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Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset
Lewis Steell1,2, Blair A Johnston3, Dickson Dewantoro2
1Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow.
Insights
Adults with childhood-onset Crohn's disease (CD) show normal bone structure but reduced muscle mass and strength. These muscle deficits may lead to future bone and muscle problems, suggesting a need for interventions to improve muscle health.
Area of Science:
- Musculoskeletal health
- Pediatric gastroenterology
- Inflammatory bowel disease
Background:
- Childhood-onset Crohn's disease (CD) frequently causes muscle-bone deficits.
- Long-term musculoskeletal outcomes in adults with childhood-onset CD are understudied.
- This study compared musculoskeletal health in young adults with childhood-onset CD to healthy controls.
Purpose of the Study:
- To assess bone microarchitecture, muscle characteristics, and function in adults with childhood-onset CD.
- To identify potential long-term musculoskeletal complications associated with childhood-onset CD.
- To compare these outcomes against a healthy control group.
Main Methods:
- High-resolution MRI and MR spectroscopy were used to evaluate bone and muscle at the distal femur and lumbar spine.
- Bone marrow adiposity (BMA), muscle area, and fat fraction were quantified.
- Muscle strength (grip) and relative power, along with muscle-bone biomarkers, were assessed.
Main Results:
- No significant differences in bone microarchitecture, cortical geometry, or BMA were found between CD patients and controls.
- Adults with CD exhibited smaller muscle area and higher fat fraction in the distal femur.
- CD patients demonstrated significantly lower grip strength and relative muscle power compared to controls.
Conclusions:
- Young adults with well-controlled childhood-onset CD have normal bone structure but significant muscle deficits.
- These muscle deficits may increase the risk of future musculoskeletal morbidity.
- Interventions targeting muscle mass and function are warranted for investigation in this population.
Background:
Muscle-bone deficits are common in pediatric Crohn's disease; however, few studies have assessed long-term musculoskeletal outcomes in adults with childhood-onset Crohn's disease. This study assessed the prevalence of musculoskeletal deficits in young adults with childhood-onset Crohn's disease compared with healthy controls.
Methods:
High-resolution MRI and MR spectroscopy were used to assess bone microarchitecture, cortical geometry and muscle area, and adiposity at distal femur and bone marrow adiposity (BMA) at lumbar spine. Muscle function and biomarkers of the muscle-bone unit were also assessed.
Results:
Twenty-seven adults with Crohn's disease with median (range) age 23.2 years (18.0, 36.1) and 27 age and sex-matched controls were recruited. Trabecular microarchitecture, cortical geometry and BMA were not different between Crohn's disease and controls (P > 0.05 for all). Muscle area was lower (P = 0.01) and muscle fat fraction was higher (P = 0.04) at the distal femur in Crohn's disease compared to controls. Crohn's disease participants had lower grip strength [-4.3 kg (95% confidence interval (CI), -6.8 to -1.8), P = 0.001] and relative muscle power [-5.0 W/kg (95% CI, -8.8 to -1.2), P = 0.01]. Crohn's disease activity scores negatively associated with trabecular bone volume (r = -0.40, P = 0.04) and muscle area (r = -0.41, P = 0.03).
Conclusion:
Young adults with well-controlled Crohn's disease managed with contemporary therapies did not display abnormal bone microarchitecture or geometry at the distal femur but exhibited muscle deficits. The observed muscle deficits may predispose to musculoskeletal morbidity in future and interventions to improve muscle mass and function warrant investigation.
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