内脏脂肪过多可预测急性胰腺炎的严重程度。

Visceral Adiposity Predicts Severity of Acute Pancreatitis.

作者信息

Natu Ashwinee, Stevens Tyler, Kang Lorna, Yasinow Scott, Mansoor Emad, Lopez Rocio, Glessing Brooke, Remer Erick, Richards Tyler, Gupta Amit, Chak Amitabh, Lee Peter J W

机构信息

From the *Department of Internal Medicine, University Hospitals Cleveland Medical Center; †Department of Gastroenterology, Digestive Disease Institute, Cleveland Clinic; ‡Case Western Reserve University School of Medicine; §Department of Quantitative Health Sciences, Cleveland Clinic; ∥Department of Gastroenterology, Digestive Disease Institute, University Hospitals Cleveland Medical Center; ¶Department of Abdominal Imaging, Imaging Institute, Cleveland Clinic; #Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH.

出版信息

Pancreas. 2017 Jul;46(6):776-781. doi: 10.1097/MPA.0000000000000845.

DOI:10.1097/MPA.0000000000000845

PMID:28609366

Abstract

OBJECTIVES

The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP).

METHODS

This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity.

RESULTS

Five hundred and seventy four patients were admitted during the study period, of which 252 had a computed tomography scan available. Patients with severe AP had a larger VAT area compared with those with mild or moderate AP (mean: 184.9 cm vs 79.9 cm, P = 0.006). Patients who developed multisystem organ failure or had acute necrotic collections had a larger VAT area than those who did not (150.6 cm vs 91.0 cm, P = 0.004 and 174.0 cm vs 91.9 cm, P = 0.003, respectively). Visceral adipose tissue area demonstrated superior discrimination of severe AP compared with other severity predictors.

CONCLUSIONS

Increased VAT area is a strong predictor of severe pancreatitis, necrosis, and multisystem organ failure.

摘要

目的

本研究旨在确定急性胰腺炎（AP）中内脏脂肪增多与严重结局之间的关联。

方法

这项回顾性研究纳入了2010年1月至2015年1月期间在一家三级护理医院住院并接受计算机断层扫描的连续AP患者。采用Linder及其同事的方法估算内脏脂肪组织（VAT）体积。进行多变量逻辑回归分析，以评估VAT作为严重AP的预测指标，并与其他经过验证的严重程度预测指标进行比较。

结果

研究期间共收治574例患者，其中252例有可用的计算机断层扫描结果。与轻度或中度AP患者相比，严重AP患者的VAT面积更大（平均：184.9平方厘米对79.9平方厘米，P = 0.006）。发生多系统器官衰竭或有急性坏死性积液的患者的VAT面积大于未发生者（分别为150.6平方厘米对91.0平方厘米，P = 0.004；174.0平方厘米对91.9平方厘米，P = 0.003）。与其他严重程度预测指标相比，内脏脂肪组织面积对严重AP具有更好的辨别能力。