Assessment of Acute Pancreatitis Severity and Prognosis with CT-Measured Body Composition

Abstract

The aim of this study was to investigate the possible association of muscle and adipose parameters with the severity and prognosis of patients hospitalized with acute pancreatitis (AP). Methods: A total of 392 hospitalized patients and 309 controls were enrolled in the study analysis from April 1, 2016, to February 1, 2021. The computed tomography scans of each population were evaluated for muscle and adipose parameters. The effects of parameters on developing moderately severe acute pancreatitis (MSAP) or severe acute pancreatitis (SAP) were evaluated using univariate and multivariate logistic regression analyses. Associations with disease recurrence and death were analyzed through Cox regression analysis. Results: The AP patients had higher levels of visceral adipose tissue (144.25 vs 97.81 cm 2 , p < 0.001) and subcutaneous adipose tissue (135 vs 120 cm 2 , p < 0.001) but lower levels of adipose tissue attenuation (visceral and subcutaneous) and skeletal muscle attenuation (SMA) than the controls (p < 0.05, respectively). Visceral adipose tissue (VAT) and SMA differed significantly with p-values of 0.014 and 0.003 in the different severity groups of AP. In multivariate analysis, VAT and SMA were associated with MSAP or SAP, with odds ratios of 1.003 and 0.973, respectively (95% CI 1.000-1.006, p = 0.041; 95% CI 0.953-0.993, p = 0.010). Cox regression analysis showed that low SMA was strongly associated with an increased mortality in MSAP and SAP patients (HR 10.500, 95% CI 1.344-82.025, p = 0.025). Regression analysis also showed an association of VAT loss of more than 17% with reduced 1-year recurrence of acute pancreatitis (HR 0.427, 95% CI 0.189-0.967, p = 0.041). Conclusion:VAT and SMA were influential factors for the severity and prognosis of patients with AP. Patients should proper diet and exercise after discharge to reduce VAT and strengthen muscle function to improve prognosis.

The Optimal Axial Anatomical Site for a Single-Slice Area to Quantify the Total Volume of Visceral Adipose Tissue in Quantitative CT

“…Abdominal fat quantifications can be measured accurately using computed tomography (CT) (11)(12)(13)(14), quantitative CT (QCT) (15)(16)(17), magnetic resonance imaging (MRI) (18,19), and bio-impedance analysis (BIA) (17). However, CT scan delivers radiation dosage exposure on patients and MRI in the assessment of VAT quantification is restricted by its time consuming and high costs.…”

Assessing Visceral Obesity and Abdominal Adipose Tissue Distribution in Healthy Populations Based on Computed Tomography: A Large Multicenter Cross-Sectional Study

“…Adipose tissue parameters were quantified using SliceOmatic (V5.0, Tomovision, Magog, Canada) software. Tissue segmentation was performed using Hounsfield unit thresholds of −150 to −50 for visceral adipose tissue and −190 to −30 for subcutaneous adipose tissue ( 13 ) ( Figure 1 ). Visceral adipose tissue area (VATA) is highlighted in yellow and the subcutaneous adipose tissue area is purple.…”

Effect of sarcopenia on liver cirrhosis with complicating esophageal and gastric varices after endoscopic therapy

“…The detailed information of the included patients is shown in Table 1. A total of 309 donors were also selected, and these donors were diagnosed with gastrointestinal polyps, mild gastroesophageal reflux disease, chronic gastritis, or dyspepsia as previously described [4]. The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethics Committee of PLA Rocket Force Characteristic Medical Center.…”

“…In this study, we included 309 donors, who were described previously [4]. The rate of sarcopenia in the donors was 17.4%, which was significantly lower than that in LC-EGVB patients (41.2%).…”

“…We also found that VAT and SMT were influential factors for the severity and prognosis of patients with acute pancreatitis. Patients should have a proper diet and exercise program after discharge to reduce VAT and strengthen muscle function to improve prognosis [4].…”