Novel approach to assess sarcopenia in children with inflammatory bowel disease

Kriszta Katinka Boros; Gábor Veres; Hajnalka Krisztina Pintér; Éva Richter; Áron Cseh; Antal Dezsőfi; András Arató; George S Reusz; Dóra Dohos; Katalin E Müller; Orsolya Cseprekál

doi:10.3389/fped.2024.1204639

Novel approach to assess sarcopenia in children with inflammatory bowel disease

Front Pediatr. 2024 Nov 19:12:1204639. doi: 10.3389/fped.2024.1204639. eCollection 2024.

Authors

Kriszta Katinka Boros¹, Gábor Veres^{2

3}, Hajnalka Krisztina Pintér³, Éva Richter¹, Áron Cseh¹, Antal Dezsőfi¹, András Arató¹, George S Reusz¹, Dóra Dohos^{4

5}, Katalin E Müller^#^{4

5

6}, Orsolya Cseprekál^#⁷

Affiliations

¹ Pediatric Center, MTA Center of Excellence, Semmelweis University, Budapest, Hungary.
² Department of Internal Medicine, Pediatrics Clinic University of Debrecen, Clinical Center, ÁOK, DEKK, Debrecen, Hungary.
³ School of Ph.D. Studies, Semmelweis University, Budapest, Hungary.
⁴ Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
⁵ Department of Gastroenterology and Nephrology, Heim Pál National Pediatric Institute, Budapest, Hungary.
⁶ Department of Health Care Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.
⁷ Department of Surgery Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary.

^# Contributed equally.

Abstract

Introduction: Sarcopenia is associated with poor clinical outcomes in chronic diseases. Our study aimed to characterize body composition (BC) parameters in patients with inflammatory bowel disease (IBD) and compare skeletal muscle mass (SMM) parameters with the healthy pediatric population.

Methods: BC of healthy controls (HC) and of patients with IBD were measured via multifrequency bioelectrical impedance (InBody 720 device) in a cross-sectional manner. The effect of sex, age, height, weight, and body mass index (BMI) on BC parameters, with a special attention to SMM, was assessed. Reference tables from SMM were generated using a maximum-likelihood curve-fitting technique for calculating Z scores.

Results: BC parameters were associated with age, body size, and sex. SMM was lower in patients with IBD (n = 57, aged 6.71 ± 8.7 years) compared to unadjusted HC (n = 307, aged 9.9-19.3 years; 143 males; SMM: 22.34 ± 8.38 vs. 24.4 ± 6.3 kg; p = 0.03). SMM showed a moderately strong correlation with age, weight, height, and BMI (R = 0.65, 0.9, 0.87, and 0.66; p < 0.05 for each) in HC. In multivariate stepwise, ridge regression analysis, age, sex, and BMI remained the significant predictors of SMM (age β = 0.47, -0.31, and 0.38, respectively; p < 0.05). SMM of sex-, age-, and BMI-adjusted HC did not differ from IBD. Therefore, BMI Z score-based references were plotted for normalizing SMM, and SMM Z score was calculated and found to be similar to that of HC.

Conclusions: BC is supposed to be an easy-to-measure and objective marker of sarcopenia in children with IBD. Adjustment of SMM for BMI Z score might be needed to avoid the overestimation of sarcopenia in this patient population.

Keywords: bioelectrical impedance analysis (BIA); body composition (BC); body fat mass (BFM); body mass index (BMI); fat-free mass (FFM); inflammatory bowel disease (IBD); skeletal muscle mass (SMM).

Grants and funding

The study was supported by NKFI grant 124549 (GSR) and the Centre for Translational Medicine, Semmelweis University, by the Janos Bolyai Research Scholarship of the Hungarian Academy of Sciences (BO/00693/25/5) and by the ÚNKP-23-5-SE22 New National Excellence Program of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.