Саркопения у пациентов с воспалительными заболеваниями кишечника (обзор литературы)
Аннотация. В обзоре обобщены современные сведения о саркопении у пациентов с воспалительными заболеваниями кишечника (ВЗК). Рассмотрены данные о частоте встречаемости саркопении, ее клиническом значении, диагностических подходах и предполагаемых механизмах формирования на фоне хронического воспаления, мальабсорбции и нутритивной недостаточности. Представлен практический алгоритм диагностики и изложены актуальные стратегии лечения, основанные на коррекции питания, физической реабилитации и контроле воспалительного процесса. Цель работы – обобщить и систематизировать современные данные о распространенности саркопении у пациентов с ВЗК, раскрыть ключевые механизмы ее патогенеза и диагностические маркеры, а также представить практико-ориентированный алгоритм выявления этого состояния на амбулаторном этапе и подходы к лечению с акцентом на раннюю диагностику и клиническую значимость для оценки активности ВЗК.К.Ш. Фазлыахметова, Л.Д. Садретдинова, Х.Х. Ганцева, А.С. Сарсенбаева, А.В. Тюрин
Ключевые слова
Список литературы
- Mak WY, Zhao M, Ng SC, Burisch J. The epidemiology of inflammatory bowel disease: East meets west. J Gastroenterol Hepatol. 2020;35(3):380–89.
PMID: 31596960. https://doi.org/10.1111/jgh.14872
- Jabłonska B, Mrowiec S. Nutritional status and its detection in patients with inflammatory bowel diseases. Nutrients. 2023;15(8):1991.
PMID: 37111210. PMCID: PMC10143611. https://doi.org/10.3390/nu15081991
- Cankurtaran RE, Gunes YC, Dirican E, Algın O, Cankurtaran D, Tayfur Yurekli O. Sarcopenia and myosteatosis assessed by magnetic resonance enterography may predict negative outcomes in patients with Crohn’s disease. Turk J Gastroenterol. 2023;34(8):839–49.
PMID: 37404120. PMCID: PMC10543407. https://doi.org/10.5152/tjg.2023.22644
- Faye AS, Khan T, Cautha S, Kochar B. Sarcopenia in inflammatory bowel diseases: Reviewing past work to pave the path for the future. Curr Treat Options Gastroenterol. 2022;20(3):250–60.
PMID: 36388172. PMCID: PMC9648863. https://doi.org/10.1007/s11938-022-00389-8
- Bamba S, Sasaki M, Takaoka A, Takahashi K, Imaeda H, Nishida A, et al. Sarcopenia is a predictive factor for intestinal resection in admitted patients with Crohn’s disease. PLoS One. 2017;12(6):e0180036.
PMID: 28644887. PMCID: PMC5482469. https://doi.org/10.1371/journal.pone.0180036
- Садретдинова Л.Д., Ганцева Х.Х., Ахиярова К.Э., Хафизов М.М., Тюрин А.В. Саркопения, ассоциированная с заболеваниями печени и желчевыводящих путей. Экспериментальная и клиническая гастроэнтерология. 2024;(10):179–185. [Sadretdinova LD, Gantseva HH, Akhiyarova KE, Khafizov MM, Tyurin AV. Sarcopenia associated with liver diseases and biliary tract. Eksperimental’naya i klinicheskaya gastroenterologiya = Experimental and Clinical Gastroenterology. 2024;(10):179–185 (In Russ.)].
EDN: HLWLAE. https://doi.org/10.31146/1682-8658-ecg-230-10-179-185
- Massironi S, Vigano C, Palermo A, Pirola L, Mulinacci G, Allocca M, et al. Inflammation and malnutrition in inflammatory bowel disease. Lancet Gastroenterol Hepatol. 2023;8(6):579–90.
PMID: 36933563. https://doi.org/10.1016/S2468-1253(23)00011-0
- Ryan E, McNicholas D, Creavin B, Kelly ME, Walsh T, Beddy D. Sarcopenia and inflammatory bowel disease: A systematic review. Inflamm Bowel Dis. 2019;25(1):67–73.
PMID: 29889230. https://doi.org/10.1093/ibd/izy212
- Unal NG, Oruc N, Tomey O, Omer Ozutemiz A. Malnutrition and sarcopenia are prevalent among inflammatory bowel disease patients with clinical remission. Eur J Gastroenterol Hepatol. 2021;33(11):1367–75.
PMID: 33470696. https://doi.org/10.1097/MEG.0000000000002044
- Gold SL, Raman M, Sands BE, Ungaro R, Sabino J. Review article: Putting some muscle into sarcopenia – the pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2023;57(11):1216–30.
PMID: 37051722. https://doi.org/10.1111/apt.17498
- Pizzoferrato M, de Sire R, Ingravalle F, Mentella MC, Petito V, Martone AM, et al. Characterization of sarcopenia in an IBD population attending an Italian gastroenterology tertiary center. Nutrients. 2019;11(10):2281.
PMID: 31554166. PMCID: PMC6835412. https://doi.org/10.3390/nu11102281
- Dermine S, Bazin T, Hassan FA, Bettolo J, Billiauws L, Bourdillel J, et al. Prevalence and impact of sarcopenia in patients with inflammatory bowel diseases: A prospective cohort study. Clin Res Hepatol Gastroenterol. 2025;49(4):102555.
PMID: 40021084. https://doi.org/10.1016/j.clinre.2025.102555
- Bezzio C, Brinch D, Ribaldone DG, Cappello M, Ruzzon N, Vernero M, et al. Prevalence, risk factors and association with clinical outcomes of malnutrition and sarcopenia in inflammatory bowel disease: A prospective study. Nutrients. 2024;16(23):3983.
PMID: 39683376. PMCID: PMC11643262. https://doi.org/10.3390/nu16233983
- Neelam PB, Sharma A, Sharma V. Sarcopenia and frailty in inflammatory bowel disease: emerging concepts and evidence. JGH Open. 2024;8(1):e13033.
PMID: 38283070. PMCID: PMC10821747. https://doi.org/10.1002/jgh3.13033
- Kreienbuehl AS, Rogler G, Emanuel B, Biedermann L, Meier C, Juillerat P, et al. Bone health in patients with inflammatory bowel disease. Swiss Med Wkly. 2024;154:3407.
PMID: 38875461. https://doi.org/10.57187/s.3407
- He C, Huang G, Bi J, Fu W, Liu CJ. cPLA2 in musculoskeletal and autoimmune diseases: Molecular mechanisms and therapeutic insights. Cytokine Growth Factor Rev. 2026;88:18–31.
PMID: 41512597. https://doi.org/10.1016/j.cytogfr.2026.01.002
- Marzban Abbas Abadi M, Emadian ST, Zamani M, Khalilizad M. Prevalence of osteoporosis in patients with inflammatory bowel disease: A systematic review and meta-analysis. J Health Popul Nutr. 2025;44(1):178.
PMID: 40442831. PMCID: PMC12123853. https://doi.org/10.1186/s41043-025-00946-8
- Calvez V, Becherucci G, Covello C, Piccirilli G, Mignini I, Esposto G, et al. Navigating the intersection: Sarcopenia and sarcopenic obesity in inflammatory bowel disease. Biomedicines. 2024;12(6):1218.
PMID: 38927425. PMCID: PMC11200968. https://doi.org/10.3390/biomedicines12061218
- Maresca R, Mignini I, Varca S, Calvez V, Termite F, Esposto G, et al. Inflammatory bowel diseases and non-alcoholic fatty liver disease: Piecing a complex puzzle together. Int J Mol Sci. 2024;25(6):3278.
PMID: 38542249. PMCID: PMC10970310. https://doi.org/10.3390/ijms25063278
- Sleutjes JAM, van der Woude CJ, Verploegh PJP, Aribas E, Kavousi M, Roeters van Lennep JE, de Vries AC. Cardiovascular risk profiles in patients with inflammatory bowel disease. Eur J Prev Cardiol. 2023;30(15):1615–22.
PMID: 37075221. https://doi.org/10.1093/eurjpc/zwad124
- Noble O, Jeon D, Lewis M, Fan C, Nasir K, Abraham BP. From gut inflammation to cardiovascular conflagration: Mapping IBD’s cardiometabolic risks. Curr Atheroscler Rep. 2025;27(1):89.
PMID: 40928712. https://doi.org/10.1007/s11883-025-01329-4
- Sanchez Cruz C, Rojas Huerta A, Lima Barrientos J, Rodriguez C, Devani A, Boosahda V, et al. Inflammatory bowel disease and cardiovascular disease: An integrative review with a focus on the gut microbiome. Cureus. 2024;16(7):e65136.
PMID: 39170992. PMCID: PMC11338650. https://doi.org/10.7759/cureus.65136
- Barone M, Baccaro P, Molfino A. An overview of sarcopenia: Focusing on nutritional treatment approaches. Nutrients. 2025;17(7):1237.
PMID: 40218995. PMCID: PMC11990658. https://doi.org/10.3390/nu17071237
- de Sire A, de Sire R, Petito V, Masi L, Cisari C, Gasbarrini A, et al. Gut-joint axis: The role of physical exercise on gut microbiota modulation in older people with osteoarthritis. Nutrients. 2020;12(2):574.
PMID: 32098380. PMCID: PMC7071456. https://doi.org/10.3390/nu12020574
- Halfvarson J, Brislawn CJ, Lamendella R, Vazquez-Baeza Y, Walters WA, Bramer LM, et al. Dynamics of the human gut microbiome in inflammatory bowel disease. Nat Microbiol. 2017;2:17004.
PMID: 28191884. PMCID: PMC5319707. https://doi.org/10.1038/nmicrobiol.2017.4
- Ni J, Wu GD, Albenberg L, Tomov VT. Gut microbiota and IBD: causation or correlation? Nat Rev Gastroenterol Hepatol. 2017;14(10):573–84.
PMID: 28743984. PMCID: PMC5880536. https://doi.org/10.1038/nrgastro.2017.88
- Shah A, Morrison M, Burger D, Martin N, Rich J, Jones M, et al. Systematic review with meta-analysis: The prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease. Aliment Pharmacol Ther. 2019;49(6):624–35.
PMID: 30735254. https://doi.org/10.1111/apt.15133
- Singh A, Wall C, Levine A, Midha V, Mahajan R, Sood A. Nutritional screening and assessment in inflammatory bowel disease. Indian J Gastroenterol. 2022;41(1):5–22.
PMID: 35031977. https://doi.org/10.1007/s12664-021-01223-2
- Bian AL, Hu HY, Rong YD, Wang J, Wang JX, Zhou XZ. A study on relationship between elderly sarcopenia and inflammatory factors IL-6 and TNF-α. Eur J Med Res. 2017;22(1):25.
PMID: 28701179. PMCID: PMC5508730. https://doi.org/10.1186/s40001-017-0266-9
- Валеева Ф.В., Родыгина Ж.А., Йылмаз Т.С. Роль генов и миокинов в прогнозировании риска развития саркопении. Consilium Medicum. 2024;26(4):219–24. Valeeva FV, Rodygina ZA, Yilmaz TS. The role of genes and myokines of developing sarcopenia: A review. Consilium Medicum. 2024;26(4):219–24 (In Russ.)].
EDN: UHKJUI. https://doi.org/10.26442/20751753.2024.4.202735
- Guo M, Yao J, Li J, Zhang J, Wang D, Zuo H, et al. Irisin ameliorates age-associated sarcopenia and metabolic dysfunction. J Cachexia Sarcopenia Muscle. 2023;14(1):391–405.
PMID: 36510115. PMCID: PMC9891925. https://doi.org/10.1002/jcsm.13141
- Бикбавова Г.Р., Ливзан М.А., Тихонравова Д.В., Лисютенко Н.С., Романюк А.Е. Саркопения и воспалительные заболевания кишечника: механизм развития и практическое значение. РМЖ. 2023;(5):39–42. [Bikbavova GR, Livzan MA, Tikhonravova DV, Lisyutenko NS, Romanyuk AE. Sarcopenia and inflammatory bowel diseases: Pathogenetic mechanism and practical significance. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2023;(5):39–42 (In Russ.)]. EDN: DTKQMJ.
- Abdelrahman Z, Wang X, Wang D, Zhang T, Zhang Y, Wang X, Chen Z. Identification of novel pathways and immune profiles related to sarcopenia. Front Med (Lausanne). 2023;10:928285.
PMID: 37138756. PMCID: PMC10149827. https://doi.org/10.3389/fmed.2023.928285
- Nishikawa H, Nakamura S, Miyazaki T, Kakimoto K, Fukunishi S, Asai A, et al. Inflammatory bowel disease and sarcopenia: Its mechanism and clinical importance. J Clin Med. 2021;10(18):4214.
PMID: 34575326. PMCID: PMC8470813. https://doi.org/10.3390/jcm10184214
- Mafi F, Biglari S, Ghardashi Afousi A, Gaeini AA. Improvement in skeletal muscle strength and plasma levels of follistatin and myostatin induced by an 8-week resistance training and epicatechin supplementation in sarcopenic older adults. J Aging Phys Act. 2019;27(3):384–91.
PMID: 30299198. https://doi.org/10.1123/japa.2017-0389
- Choi K, Jang HY, Ahn JM, Hwang SH, Chung JW, Choi YS, et al. The association of the serum levels of myostatin, follistatin, and interleukin-6 with sarcopenia, and their impacts on survival in patients with hepatocellular carcinoma. Clin Mol Hepatol. 2020;26(4):492–505.
PMID: 32646201. PMCID: PMC7641544. https://doi.org/10.3350/cmh.2020.0005
- Harada M, Morikawa M, Ozawa T, Kobayashi M, Tamura Y, Takahashi K, et al. Palbociclib enhances activin-SMAD-induced cytostasis in estrogen receptor-positive breast cancer. Cancer Sci. 2019;110(1):209–20.
PMID: 30343527. PMCID: PMC6317929. https://doi.org/10.1111/cas.13841
- Godala M, Gaszynska E, Walczak K, Małecka-Wojciesko E. Myostatin and activin A as biomarkers of sarcopenia in inflammatory bowel disease patients. Nutrients. 2024;16(6):810.
PMID: 38542721. PMCID: PMC10974648. https://doi.org/10.3390/nu16060810
- Cakar S, Eren G, Erdur CB, Onder M, Pelek S, Demirtas D, et al. Are vitamin D levels related to sarcopenia in children with inflammatory bowel disease? J Clin Med. 2025;14(5):1548.
PMID: 40095479. PMCID: PMC11900381. https://doi.org/10.3390/jcm14051548
- Ooi PH, Thompson-Hodgetts S, Pritchard-Wiart L, Gilmour SM, Mager DR. Pediatric sarcopenia: A paradigm in the overall definition of malnutrition in children? JPEN J Parenter Enteral Nutr. 2020;44(3):407–18.
PMID: 31328301. https://doi.org/10.1002/jpen.1681
- Cakar S, Eren G. Diagnosis of sarcopenia with magnetic resonance imaging of newly diagnosed pediatric inflammatory bowel disease. Ann Clin Anal Med. 2023;14(Suppl 3):301–5.
https://doi.org/10.4328/ACAM.21913
- Caraceni P, Domenicali M, Tovoli A, Napoli L, Ricci CS, Tufoni M, Bernardi M. Clinical indications for the albumin use: Still a controversial issue. Eur J Intern Med. 2013;24(8):721–28.
PMID: 23790570. https://doi.org/10.1016/j.ejim.2013.05.015
- Zhang Q, Pereira SL, Luo M, Matheson EM. Evaluation of blood biomarkers associated with the risk of malnutrition in older adults: A systematic review and meta-analysis. Nutrients. 2017;9(8):829.
PMID: 28771192. PMCID: PMC5579622. https://doi.org/10.3390/nu9080829
- Ingenbleek Y. Plasma transthyretin is a nutritional biomarker in human morbidities. Front Med. 2022;16(4):540–50.
PMID: 35943703. PMCID: PMC9361973. https://doi.org/10.1007/s11684-022-0940-3
- Loh KW, Vriens MR, Gerritsen A, Borel Rinkes IH, van Hillegersberg R, Schippers C, et al. Unintentional weight loss is the most important indicator of malnutrition among surgical cancer patients. Neth J Med. 2012;70(8):365–69. PMID: 23065984.
- Wiech P, Dąbrowski M, Bazalinski D, Salacinska I, Korczowski B, Binkowska-Bury M. Bioelectrical impedance phase angle as an indicator of malnutrition in hospitalized children with diagnosed inflammatory bowel diseases: A case-control study. Nutrients. 2018;10(4):499.
PMID: 29673210. PMCID: PMC5946284. https://doi.org/10.3390/nu10040499
- Papadimitriou K, Detopoulou P, Soufleris K, Voulgaridou G, Tsoumana D, Ntopromireskou P, et al. Nutritional risk and sarcopenia features in patients with Crohn’s disease: Relation to body composition, physical performance, nutritional questionnaires and biomarkers. Nutrients. 2023;15(16):3615.
PMID: 37630805. PMCID: PMC10458234. https://doi.org/10.3390/nu15163615
- Martin P, Botsen D, Brugel M, Bertin E, Carlier C, Mahmoudi R, et al. Association of low handgrip strength with chemotherapy toxicity in digestive cancer patients: A comprehensive observational cohort study (FIGHTDIGOTOX). Nutrients. 2022;14(21):4448.
PMID: 36364711. PMCID: PMC9654937. https://doi.org/10.3390/nu14214448
- Жданова А.С., Белая Ж.Е., Омельченко К.А., Айрапетов Г.А. Возможности диагностики саркопении: клинические, лабораторные, инструментальные. Остеопороз и остеопатии. 2025;28(3):12–23. [Zhdanova AS, Belaya ZE, Omelchenko KA, Airapetov GA. Clinical, laboratory and instrumental aspects of sarcopenia diagnostics. Osteoporoz i osteopatii = Osteoporosis and Bone Diseases. 2025;28(3):12–23 (In Russ.)].
EDN: GNREFO. https://doi.org/10.14341/osteo13206
- Seron-Arbeloa C, Labarta-Monzon L, Puzo-Foncillas J, Mallor-Bonet T, Lafita-Lopez A, Bueno-Vidales N, Montoro-Huguet M. Malnutrition screening and assessment. Nutrients. 2022;14(12):2392.
PMID: 35745121. PMCID: PMC9228435. https://doi.org/10.3390/nu14122392
- Kruizenga HM, Seidell JC, de Vet HC, Wierdsma NJ, van Bokhorst-de van der Schueren MA. Development and validation of a hospital screening tool for malnutrition: The short nutritional assessment questionnaire (SNAQ). Clin Nutr. 2005;24(1):75–82.
PMID: 15681104. https://doi.org/10.1016/j.clnu.2004.07.015
- Rubenstein LZ, Harker JO, Salvà A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci. 2001;56(6):M366–M372.
PMID: 11382797. https://doi.org/10.1093/gerona/56.6.m366
- Boros KK, Veres G, Pinter HK, Richter E, Cseh A, Dezsofi A, et al. Novel approach to assess sarcopenia in children with inflammatory bowel disease. Front Pediatr. 2024;12:1204639.
PMID: 39629099. PMCID: PMC11611584. https://doi.org/10.3389/fped.2024.1204639
- Hu Q, Long Q, Wang W, Ma M. Bioelectrical impedance analysis for measuring body composition and predicting low muscle mass in apparently healthy pediatric outpatients: A retrospective observational study. BMC Pediatr. 2025;25(1):303.
PMID: 40241085. PMCID: PMC12004640. https://doi.org/10.1186/s12887-025-05579-8
- Celentano V, Kamil-Mustafa L, Beable R, Ball C, Flashman KG, Jennings Z, et al. Preoperative assessment of skeletal muscle mass during magnetic resonance enterography in patients with Crohn’s disease. Updates Surg. 2021;73(4):1419–27.
PMID: 32410158. PMCID: PMC8397655. https://doi.org/10.1007/s13304-020-00790-x
- Perkisas S, Bastijns S, Baudry S, Bauer J, Beaudart C, Beckwee D, et al. Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update. Eur Geriatr Med. 2021;12(1):45–59.
PMID: 33387359. https://doi.org/10.1007/s41999-020-00433-9
- Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyere O, Cederholm T, et al.; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.
PMID: 30312372. PMCID: PMC6322506. https://doi.org/10.1093/ageing/afy169. Erratum in: Age Ageing. 2019;48(4):601.
https://doi.org/10.1093/ageing/afz046
- Haskey N, Pena-Sanchez JN, Jones JL, Fowler SA. Development of a screening tool to detect nutrition risk in patients with inflammatory bowel disease. Asia Pac J Clin Nutr. 2018;27(4):756–62.
PMID: 30045418. https://doi.org/10.6133/apjcn.112017.01
- Gold SL, Bhanji RA, Epp S, Tandon P. Putting some muscle into sarcopenia: The pathogenesis, assessment and clinical impact of muscle loss in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2023;57(8):807–23.
PMID: 36645152. PMCID: PMC11497233. https://doi.org/10.1111/apt.17392
- RadiologyInfo. Bone density scan (DEXA or DXA). Last reviewed on March 11, 2024. URL: https://www.radiologyinfo.org/en/info/dexa (date of access – 15.08.2026).
- Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Hooper L, Kiesswetter E, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958–89.
PMID: 35306388. https://doi.org/10.1016/j.clnu.2022.01.02
- Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, et al. Protein intake and exercise for optimal muscle function with aging: Recommendations from the ESPEN Expert Group. Clin Nutr. 2014;33(6):929–36.
PMID: 24814383. PMCID: PMC4208946. https://doi.org/10.1016/j.clnu.2014.04.007
- Liu S, Zhang L, Li S. Advances in nutritional supplementation for sarcopenia management. Front Nutr. 2023;10:1189522.
PMID: 37492597. PMCID: PMC10365293. https://doi.org/10.3389/fnut.2023.1189522
- Zhang F, Li W. Vitamin D and sarcopenia in the senior people: A review of mechanisms and comprehensive prevention and treatment strategies. Ther Clin Risk Manag. 2024;20:577–95.
PMID: 39253031. PMCID: PMC1138265. https://doi.org/10.2147/TCRM.S471191
Об авторах / Для корреспонденции
Камилла Шамилевна Фазлыахметова, студентка 4 курса лечебного факультета ФГБОУ ВО БГМУ Минздрава России, Уфа, Республика Башкортостан.E-mail: Kamilla14.03@mail.ru
Лидия Данисовна Садретдинова, к. м. н., доцент кафедры внутренних болезней ФГБОУ ВО БГМУ Минздрава России, Уфа, Республика Башкортостан.
E-mail: shuraleyka1@mail.ru
ORCID: https://orcid.org/0000-0001-9421-9545
Халида Ханафиевна Ганцева, д. м. н., профессор кафедры внутренних болезней ФГБОУ ВО БГМУ Минздрава России, Уфа, Республика Башкортостан.
E-mail: halide.ganceva@mail.ru
ORCID: https://orcid.org/0000-0002-7217-7222
Айман Силкановна Сарсенбаева, д. м. н., профессор кафедры терапии ИДПО ФГБОУ ВО ЮУГМУ Минздрава России, Челябинск, Российская Федерация.
E-mail: aiman-ss@yandex.ru
ORCID: https://orcid.org/0000-0001-5922-2271
Антон Викторович Тюрин, д. м. н., доцент, заведующий кафедрой внутренних болезней ФГБОУ ВО БГМУ Минздрава России, Уфа, Республика Башкортостан.
E-mail: anton.bgmu@gmail.com
ORCID: https://orcid.org/0000-0002-0841-3024



