Long-Term Risk of Inflammatory Bowel Disease With Sarcopenia Status: A Large-Scale Prospective Cohort Study

The relationship between sarcopenia and Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), remains poorly understood. We aimed to investigate the association between risk of incident IBD and sarcopenia from a large, long-term prospective cohort.

Participants free of prevalent IBD diagnosis at baseline (N = 436 378) were included. Baseline sarcopenia status (probable and confirmed sarcopenia) was assessed according to EWGSOP2 criteria. The outcome of interest was incident IBD, CD, UC. Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).

Overall, 56 947 (13.0%) and 2520 (0.6%) participants were diagnosed with probable sarcopenia and confirmed sarcopenia at baseline, respectively. During a median of 13.3 years' follow-up, 2592 incident IBD cases (1858 UC, 895 CD) were identified. After multivariable adjustment, 81% and 94% higher risk of IBD (HR = 1.81, 95% CI: 1.27-2.58) and UC (HR = 1.94, 95% CI: 1.30-2.89) were observed in confirmed sarcopenia than the normal group, whereas no risk of CD associated with confirmed sarcopenia (HR = 1.56, 95% CI: 0.80-3.03) was detected. Particularly, evidently higher IBD risk (HR = 2.25, 95% CI: 1.39-3.64) and UC (HR = 2.58, 95% CI: 1.52-4.39) were detected in severe sarcopenia. Meanwhile, individuals with probable sarcopenia were associated with 26%, 27%, and 32% higher risk of IBD (HR = 1.26, 95% CI: 1.14-1.40), UC (HR = 1.27, 95% CI: 1.12-1.44), and CD (HR = 1.32, 95% CI: 1.11-1.58) versus normal individuals.

Sarcopenic individuals had an increased risk of developing IBD. It is necessary to conduct targeted screening for sarcopenia in high-risk populations, and interventions to improve physical capability should be encouraged, which in turn may reduce the risk of developing IBD.