Sarcopenia or the loss of skeletal muscle is highly prevalent in many diseases, including short bowel syndrome (SBS). While adaptation is more likely in SBS patients with a colon-in-continuity, the consequences and underlying mechanisms are unclear. An overabundance of fecal Lactobacillus was found but not yet linked to adaptation or sarcopenia. The objectives are to study the evolution of sarcopenia and the link with intestinal adaptation in SBS.
Patients with short bowel syndrome (SBS) will be screened and included in longitudinal or cross-sectional studies if eligible. The longitudinal study will follow patients with type 1 SBS (enterostomy) before and every 3 months after continuity surgery for 1 year. Cross-sectional studies will follow patients with type 2 or 3 SBS (jejunocolonic or -ileal anastomosis) for 1 year (every 3 months during the first 2 years after continuity surgery or every 6 months after). Study visits will include clinical examination, nutritional assessment, endoscopy with biopsies and/or intestinal absorption assessment planned as part of routine follow-up. In addition, questionnaires will be completed (GPAQ, SarQoL, EQ-5D -3L, SF36), with collection of stool (for routine and research) and urine samples (for research). The objective are to study the evolution of sarcopenia and the link with intestinal adaptation in SBS. The results may identify metabolic or microbial biomarkers and predictors of nutritional optimisation in SBS, which is a complex and costly orphan disease.
Study Type
OBSERVATIONAL
Enrollment
110
questionnaires will be completed (GPAQ, SarQoL, EQ-5D-3L, SF36), with collection of stool (for care and research) and urine
Service de Coprologie Fonctionnelle Hôpital Pitié-Salpêtrière
Paris, France
Evolution of sarcopenia
Changes in muscle strength (Jamar's dynamometer)
Time frame: at 12 months
Evolution of sarcopenia
Changes in muscle mass (bioimpedance analysis)
Time frame: at 12 months
Impact of sarcopenia
Changes in questionnaire of quality of life SarQoL
Time frame: at 12 months
Impact of sarcopenia
Changes in questionnaire of quality of life EQ-5D-3L
Time frame: at 12 months
Impact of sarcopenia
Changes in questionnaire of quality of life SF36
Time frame: at 12 months
Impact of sarcopenia
Changes in questionnaire of physical activity (GPAQ)
Time frame: at 12 months
Link with intestinal adaptation
Number of changes in histological markers of adaptation in relation to sarcopenia. Each of these elements can be considered as a chang : crypt depths, villi length, immune cells.
Time frame: at 12 months
Link with intestinal adaptation
Changes in biological markers of adaptation in relation to sarcopenia: ApoB48, citrulline, leptin, nutrients
Time frame: at 12 months
Quantification of intestinal adsorption and its link with intestinal adaptation
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Changes in intestinal absorption balance markers of adaptation in relation to sarcopenia: digestive losses in fat, proteins, carbohydrates and total energy. These elements will be quantified by biological assessements.
Time frame: at 12 months
Link with intestinal adaptation
Changes in bacterial fermentation markers of adaptation in relation to sarcopenia: D-lactate, short-chain fatty acids (SCFAs)
Time frame: at 12 months
Quantification of urinary metabolite linked with sarcopenia
Changes in urinary markers of fermentation in relation to sarcopenia (metagenomic sequencing)
Time frame: at 12 months
Quantification of fecal metabolite linked with sarcopenia
Changes in fecal markers of fermentation in relation to sarcopenia (mass spectrometry)
Time frame: at 12 months