Creeping Fat Assessed by Small Bowel MRI Is Linked to Bowel Damage and Abdominal Surgery in Crohn’s Disease

Althoff, P.-H.; Schmiegel, Wolff; Lang, Gernot; Nicolas, Volkmar; Brechmann, Thorsten

doi:10.1007/s10620-018-5303-1

Cited by 26 publications

(13 citation statements)

References 43 publications

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“…VFA increased as disease activity decreased during treatment follow-up, which might be partly attributed to mesenteric fatty proliferation near the diseased bowel segment, represented by creeping fat. Creeping fat is defined as an increase in fat appearing as a blank space that results in the separation or displacement of the adjacent bowel loops [ 36 ]. This accumulation in mesenteric fat correlates with the degree of bowel inflammation and fibrosis [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Lee

Kim²,

Ko³

et al. 2022

Diagnostics

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Objectives: To analyze serial changes in body composition and investigate the association between body composition changes and disease activity changes in patients with Crohn’s disease (CD). Methods: Seventy-one patients with CD who had been treated and followed-up at our institution were included. Two to four computed tomography images were acquired at baseline, and the 2–5-year, 5–8-year, and last follow-ups were selected per patient for body composition and disease activity analyses. Visceral fat area (VFA), skeletal muscle index (SMI; skeletal muscle area/height2), and subcutaneous fat area (SFA) were assessed using an artificial-intelligence-driven fully automated method. Disease activity was assessed using a modified computed tomography scoring system and the Simple Endoscopic Score for Crohn’s Disease. The associations between body composition, disease activity, and remission were investigated. Results: The mean age was 29.83 ± 11.27 years; most patients were men (48/71, 67.6%); and the median follow-up was 144 (12–264) months. Overall, VFA and SFA gradually increased, while SMI decreased during the follow-up. Sarcopenia was associated with the female sex, higher disease activities at baseline (p = 0.01) and the last follow-up (p = 0.001). SMI and SFA inversely correlated with the disease activity, i.e., the more severe the disease activity, the lower the SMI and SFA (p < 0.05). SMI at the last follow-up was the only significant predictor of remission (OR = 1.21, 95% confidence interval: 1.03–1.42, p = 0.021). Conclusion: SMI decreased while VFA and SFA increased during the treatment follow-up in patients with CD. Sarcopenia was associated with higher disease activity, and SMI and SFA inversely correlated with disease activity. SMI at the last follow-up was the significant factor for remission.

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Section: Discussionmentioning

confidence: 99%

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Lee

Kim²,

Ko³

et al. 2022

Diagnostics

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“…Altered MAT near the affected intestinal area is considered to be characteristic of severe CD [6,[27][28][29][30]. Persistent alterations in this tissue even after endoscopic remission can be observed by magnetic resonance imaging [31], and may be associated with a complicated disease course and abdominal surgery in CD [32]. There is now more evidence to link intestinal and mesenteric abnormalities in CD, and this knowledge may influence clinical and surgical management of this disease.…”

Section: Discussionmentioning

confidence: 99%

Whole transcriptional analysis identifies markers of B, T and plasma cell signaling pathways in the mesenteric adipose tissue associated with Crohn’s disease

et al. 2020

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Background: Crohn's disease (CD) is a multifactorial disease characterized by chronic intestinal inflammation. The increased visceral adiposity near the affected intestinal area, of which mesenteric adipose tissue (MAT) is the main component, is a feature of CD. Both protective and pathological roles have been attributed to this disease-associated tissue in CD. To understand the contribution of MAT to CD pathophysiology, a molecular and cellular signature of disease-associated MAT in CD patients was provided. Methods: We performed an observational study with whole transcriptional analysis by RNA sequencing (RNA-seq) of MAT and ileal mucosa from CD patients with active disease and controls. qPCR and immunohistology were performed for validation analysis. Results: RNA-seq identified 17 significantly regulated genes (|FC| > 1.5; FDR < 0.05) in CD-MAT compared to non-IBD controls, with a marked upregulation of plasma cell genes (i.e., IGLL5, MZB1, CD79A, POU2AF1, FCRL5, JCHAIN, DERL3, SDC1, PIM2). A less strict statistical cutoff value (|FC| > 1.5, nominal p ≤ 0.05) yielded a larger list of 651 genes in CD-MAT compared to controls. CD ileum showed the significant regulation compared to control ileum of 849 genes (|FC| > 1.5; FDR < 0.05) or 2654 genes (|FC| > 1.5, nominal p ≤ 0.05). Ingenuity Pathway Analysis revealed the significant regulation of pathways related to T-and B cell functionality in the MAT of CD patients. Despite the differences between the MAT and ileal signatures of CD patients, we identified a subset of 204 genes significantly modulated in both tissues compared to controls. This common signature included genes related to the plasma cell signature. Genes such as S100A8, S100A9 (calprotectin) and IL1B, which are associated with acute inflammatory response, were exclusively regulated in the ileal mucosa of CD disease. In contrast, some genes encoding for lymphocyte receptors

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“…Also referred to as “creeping fat”, this layer of tissue has been thought of as a physical barrier to inflammation & inflammatory markers, controlling host immune response to translocation of gut bacteria, and immunomodulation 18 , 19 . It is now, however, evident that mesenteric fat is implicated in both pathogenesis and treatment outcomes in CD 17 , 20 especially disease activity and severity of symptoms 21 , bowel damage and stricture formation 20 , 22 , 23 .…”

Section: Introductionmentioning

confidence: 99%

Adults with Crohn’s disease exhibit elevated gynoid fat and reduced android fat irrespective of disease relapse or remission

Dowling

Jakeman

Norton

et al. 2021

Sci Rep

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Crohn’s disease (CD) is a debilitating inflammatory bowel condition of unknown aetiology that is growing in prevalence globally. Large-scale studies have determined associations between female obesity or low body mass index (BMI) with risk of CD at all ages or 8– < 40 years, respectively. For males, low BMI entering adult life is associated with increased incidence of CD or ulcerative colitis up to 40 years later. Body composition analysis has shown that combinations of lean tissue loss and high visceral fat predict poor CD outcomes. Here, we assessed dietary intake, physical activity and whole or regional body composition of patients with CD relapse or remission. This anthropometric approach found people with CD, irrespective of relapse or remission, differed from a large representative healthy population sample in exhibiting elevated gynoid fat and reduced android fat. CD is associated with mesenteric adipose tissue, or “creeping fat”, that envelops affected intestine exclusive of other tissue; that fat is localised to the android region of the body. In this context, CD mesenteric adiposity represents a stark juxtaposition of organ-specific and regional adiposity. Although our study population was relatively small, we suggest tentatively that there is a rationale to refer to Crohn’s disease as a fatty intestine condition, akin to fatty liver conditions. We suggest that our data provide early insight into a subject that potentially warrants further investigation across a larger patient cohort.

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Creeping Fat Assessed by Small Bowel MRI Is Linked to Bowel Damage and Abdominal Surgery in Crohn’s Disease

Cited by 26 publications

References 43 publications

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Whole transcriptional analysis identifies markers of B, T and plasma cell signaling pathways in the mesenteric adipose tissue associated with Crohn’s disease

Adults with Crohn’s disease exhibit elevated gynoid fat and reduced android fat irrespective of disease relapse or remission

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