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Impact of visceral adiposity on severity of acute pancreatitis: a propensity score-matched analysis.


ABSTRACT:

Background

The relationship between visceral adiposity and acute pancreatitis (AP) has not been completely elucidated. This study evaluated the significance of visceral adipose tissue (VAT) and the ratio of VAT to skeletal muscle tissue (VAT/SMT) in the prognosis of AP patients.

Methods

Based on a 1:2 propensity score matching, 306 hospitalized patients were enrolled in the study analysis from 2010 to 2017. VAT, subcutaneous adipose tissue (SAT), and SMT were measured using unenhanced computed tomography (CT). Cox proportional hazards models were applied for the analysis.

Results

VAT and the VAT/SMT ratio were significantly higher in the severe AP (SAP) and moderately severe AP (MSAP) groups compared to the mild AP (MAP) group (both p < 0.001). Intensive care transfer, AP severity, systemic complications, and prognostic scores (Acute Physiology and Chronic Health Evaluation II [APACHE-II] score ≥ 8, Ranson's score ≥ 3, Bedside Index of Severity in Acute Pancreatitis [BISAP] score ≥ 3, and the systemic inflammatory response syndrome [SIRS] score ≥ 2) significantly correlated with VAT and the VAT/SMT ratio in AP patients. The multivariate adjusted hazard ratios (HRs) for VAT and the VAT/SMT ratio in the relationship of body parameters and AP mortality were 1.042 (95% confidence interval (CI), 1.019-1.066) and 7.820 (95% CI, 1.978-30.917), respectively. Compared with other prognostic scores, VAT had the highest area under the curve of receiver operating characteristics (ROC) (0.943, 95% CI, 0.909-0.976).

Conclusion

High VAT and VAT/SMT ratio are independent negative prognostic indicators of AP.

Trial registration

Clinical study registration number: NCT03482921 . Date of registration: 03/23/2018.

SUBMITTER: Xie J 

PROVIDER: S-EPMC6567912 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Impact of visceral adiposity on severity of acute pancreatitis: a propensity score-matched analysis.

Xie Jiarong J   Xu Lu L   Pan Yuning Y   Li Peifei P   Liu Yi Y   Pan Yue Y   Xu Lei L  

BMC gastroenterology 20190613 1


<h4>Background</h4>The relationship between visceral adiposity and acute pancreatitis (AP) has not been completely elucidated. This study evaluated the significance of visceral adipose tissue (VAT) and the ratio of VAT to skeletal muscle tissue (VAT/SMT) in the prognosis of AP patients.<h4>Methods</h4>Based on a 1:2 propensity score matching, 306 hospitalized patients were enrolled in the study analysis from 2010 to 2017. VAT, subcutaneous adipose tissue (SAT), and SMT were measured using unenha  ...[more]

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