Sarcopenia and low prognostic nutritional index as markers of disease activity in patients with inflammatory bowel disease and predictors of poor outcome: a cohort longitudinal study

Abstract
Background
Inflammatory Bowel Diseases (IBD) are the gastro-intestinal diseases of the current century. They are described by alternating periods of activity & remission. The assessment of severity is classically done by scoring systems for each disease which depend on patients’ symptoms, inflammatory markers, endoscopic findings, and disease impact on functional activities. The current study focused on some of the potentially modifiable risk factors for activity, not involved in classic scoring systems like sarcopenia & Prognostic Nutritional Index (PNI) in a group of IBD studied cases.

Results
A prospective study on 146 patients with established diagnosis of IBD; divided into two groups; Group1 were studied cases in activity; and Group 2 were patients in remission. Both groups were subjected to clinical assessment, laboratory tests, endoscopies, cross-sectional imaging with specific attention to psoas muscle indices. Both groups were followed up clinically for at least 6 months by clinical activity scores. In this research, the mean patients’ age was 35 years and 45% were females; the prevalence of sarcopenia in studied cases with active IBD had been 49.3% & 6.8% in remission. It was more prevalent in Crohn’s disease. Sarcopenia and low PNI were significantly related to disease activity, & poor clinical outcome in studied cases with IBD with a p- value < 0.05.

Conclusion
Sarcopenia and low PNI can be used as markers of activity of IBD. They are associated with worse outcomes. It is recommended to early detect and manage sarcopenia and malnutrition in IBD patients to improve outcomes.