Assessment of sarcopenia in female patients with sarcoidosis upon initial diagnosis
Keywords:
Sarcoidosis, Sarcopenia, Computed tomography, Skeletal muscle index, Cross-sectional StudyAbstract
Background and aim: There is a substantial body of literature that discusses the potential relationship between sarcopenia and sarcoidosis. This study aimed to evaluate the muscle mass of sarcoidosis patients without any treatment at the time of diagnosis using computed tomography (CT) images.
Methods: This retrospective study included only female patients, as the vast majority of sarcoidosis cases in our dataset were female, and this approach allowed us to minimize gender-related confounding. The sarcoidosis group consisted of newly diagnosed, untreated female patients who underwent abdominal CT as part of their diagnostic work-up. The control group comprised female patients with a comparable age distribution to the sarcoidosis cohort, who presented to the emergency department with non-chronic, unrelated conditions and had no history of chronic illness or medication use known to affect muscle mass. Total skeletal muscle (TSM), skeletal muscle index (SMI), and psoas muscle index (PMI) at the L3 vertebral level were measured using manual segmentation. SMI-based sex-, age-, and BMI-specific thresholds from the literature were used to define sarcopenia.
Results: A total of 168 female patients were evaluated. Sarcoidosis patients were significantly older and shorter than controls. TPM (p = 0.003), TSM (p = 0.027), SMI (p = 0.037), and PMI (p = 0.001) values were significantly lower in the sarcoidosis group. However, the prevalence of sarcopenia based on SMI criteria did not significantly differ between groups. Notably, significant muscle mass differences were most evident in the 50–60 age group.
Conclusions: Our findings suggest that muscle loss may already be present at the time of diagnosis in female sarcoidosis patients, becoming more apparent with age. Further studies with broader populations and prospective designs are needed to clarify the association between sarcoidosis and sarcopenia.
References
1. Judson MA. The clinical features of sarcoidosis: a comprehensive review. Clin Rev Allergy Immunol. 2015;49:63–78. doi:10.1007/s12016-014-8450-y
2. Iannuzzi MC, Fontana JR. Sarcoidosis: clinical presentation, immunopathogenesis, and therapeutics. JAMA. 2011;305:391–9. doi:10.1001/jama.2011.10
3. Boots AW, Drent M, Swennen EL, et al. Antioxidant status associated with inflammation in sarcoidosis: a potential role for antioxidants. Respir Med. 2009;103:364–72. doi:10.1016/j.rmed.2008.10.007
4. Hunninghake GW, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 1999;16(2):149–73.
5. Wessendorf TE, Bonella F, Costabel U. Diagnosis of sarcoidosis. Clin Rev Allergy Immunol. 2015;49:54–62. doi:10.1007/s12016-015-8475-x
6. Sharma OP. Fatigue and sarcoidosis. Eur Respir J. 1999;13:713–4. doi:10.1034/j.1399-3003.1999.13d01.x
7. Drent M, Lower EE, De Vries J. Sarcoidosis-associated fatigue. Eur Respir J. 2012;40:255–63. doi:10.1183/09031936.00002512
8. Raasing L, Veltkamp M, Datema M, Korenromp I, Grutters JC, Vogels OJ. Sarcoidosis-related small fiber neuropathy: focus on fatigue, pain, restless legs syndrome, and cognitive function. Sarcoidosis Vasc Diffuse Lung Dis. 2025;42(1):16214. doi:10.11138/sarcoidosis.2025.16214
9. Pozzan R, Salton F, Confalonieri P, et al. Autoantibodies in sarcoidosis: innocent bystander or promising biomarker for organ involvement? Sarcoidosis Vasc Diffuse Lung Dis. 2024;41(4):e2024056. doi:10.4081/sarcoidosis.2024.e2024056
10. Fanzani A, Conraads VM, Penna F, et al. Molecular and cellular mechanisms of skeletal muscle atrophy: an update. J Cachexia Sarcopenia Muscle. 2012;3:163–79. doi:10.1007/s13539-012-0074-6
11. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:16–31. doi:10.1093/ageing/afy169
12. van der Werf A, Langius JAE, et al. Percentiles for skeletal muscle index, area and radiation attenuation based on computed tomography imaging in a healthy Caucasian population. Eur J Clin Nutr. 2018 Feb;72(2):288-296. doi: 10.1038/s41430-017-0034-5
13. Cremers JP, Drent M, Elfferich MD, et al. Body composition profiling in a Dutch sarcoidosis population. Sarcoidosis Vasc Diffuse Lung Dis. 2013 Dec 17;30(4):289-99. PMID: 24351620.
14. Starshinova AA, Malkova AM, Basantsova NY, et al. Sarcoidosis as an autoimmune disease. Front Immunol. 2020;10:2933. doi:10.3389/fimmu.2019.02933
15. Spruit MA, Thomeer MJ, Gosselink R, et al. Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status. Thorax. 2005;60:32–8. doi:10.1136/thx.2004.022244
16. Esme M, Karcioglu O, Oncel A, et al. Ultrasound assessment of sarcopenia in patients with sarcoidosis. J Ultrasound Med. 2022;41:951–9. doi:10.1002/jum.15780
17. Chaigne B, Rodeia S, Benmostefa N, et al. Corticosteroid-sparing benefit of intravenous immunoglobulin in systemic sclerosis-associated myopathy: a comparative study in 52 patients. Autoimmun Rev. 2020;19:102431. doi:10.1016/j.autrev.2019.102431
18. Minetto MA, D'Angelo V, Arvat E, et al. Diagnostic work-up in steroid myopathy. Endocrine. 2018;60:219–23. doi:10.1007/s12020-017-1472-5
19. Cederholm T, Bauer JM, Boirie Y, Schneider SM, Sieber CC, Rolland Y. Toward a definition of sarcopenia. Clin Geriatr Med. 2011;27(3):341–53. doi:10.1016/j.cger.2011.04.001
20. Korkmaz C, Demircioglu S. The association of neutrophil/lymphocyte and platelet/lymphocyte ratios and hematological parameters with diagnosis, stages, extrapulmonary involvement, pulmonary hypertension, response to treatment, and prognosis in patients with sarcoidosis. Can Respir J. 2020;2020:1696450. doi:10.1155/2020/1696450
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Copyright (c) 2026 Cesur Samancı, Vefa Salt, Bilal Demir, Rauf Hamid, Ömer Faruk Sarıahmetoğlu, Kerime Hatun Acar, Seyfullah Halit Karagöz, Ahmet Üstündağ, Buket Çalışkaner Öztürk, Ersan Atahan, Fatma Ateş Ustabaşoğlu, Ahmet Baş

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