Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
J Gastroenterol. 2011 Oct;46(10):1213-8. doi: 10.1007/s00535-011-0430-x. Epub 2011 Jul 30.
Obesity plays an important role in acute pancreatitis. Assuming that the volume of visceral adipose tissue (VAT) directly influences the severity of acute pancreatitis, we investigated the relationship between VAT and acute pancreatitis.
Data were collected consecutively from 124 patients who were diagnosed with acute pancreatitis. Body mass index (BMI) was calculated from the database. Computed tomography was performed in all patients, and VAT, subcutaneous adipose tissue (SAT), and waist circumference (WC) were measured at the level of the intervertebral disk between L2 and L3. Atlanta criteria were adopted to define severe acute pancreatitis. Clinical courses were investigated, and the Ranson and acute physiology and chronic health evaluation II (APACHE II) scores were calculated for all patients.
Forty-eight patients had severe acute pancreatitis (38.7%), and 76 were mild cases. BMI, VAT, SAT, and WC were correlated with the severity of acute pancreatitis in a univariate analysis, but only VAT had a strong correlation with severe acute pancreatitis in the multivariate analysis. In a trend analysis, not only severity but also the presence of pseudocysts (local complication) and prognostic factors (Ranson and APACHE II scores) were significantly related to VAT volume. In particular, the presence of a pancreatic pseudocyst was strongly related to VAT volume (p < 0.001).
In acute pancreatitis, peripancreatic VAT has a stronger correlation with severe acute pancreatitis than BMI or WC. VAT volume is strongly correlated with the formation of a pseudocyst and with systemic inflammatory response syndrome in patients with acute pancreatitis and high VAT volume may lead to severe acute pancreatitis.
肥胖在急性胰腺炎中起着重要作用。假设内脏脂肪组织（VAT）的体积直接影响急性胰腺炎的严重程度，我们研究了 VAT 与急性胰腺炎之间的关系。
从数据库中收集了 124 名被诊断为急性胰腺炎的患者的数据。计算了体重指数（BMI）。所有患者均进行了计算机断层扫描，并在 L2 和 L3 椎间盘水平测量了 VAT、皮下脂肪组织（SAT）和腰围（WC）。采用亚特兰大标准定义重症急性胰腺炎。调查了临床过程，并计算了所有患者的 Ranson 和急性生理学和慢性健康评估 II（APACHE II）评分。
48 例患者为重症急性胰腺炎（38.7%），76 例为轻症病例。BMI、VAT、SAT 和 WC 在单因素分析中与急性胰腺炎的严重程度相关，但只有 VAT 在多因素分析中与重症急性胰腺炎有强烈相关性。在趋势分析中，不仅严重程度，而且假性囊肿（局部并发症）和预后因素（Ranson 和 APACHE II 评分）的存在与 VAT 体积显著相关。特别是胰腺假性囊肿的存在与 VAT 体积呈强相关（p<0.001）。
在急性胰腺炎中，胰周 VAT 与重症急性胰腺炎的相关性强于 BMI 或 WC。VAT 体积与假性囊肿的形成以及急性胰腺炎患者全身炎症反应综合征密切相关，高 VAT 体积可能导致重症急性胰腺炎。
