A230 SARCOPENIA IN PRIMARY SCLEROSING CHOLANGITIS AND INFLAMMATORY BOWEL DISEASE IN PAEDIATRICS AND CLINICAL IMPLICATIONS
Bibliographic record
Abstract
Abstract Background Sarcopenia is defined in paediatrics as a decrease in muscle mass for a given age. The coexistence of primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) is recognized to be a distinct entity with a distinct phenotype. However, to date, there is no study that has assessed the prevalence of sarcopenia and its clinical implications in paediatric PSC-IBD, compared to paediatric colitis. Aims We first aimed to determine whether sarcopenia is more prevalent in paediatric PSC-IBD than children with colitis without liver disease. Our secondary aim was to explore the prognostic implications of sarcopenia in paediatric PSC-IBD both for liver and IBD outcomes. Methods This was a single-center retrospective cohort study including paediatric IBD patients with and without PSC who underwent magnetic resonance enterography (MRE) for clinical care. Psoas muscle area (PMA) at the L4-5 intervertebral disc level was calculated. Sarcopenia was defined as PMA ampersand:003C 3rd percentile for age and sex. The association between PSC and sarcopenia was examined using logistic regression, adjusting for variables selected using change in estimate method. Survival analysis was used to examine the association between sarcopenia and IBD/liver outcomes. Results A total of 85 IBD patients were included – 31 PSC-IBD and 54 colitis controls. Both groups had male predominance. A higher proportion of children with PSC-IBD had pancolitis (Pampersand:003C0.001), and PSC-IBD patients had less severe clinical IBD disease activity than controls (P=0.003). Sarcopenia was present in 39% PSC-IBD and 18% colitis (odds ratio (OR) 2.7, 95%CI 1.02-7.53, P=0.044). Adjusting for endoscopic Mayo score and biologic therapy exposure prior to MRE, the adjusted OR for the association between PSC and sarcopenia was 4.22, 95%CI 1.32-13.44, P=0.015. Sarcopenic patients were younger than non-sarcopenic patients (mean 12.4(SD2.9) years versus 14.3(SD2.3) years, P=0.003), and also had lower weight and height (Pampersand:003C0.001, P=0.002, respectively). Sarcopenia was not a risk factor for escalation to biologics and/or surgery (hazards ratio (HR) 1.18, 95%CI 0.55-2.50, P=0.67) nor for progression to liver fibrosis and/or portal hypertension (HR 0.40, 95%CI 0.044-3.54, P=0.40). Conclusions Sarcopenia was 4 times more frequent in PSC-IBD compared to colitis controls in our cohort, after accounting for differences in IBD severity and biologic exposure. Sarcopenia may represent an additional feature that is distinct to PSC-IBD versus colitis without associated PSC. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".