA, Peters KW, Alley DE, et al. The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates. J Gerontol Ser A. 2014;69:547–58.

    Article  Google Scholar 

  47. Bamba S, Inatomi O, Takahashi K, et al. Assessment of body composition from CT Images at the level of the third lumbar vertebra in inflammatory bowel disease. Inflamm Bowel Dis. 2021;27:1435–42.

    Article  PubMed  Google Scholar 

  48. Kaplan GG, Windsor JW. The four epidemiological stages in the global evolution of inflammatory bowel disease. Nat Rev Gastroenterol Hepatol. 2021;18:56–66.

    Article  PubMed  Google Scholar 

  49. Prado CMM, Baracos VE, McCargar LJ, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15:2920–6.

    Article  CAS  PubMed  Google Scholar 

  50. Ganju RG, Morse R, Hoover A, et al. The impact of sarcopenia on tolerance of radiation and outcome in patients with head and neck cancer receiving chemoradiation. Radiother Oncol. 2019;137:117–24.

    Article  PubMed  Google Scholar 

Download references

Funding

R03AG074059 [BK].

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bharati Kochar MD, MS.

Ethics declarations

Conflict of Interest

All the authors have no relevant conflicts of interest to declare. Adam S. Faye reports the following disclosures: consulting for GuidePoint, Janssen, LEK, M3, and Schlesinger. Bharati Kochar reports the following disclosures: advisory board for Pfizer, Inc. Tasnin Khan and Sandhya Cautha declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Adam S. Faye and Tasnin Khan are co-first authors.

This article is part of the Topical Collection on Irritable Bowel Diseases.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Faye, A., Khan, T., Cautha, S. et al. Sarcopenia in Inflammatory Bowel Diseases: Reviewing Past Work to Pave the Path for the Future. Curr Treat Options Gastro 20, 250–260 (2022). https://doi.org/10.1007/s11938-022-00389-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11938-022-00389-8

Keywords

Navigation