TOPLINE:

Sarcopenia affected 59% of children with Crohn's disease (CD) at the diagnosis and increased their risk for clinical relapses within the first year.

METHODOLOGY:

• Researchers conducted a retrospective study at the paediatric gastroenterology and hepatology unit of a hospital in Rome (2009-2023) to assess the effect of sarcopenia at the diagnosis on clinical outcomes in 78 children (median age, 12 years) with CD.
• Sarcopenia was evaluated by measuring the total psoas muscle area at the L3-L4 level on MRI and defined as z-score values < -2 SD.
• Outcomes included the relapse of disease, defined as a weighted Pediatric Crohn's Disease Activity Index score > 12.5 points after the achievement of remission or an increase of 20 points from the previous assessment; hospitalisation; disease-related complications; therapeutic step-up; and corticosteroid use between children with and without sarcopenia over a follow-up duration of 2 years.
• A subgroup analysis was conducted to examine the resolution rate of sarcopenia and identify risk factors associated with its persistence.

TAKEAWAY:

• Among the 78 children, 46 (59%) had sarcopenia at diagnosis and 32 (41%) did not; children with sarcopenia had a higher risk for relapses at 6 months (odds ratio [OR], 7.5; P = .04) and 12 months (OR, 5.9; P = .01) than those without sarcopenia.
• Moreover, they had lower relapse-free survival than those without sarcopenia (hazard ratio, 2.7; 95% CI, 1.4-4.5; log-rank P = .01).
• Sarcopenia was an independent predictor of clinical relapses (adjusted OR, 1.7; P = .04).
• The resolution of sarcopenia occurred in 18 of 38 patients (39%) at 24-month MRI reevaluation. Children with persistent sarcopenia demonstrated a lower muscle mass than those with resolved sarcopenia (P = .01).

IN PRACTICE:

"Sarcopenia is well known to affect the quality of life of individuals and their families. Addressing sarcopenia should, therefore, be a therapeutic goal, as its persistence during child­hood may have long-term consequences on growth and devel­opment," the authors of the study wrote.

SOURCE:

This study was led by Giulia D'Arcangelo, MD, PhD, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy. It was published online on September 05, 2025, in Inflammatory Bowel Diseases.

LIMITATIONS:

This study was retrospective in nature, and paediatric-specific guidelines for defining sarcopenia were lacking. Its single-centre design may have limited generalisability, and the high prevalence of sarcopenia may have reflected a selection bias.

DISCLOSURES:

This study did not receive any specific funding. Two authors reported receiving consultation fees or honorarium in the last 3 years from Nestle and various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.