Skeletal muscle depletion correlates with disease activity in ulcerative colitis and is reversed after colectomy.
The body composition of patients with ulcerative colitis (UC) remains unclear. This study evaluated body composition in adult patients with UC and the associations of body composition with disease activity and surgical intervention.



This study included 99 patients with UC, 105 with Crohn's disease (CD) and 60 controls. Skeletal muscle area (SMA), visceral fat area (VFA) and subcutaneous fat area (SFA) of the third lumbar vertebrae were evaluated by abdominal computed tomography. The effects of medical therapy and surgery on body composition in UC patients were determined.



Sarcopenia was more frequent in UC patients (27.3%) than in controls (8.3%), but less frequent than in CD patients (59.0%). The prevalence of sarcopenia was significantly higher (33.8% vs. 4.5%, p < 0.001), and SMA (144.26 vs. 182.32 cm2, p < 0.001), skeletal muscle index (SMI) (52.22 vs. 65.52 cm2/m2, p < 0.001) significantly lower, in UC patients with high (≥6) than low (<6) Mayo score, but SFA and VFA were similar. The prevalence of sarcopenia and alterations in body composition were reversed, along with UC disease activity, following medical treatment or surgery. SMA and SMI correlated significantly with disease activity in UC patients. Multivariate analysis showed that sarcopenia (odds ratio, 8.49; 95% confidence interval, 1.80-40.10; p = 0.007) was a negative predictor of high Mayo score in UC patients. Sarcopenic patients with UC had high probability of need for colectomy in Kaplan-Meier survival curves.



Sarcopenia is associated with high disease activity and poor clinical outcome in UC patients. Medical treatment and colectomy have positive effects on sarcopenia and skeletal muscle depletion.
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: tenghuiff@163.com.
Tenghui
T
Zhang
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: dingchao19910521@126.com.
Chao
C
Ding
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: 18351875182@163.com.
Tingbin
T
Xie
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: yang_jianbo@126.com.
Jianbo
J
Yang
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: d670677094@163.com.
Xujie
X
Dai
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: itengfeilv@163.com.
Tengfei
T
Lv
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: liyi1860@126.com.
Yi
Y
Li
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: drgulili@163.com.
Lili
L
Gu
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: dr_betty@126.com.
Yao
Y
Wei
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: gongjianfeng@aliyun.com.
Jianfeng
J
Gong
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: dr_zhuweiming@126.com.
Weiming
W
Zhu
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: liningrigs@vip.sina.com.
Ning
N
Li
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: lijieshounj@163.com.
Jieshou
J
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D055948:Sarcopenia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D002097:C-Reactive Protein
Body composition; Disease activity; Inflammatory bowel disease; Sarcopenia; Skeletal muscle mass; Ulcerative colitis