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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SBS patients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| questionnaires with collection of stool and urine | Other | questionnaires will be completed (GPAQ, SarQoL, EQ-5D-3L, SF36), with collection of stool (for care and research) and urine |
| Measure | Description | Time Frame |
|---|---|---|
| Evolution of sarcopenia | Changes in muscle strength (Jamar's dynamometer) | at 12 months |
| Evolution of sarcopenia | Changes in muscle mass (bioimpedance analysis) | at 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Impact of sarcopenia | Changes in questionnaire of quality of life SarQoL | at 12 months |
| Impact of sarcopenia | Changes in questionnaire of quality of life EQ-5D-3L |
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Inclusion Criteria:
Exclusion Criteria:
Pregnancy
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Adult patients in CMS cared for and followed in the gastroenterology and nutritional assistance department of Beaujon Hospital
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| Name | Affiliation | Role |
|---|---|---|
| Nathalie KAPEL, MPharma PhD | APHP | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service de Coprologie Fonctionnelle Hôpital Pitié-Salpêtrière | Paris | 75013 | France |
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| ID | Term |
|---|---|
| D012778 | Short Bowel Syndrome |
| D055948 | Sarcopenia |
| ID | Term |
|---|---|
| D008286 | Malabsorption Syndromes |
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| D014554 | Urination |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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| at 12 months |
| Impact of sarcopenia | Changes in questionnaire of quality of life SF36 | at 12 months |
| Impact of sarcopenia | Changes in questionnaire of physical activity (GPAQ) | 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. | at 12 months |
| Link with intestinal adaptation | Changes in biological markers of adaptation in relation to sarcopenia: ApoB48, citrulline, leptin, nutrients | at 12 months |
| Quantification of intestinal adsorption and its link with intestinal adaptation | 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. | 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) | at 12 months |
| Quantification of urinary metabolite linked with sarcopenia | Changes in urinary markers of fermentation in relation to sarcopenia (metagenomic sequencing) | at 12 months |
| Quantification of fecal metabolite linked with sarcopenia | Changes in fecal markers of fermentation in relation to sarcopenia (mass spectrometry) | at 12 months |
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009133 | Muscular Atrophy |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D012816 | Signs and Symptoms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
| D014553 | Urinary Tract Physiological Phenomena |
| D012101 | Reproductive and Urinary Physiological Phenomena |