P2189 - Radiographically-Measured Sarcopenia Predicts Hospitalization in Patients with Ulcerative Colitis

Aman Bali, MD¹, Ahmed Ouni, MD², Kwon Joshua, MD³, Varun Moktan, MD⁴, Chen Frank, MD¹, Francis A. Farraye, MD, MSc, MACG², Jana G.. Hashash, MD, MSc, FACG^2
1Mayo Clinic Florida, Jacksonville, FL; ²Mayo Clinic, Jacksonville, FL; ³University of California Irvine, Orange, CA; ⁴Prisma Health-Upstate, Greenville, SC

Introduction: Sarcopenia (SP) is a measure of body composition defined as low lean muscle mass with decreased functional strength. It is increasingly recognized as a poor prognostic factor in patients with ulcerative colitis (UC), predicting increased disease activity as well as need for surgical intervention and post-surgical infection. However, its role in other UC-related outcomes remains underinvestigated.

Methods: We retrospectively identified adult patients (≥18 years) with UC who were evaluated at our outpatient tertiary care center between 2017-2020 and underwent CT scan within 3 months of their visit. Using CT cross-sectional measurements at the L3 vertebral level, we quantified visceral, subcutaneous, and intermuscular adipose tissue area as well as skeletal muscle area (SMA; the sum of psoas, quadratus lumborum, erector spinae, and abdominal wall muscle areas, Figure). SMA was indexed to height as skeletal muscle index (SMI) and SP was defined as SMI < 25^th percentile of the study population of men and women. Sarcopenic obesity (SO) was concomitant SP and body mass index (BMI) >30. We collected data on patient demographics, comorbidities, disease phenotype, and outcomes including hospitalization at 1 year. Categorical variables were compared using Chi-squared and Fisher's exact test and continuous variables using independent t-tests. Multivariate logistic regression was used to determine odds ratios (ORs) with 95% confidence intervals (CIs).

Results: Twenty-two patients with UC were included with mean age of 56.5 years ±19.3. Overall 40.9% (9/22) of patients were women with average SMI of 38.5±6.8 cm²/m² vs 53.3±14.8 for men. A third, 31.8% (7/22), of patients had SP and of these 14.3% (1/7) had SO. In univarate analysis comparing patients with normal body composition to those with SP alone and SO, no statiscally significant differences were observed in rates of UC-related outcomes including hospitalization at 1 year or receiving inpatient antibiotics or steroids. On multivariate regression, lower SMI was associated with increased odds of hospitalization at 1 year, with each 1 unit increase in SMI conferring 0.78 lower odds of hospitalization (OR 0.78 [95%CI 0.61-1.00], p=0.05).

Discussion: In patients with UC, radiographically-measured SP was associated with increased odds of hospitalization at 1 year. Body composition metrics may serve as important markers of disease status and prognosis.



Disclosures:


Aman Bali, MD¹, Ahmed Ouni, MD², Kwon Joshua, MD³, Varun Moktan, MD⁴, Chen Frank, MD¹, Francis A. Farraye, MD, MSc, MACG², Jana G.. Hashash, MD, MSc, FACG². P2189 - Radiographically-Measured Sarcopenia Predicts Hospitalization in Patients with Ulcerative Colitis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.