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Updated: Jul 14, 2026
Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
Investigating sarcopenia in pediatric Crohn's Disease with magnetic resonance enterography: An observational study
Margherita Calia1, Paola Rebora2, Davide Gandola3
1Department of Pediatrics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Insights
Sarcopenia, or muscle loss, is common in pediatric Crohn's Disease (CD) at diagnosis. Magnetic resonance enterography (MRE) can identify this, with sarcopenic children showing more severe disease markers.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Nutritional Assessment in Children
Background:
- Sarcopenia negatively impacts adult Crohn's Disease (CD) outcomes.
- Data on sarcopenia prevalence and impact in pediatric CD patients are limited.
Purpose of the Study:
- To determine the prevalence of sarcopenia in children newly diagnosed with CD.
- To assess the relationship between sarcopenia and baseline disease characteristics and clinical outcomes in pediatric CD.
Main Methods:
- Utilized magnetic resonance enterography (MRE) to measure total psoas muscle area (tPMA) in 74 children with new-onset CD.
- Defined sarcopenia as tPMA below the 3rd percentile of pediatric reference values.
- Collected demographic, anthropometric, laboratory, and disease activity data at diagnosis and during follow-up.
Main Results:
- Sarcopenia was identified in 46% of pediatric CD patients at diagnosis.
- Sarcopenic children exhibited lower BMI z-scores and hemoglobin levels.
- Higher clinical and endoscopic disease activity scores were observed in sarcopenic patients at diagnosis.
Conclusions:
- Sarcopenia is highly prevalent in pediatric CD at diagnosis.
- MRE-based muscle mass assessment is valuable for nutritional screening in these patients.
- While sarcopenic children showed more severe initial disease and a trend towards more flares, a significant association with long-term outcomes was not established, warranting further research.
Background And Aims:
Sarcopenia has a negative impact on clinical outcome in adult patients with Crohn's Disease (CD), but data on children are scarce. The aim of this study is to evaluate the prevalence of sarcopenia in children with CD using magnetic resonance enterography (MRE) and describe its relationship with baseline values and clinical outcome.
Methods:
We included children with a new diagnosis of CD from 2 tertiary referral pediatric Inflammatory Bowel Disease (IBD) centres, who underwent MRE at diagnosis between 2013 and 2023. Muscle mass was assessed by measuring the total area of the total psoas muscle (tPMA) at the level of the fourth and fifth lumbar vertebrae (L4/L5). Data were compared with pediatric reference values of tPMA, and sarcopenia was defined as a tPMA below the 3rd percentile. Demographic and anthropometric data, laboratory results, clinical disease activity and endoscopic index were collected at diagnosis and during follow-up. Clinical outcomes included relapse frequency, treatment changes, surgery, and IBD-related complications.
Results:
A total of 74 children (25 females, mean age 13.2 years) with CD were enrolled in the study. Sarcopenia was present in 34/74 patients (46 %) at diagnosis. Patients with sarcopenia had a lower Body Mass Index z-score and hemoglobin levels. Clinical disease activity (assessed using the Pediatric CD Activity Index) and endoscopic activity (assessed using the Simple Endoscopic Score for CD) were significantly higher in sarcopenic compared to non-sarcopenic children (median and quartiles scores: 25 [20, 40] vs. 21 [13, 35] and 10 [5, 13] vs. 6 [3, 13], respectively). During the follow-up period (median: 35 months; range: 1-99 months), no significant differences were observed between the sarcopenic and non-sarcopenic groups in terms of the composite outcome (defined as the occurrence of at least one unfavorable event). However, the rate of flares (number per person-year) was also higher in sarcopenic children compared to non-sarcopenic ones (27 % vs. 15 %; p = 0.0679).
Conclusions:
Sarcopenia is highly prevalent among children with CD at diagnosis. MRE-based muscle mass measurement correlates with traditional anthropometric measurements and can be valuable for comprehensive nutritional screening in pediatric CD patients. Patients with sarcopenia presented with more severe clinical, laboratory, and endoscopic findings at diagnosis; although sarcopenic children experienced more clinical relapses we were not able to show a significant association between sarcopenia and outcomes. Larger series need to be studied.
