The role of bioelectrical impedance analysis in assessing sarcopenia in inflammatory bowel disease

Sarcopenia, defined as the loss of muscle mass and strength, is an under-recognized complication in patients with inflammatory bowel disease (IBD). Sarcopenia is linked to poor clinical outcomes in IBD, including reduced treatment response, prolonged hospitalization, and frequent flares. We used bioelectrical impedance analysis (BIA) to determine the prevalence of sarcopenia in IBD patients and examine the relationship between the sarcopenic index and several disease activity markers.

We conducted a prospective cross-sectional study of IBD patients attending the Canberra Hospital between February and June 2024. BIA was used to assess skeletal muscle mass and sarcopenic index, with sarcopenia defined using European Working Group on Sarcopenia in Older People criteria. Disease activity data were extracted from medical records within a 2-week window of BIA and then analyzed for associations with sarcopenic index.

Of the 94 eligible IBD patients (mean age = 44.9 ± 15.4 years), 63% were classified as sarcopenic. Sarcopenia was more prevalent in males (89%) than in females (36%) and in Crohn's disease (73%) compared with ulcerative colitis (44%). Gender and type of IBD were both associated with sarcopenia (P < 0.0001). Lower sarcopenic index values were associated with clinical assessments of active disease (P < 0.05), higher platelet counts (P < 0.05), and lower hemoglobin levels (P < 0.0001).

Sarcopenia is highly prevalent in IBD populations and is associated with several clinical and biochemical markers of active disease. Routine BIA assessment, may offer a practical way to identify patients who may benefit from early nutritional assessment or dietary/exercise intervention.