O40 High prevalence of sarcopenic obesity in pancreatic exocrine insufficiency patients: a prospective study

Background Pancreatic exocrine insufficiency (PEI) is an important cause of malnutrition. There is scarce information on the effect of PEI on body composition including muscle mass. Objective To assess the prevalence of sarcopenia using a novel skeletal muscle recognition software in PEI patients compared to normal exocrine function. The secondary aim was to assess the prevalence of sarcopenia in PEI with normal BMI compared to those with PEI and obesity. Methods Prospective recruitment of patients referred for endoscopic ultrasound examination for the assessment of chronic pancreatitis and/or abdominal pain. All pancreatic enzyme replacement therapy naive and none had steatorrhoea as a main symptom. Age, sex, BMI, presence of DM, smoking and alcohol history were collected. FEL-1 Results A total of 102 patients were recruited, median age 52 years, 52(51%) female. PEI was present in 46(45.1%) patients. Diagnosis of CP based on EUS and cross section images was made in 21(45.6%) patients in PEI compared to 7(12.5%) in normal FEL-1, p=0.003. Sarcopenia was prevalent in PEI group 31(67.4%) compared to normal FEL-1 18(32.1%), p=0.0006. Similar prevalence of sarcopenia was found in PEI with no-CP 66.7% and in PEI with CP 68.2%. Sarcopenic obesity was more prevalent in PEI 14/20 (70%) compared to normal FEL-1 8/28(28.6%), p=0.008. Sarcopenia and DM was strongly associated with PEI in multivariate analysis. Pack-year smoking was significantly higher in PEI, p=0.03. Conclusions Sarcopenia was strongly associated with PEI. The prevalence of sarcopenia was the same in both PEI with CP and PEI with no-CP. Risk of sarcopenia still exit in PEI patients with obesity, therefore, quantification of skeletal muscle using digital analysis software could make a rapid, and objective assessment of nutritional status.