A large volume of visceral adipose tissue leads to severe acute pancreatitis

Yashima, Yoko; Isayama, Hiroyuki; Tsujino, Takeshi; Nagano, Reiko; Yamamoto, Keisuke; Mizuno, Suguru; Yagioka, Hiroshi; Kawakubo, Kazumichi; Sasaki, Takashi; Kogure, Hirofumi; Nakai, Yousuke; Hirano, Keisuke; Sasahira, Naoki; Tada, Minoru; Kawabe, Takao; Koike, Kazuhiko; Omata, Masao

doi:10.1007/s00535-011-0430-x

Cited by 84 publications

(58 citation statements)

References 27 publications

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“…Indeed, visceral fat was the only variable with a strong correlation to severity on multivariate analysis. 4 The association of visceral fat and poor outcomes may originate from its propensity to release cytokines and its necrosis predisposing to pseudocyst and acute fluid collection formation, particularly when the necrotic region becomes infected and may therefore lead to an increased risk of local complications. 8 , 20 The study by O'Leary, however, did not find any association between visceral fat volume and increased local complications.…”

Section: Discussionmentioning

confidence: 99%

Is Abdominal Fat Distribution Measured by Axial CT Imaging an Indicator of Complications and Mortality in Acute Pancreatitis?

Hall

Stephenson

Jones

et al. 2015

Journal of Gastrointestinal Surgery

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Section: Discussionmentioning

confidence: 99%

Is Abdominal Fat Distribution Measured by Axial CT Imaging an Indicator of Complications and Mortality in Acute Pancreatitis?

Hall

Stephenson

Jones

et al. 2015

Journal of Gastrointestinal Surgery

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“…NAFLD is a well-recognized objective marker of visceral obesity [4][5][6] Obesity is associated with increased incidence and even worsened severity on AP. A pooled data of 3 studies involving 1029 patients showed that relative risk of developing AP in individuals with a waist circumference >105 cm as compared to individuals with waist circumference <75 cm was 2.37 (95% CI 1.50-3.74).…”

Section: Discussionmentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease as a Risk Factor for Acute Pancreatitis: A Case Control Study

M¹

2015

Emerg Med (Los Angel)

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Objective: Visceral obesity is an etiological factor and a marker of poor prognosis in acute pancreatitis (AP). Non-Alcoholic Fatty Liver Disease (NAFLD), a marker for visceral obesity, has also been recognized to have a stronger correlation to poor outcomes. With this study, we aim to assess the role of NAFLD as an etiologic factor in patients with AP. Materials and Methods:In this retrospective electronic medical record (EMR) based case control study of 530 non-alcoholic adults were classified into cases with acute pancreatitis and controls without pancreatitis. Further subgroup was classified based on gallstone formation as an etiology of pancreatitis. Data was evaluated with McNemar's Test. Results:Results showed that patients with AP due to Gallstones had a higher incidence of NAFLD as seen on abdominal imaging [OR=1.688, p=0.0235 (CI: 1.070-2.701)], but Patients with AP due to unclear etiology did not have statistically significant higher rates of NAFLD [OR: 1.400, CI: 0.688 -2.919]. Patients with AP due to all etiologies combined had higher incidence of NAFLD [(OR: 1.596, CI: 1.094-2.349, P-value 0.0145)]. Conclusion:We conclude from this study shows that NAFLD may be an independent risk factor for development of acute pancreatitis. It is also possible that NAFLD may have pathophysiologic interplay with formation of gallstones that is a known risk factor for acute pancreatitis.

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“…The role of fatty pancreas in patients with NAFLD is not clear [21]. Metabolic fat (central, visceral obesity), as measured by waist circumference or visceral adipose tissue assessment on CT abdomen, predicts a poor outcome in patients with AP better as compared to Body Mass Index (BMI) [13][14][15]. Although inexpensive, waist circumference currently is not routinely recorded and when done, is subject to measurement bias [13].…”

Section: Discussionmentioning

confidence: 99%

“…A smaller number of recent studies have specifically assessed the role of visceral obesity in poor prognosis of AP [13][14][15]. Lipotoxicity is related to visceral adiposity and fatty liver than with generalized obesity.…”

Section: Discussionmentioning

confidence: 99%

NAFLD Diagnosed with Abdominal Ultrasound is a Marker of Severity in Acute Pancreatitis

Jasdanwala¹

2015

J Gastrointest Dig Syst

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Objective: Obesity, particularly metabolic obesity, is associated with an increased incidence and enhanced severity of acute pancreatitis (AP). Non Alcoholic Fatty Liver Disease (NAFLD) is a marker of metabolic obesity, which can be easily diagnosed, with the help of initial abdominal ultrasound (AUS) routinely performed in all patients with AP upon admission to assess a biliary etiology. The aim of this study is to identify the clinical utility of detecting NAFLD by AUS in determining the severity of patients with AP Methods: Five hundred and seventy four patients with non-alcoholic AP were divided into two groups on the basis of presence or absence of NAFLD detected by AUS at the time of admission. The diagnosis of NAFLD was based solely on imaging findings. Well-established single markers of prognosis as well as scoring systems were studied in both groups. The data was analyzed using the student's t-test, chi-square test and multivariate regression analysis. Results:Patients with NAFLD had a more severe disease as compared to patients without NAFLD as measured by single markers of prognosis like serum albumin, mean length of stay, ICU admission and mortality as well as scoring systems like BISAP score and Modified Atlanta Classification system ( P value < 0.05) BMI, by itself, was not associated with any difference in outcomes in patients with and without NAFLD as assessed by multivariate regression analysis. Age, sex and individual components of metabolic syndrome also had no influence on the prognostic markers Conclusion: Presence of NAFLD as diagnosed by early AUS can be used as an additional single marker of prognosis in AP. The diagnosis of NAFLD is objective and almost always available at the time of initial presentation of AP.

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A large volume of visceral adipose tissue leads to severe acute pancreatitis

Cited by 84 publications

References 27 publications

Is Abdominal Fat Distribution Measured by Axial CT Imaging an Indicator of Complications and Mortality in Acute Pancreatitis?

Is Abdominal Fat Distribution Measured by Axial CT Imaging an Indicator of Complications and Mortality in Acute Pancreatitis?

Non-Alcoholic Fatty Liver Disease as a Risk Factor for Acute Pancreatitis: A Case Control Study

NAFLD Diagnosed with Abdominal Ultrasound is a Marker of Severity in Acute Pancreatitis

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