The prevalence of sarcopenia is markedly increased in patients with intestinal failure
A Danish study highlights that patients with intestinal insufficiency and intestinal failure are 4-7% more likely than others to suffer from muscle wasting, known as sarcopenia
Intestinal insufficiency and intestinal failure are conditions associated with malabsorption of micro- and macronutrients and often occur after an ablation of part of the small intestine. This operation is often performed due to a colorectal cancer or an inflammatory intestinal disease and can lead to malnourishment and a change in body mass. Danish scientists recently examined whether patients with these conditions were more at risk of sarcopenia and the results of their study are currently being published in Clinical Nutrition, the official journal of ESPEN.
Over half of patients suffer from sarcopenia
The study conducted between 2010 and 2016 includes 113 subjects (average age 58) with intestinal deficiency (reduced absorption) and intestinal failure (subnormal absorption). Their body mass, strength and muscle performance as well as other parameters such as inflammation, metabolism at rest, smoking, alcohol consumption etc. were assessed.
Results revealed that 60 out of 113 patients with intestinal disease (53.1%) are affected by muscle wasting and a loss of strength. In patients with intestinal failure the prevalence of sarcopenia was 72.7% compared to 34.5% in those with intestinal insufficiency. Among those identified as unaffected, most still had subnormal muscle mass.
Alcohol, inflammation and hypermetabolism increase risk
Three factors significantly increase risk:
- excessive alcohol consumption increases the risk of sarcopenia seven fold. The toxic effect of alcohol on the size of muscle cells and on the absorption of vitamins and fatsis thought to be the culprit.
- Chronic inflammation or hypermetabolism also increase the risk of sacopenia by four and seven times respectively. Both are associated with an increase in the catabolism of muscle protein.
Scientists concluded that patients with intestinal insufficiency and intestinal failure are at immense risk of developing sarcopenia. They recommend: (1) Regular monitoring of muscle mass; (2) Offering dietary advice including alcohol abstinence; (3) A resistance-based physical activity, aerobic exercise and physiotherapy to reduce the effects of inflammation on the muscle.
The prevalence of sarcopenia is markedly increased in patients with intestinal failure and associates with several risk factors. Skallerup A, Nygaard L, Olesen SS, Køhler M, Vinter-Jensen L, Rasmussen HH. Clin Nutr. 2017 Sep 23. pii: S0261-5614(17)31342-0http://www.clinicalnutritionjournal.com/article/S0261-5614(17)31342-0/fulltext