Sarcopenia and hepatobiliary disorders in children with inflammatory bowel disease

Sarcopenia, characterized as a reduction of skeletal muscle mass and functional capacity, remains a relevant but insufficiently studied issue in pediatric patients with inflammatory bowel disease. Loss of muscle mass may negatively affect the course of inflammatory bowel disease, increase the frequency of complications, and reduce treatment effectiveness. Recent studies have highlighted a possible association between sarcopenia and hepatobiliary manifestations in patients with inflammatory bowel disease. However, due to the limited number of studies and the absence of diagnostic guidelines, the prevalence of sarcopenia in children with inflammatory bowel disease and concomitant hepatobiliary manifestations remains unclear.
Objective. To assess the prevalence of sarcopenia in children with inflammatory bowel disease and to determine associations between reduced muscle mass and laboratory markers of liver injury.
Materials and Methods. Thirty-six children with inflammatory bowel disease were examined, including 18 with ulcerative colitis and 18 with Crohn’s disease. Laboratory markers were analyzed. Body composition was assessed using bioelectrical impedance analysis, and total psoas muscle area (tPMA) was measured via computed tomography or magnetic resonance imaging.
Results: Sarcopenia based on tPMA (z-score < –2) was found in 61% of patients. A decrease of skeletal muscle mass measured by bioimpedance analysis was observed in 19.4% of children, more frequently in those with hepatobiliary manifestations. A strong correlation between tPMA and body composition parameters was found.
Conclusion: These findings emphasize the importance of comprehensive nutritional assessment in children with inflammatory bowel disease, especially in the presence of hepatobiliary manifestations. Further prospective studies on sarcopenia in these patients are needed.

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