Sarcopenia in Women with Anorectal Dysfunctions-A Female Sarcopelvic Study

Ana Margarida Duarte da Silva Vieira; Sandra Pais; Viviana Martins; Barbara Castelo; Miguel Mascarenhas Saraiva

doi:10.3390/jcm13237273

Sarcopenia in Women with Anorectal Dysfunctions-A Female Sarcopelvic Study

J Clin Med. 2024 Nov 29;13(23):7273. doi: 10.3390/jcm13237273.

Authors

Ana Margarida Duarte da Silva Vieira^{1

2

3}, Sandra Pais³, Viviana Martins¹, Barbara Castelo¹, Miguel Mascarenhas Saraiva^{4

5}

Affiliations

¹ Unidade Local de Saúde do Algarve, Unidade de Portimão de Gastrenterologia, 8500-338 Portimão, Portugal.
² Faculdade de Medicina e Ciências Biomédicas, Universidade do Algarve, Campus de Gambelas, 8005-139 Faro, Portugal.
³ Comprehensive Health Research Center, Universidade de Évora, 7004-516 Évora, Portugal.
⁴ ManoPH, 4000-432 Porto, Portugal.
⁵ Hospital CUF, 4100-180 Porto, Portugal.

Abstract

Background: Anorectal dysfunctions (ARDs) include fecal incontinence (FI) and functional defecation disorders (FDDs). The pelvic floor muscles play a central role in the physiology of continence and defecation. We aimed to investigate the prevalence of sarcopenia in a female group with anorectal dysfunctions and compare them with a healthy female age-matched group. As secondary objectives, the relationship between anorectal dysfunction outcomes and sarcopenia was analyzed. Methods: We conducted a single-center cross-sectional, interventional, controlled, and double-blind study involving female adults admitted to an ARD outpatient clinic assessed for FI and/or FDD. A control group was also included of age-matched women without ARD. Sarcopenia was evaluated in the entire cohort, according to the latest criteria. Statistical analysis was performed using SPSS software v.29, considering a confidence interval of 95%. Results: A total of 130 participants were included, equally divided by the two groups. The median age was 64 years. Both groups were also similar regarding body mass index (BMI), physical activity index values, and dietary patterns. Among the 130 investigated women, there were no cases of confirmed sarcopenia or severe sarcopenia, but 15 women (11.5%) had probable sarcopenia or dynapenia. The case group had significantly more probable sarcopenia than women in the control group (14 (21.5%) vs. 1 (1.5%), p < 0.001). The presence of relevant comorbidities, such as irritable bowel syndrome (IBS), urinary incontinence (UI), and meat dietary pattern (MDP), was a risk factor for probable sarcopenia. The binomial logistic regression analysis showed that probable sarcopenia (OR 3.9; CI 1.1-14.1, p = 0.039) was associated with a worse treatment response. Conclusions: Probable sarcopenia or dynapenia was significantly more prevalent in women with ARD and was a predictive factor of a worse treatment response, regardless of the ARD severity. Concomitant UI, MDP, IBS, and psychiatric conditions were significantly associated with dynapenia. The inclusion of the evaluation of sarcopenia in these patients should be considered.

Keywords: defecation; fecal incontinence; pelvic floor; sarcopenia.

Grants and funding

The present publication was funded by FCT—Fundação para a Ciência e a Tecnologia, through Comprehensive Health Research Center (CHRC) grant number UIDP/04923/2020.