Li Y, Zhu W, Gong J, Zhang W, Gu L, Guo Z, Cao L, Shen B, Li N, Li J
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Colorectal Dis. 2015 Mar;17(3):225-34. doi: 10.1111/codi.12798.
Mesenteric hypertrophy has been recognized as an indicator of the complicated course of Crohn's disease. The aim of this study was to investigate whether the visceral fat area (VFA) is associated with postoperative clinical and endoscopic recurrence.
Computed tomography was used to measure the subcutaneous fat area and VFA, and the mesenteric fat index (MFI) was defined as the ratio of the VFA to the subcutaneous fat area. Associations between body mass index, subcutaneous fat area, VFA and MFI and postoperative clinical and endoscopic recurrence were investigated.
The factors associated with postoperative endoscopic recurrence at 6 months after surgery were a high VFA value (P = 0.019) and MFI values above the median (P = 0.008). VFA values were significantly correlated with endoscopic recurrence (r = 0.895, P = 0.040) and endoscopic lesions (r = 0.617, P < 0.0001). Additionally, MFI values correlated well with endoscopic recurrence (r = 0.918, P = 0.02) and endoscopic scores (r = 0.584, P < 0.0001). Multivariate analysis indicated that VFA values above the median (hazard ratio 2.63, 95% CI 1.03-6.74) were predictive of postoperative clinical recurrence in Crohn's disease.
A high VFA value is associated with postoperative recurrence of Crohn's disease and has clinical implications with respect to optimizing prophylaxis for each individual. However, further studies are needed to confirm the predictive role of this biomarker in a different data set.
肠系膜肥厚已被视为克罗恩病复杂病程的一个指标。本研究的目的是调查内脏脂肪面积（VFA）是否与术后临床及内镜复发相关。
采用计算机断层扫描测量皮下脂肪面积和VFA，并将肠系膜脂肪指数（MFI）定义为VFA与皮下脂肪面积之比。研究了体重指数、皮下脂肪面积、VFA和MFI与术后临床及内镜复发之间的关联。
术后6个月与内镜复发相关的因素为高VFA值（P = 0.019）和高于中位数的MFI值（P = 0.008）。VFA值与内镜复发（r = 0.895，P = 0.040）及内镜病变（r = 0.617，P < 0.0001）显著相关。此外，MFI值与内镜复发（r = 0.918，P = 0.02）及内镜评分（r = 0.584，P < 0.0001）相关性良好。多变量分析表明，高于中位数的VFA值（风险比2.63，95%可信区间1.03 - 6.74）可预测克罗恩病术后临床复发。
高VFA值与克罗恩病术后复发相关，对于为个体优化预防措施具有临床意义。然而，需要进一步研究以证实该生物标志物在不同数据集中的预测作用。
