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计算机断层扫描测量的内脏脂肪面积不能预测克罗恩病患者的术后病程。

Visceral fat area measured with computed tomography does not predict postoperative course in Crohn´s disease patients.

机构信息

Department of Surgery, Medical University of Vienna, Vienna, Austria.

Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria.

出版信息

PLoS One. 2018 Aug 22;13(8):e0202220. doi: 10.1371/journal.pone.0202220. eCollection 2018.

DOI:10.1371/journal.pone.0202220
PMID:30133500
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6104989/
Abstract

The role of visceral fat measured by computer tomography is yet not well defined in patients with Crohn's disease. Therefore, the present study was designed to assess the impact of visceral fat area on postoperative short-term outcome and surgical characteristics. We analyzed 95 patients, who underwent intestinal resection for symptomatic Crohn's disease at an academic tertiary referral center between 2003 and 2008. Visceral fat area was measured on preoperative computed tomography scans. Postoperative morbidity was graded according to the Clavien-Dindo classification. Visceral fat area was correlated with baseline characteristics, disease phenotype and 30-day morbidity. Body mass index and age were significantly associated with a higher visceral fat area (p = 0.001). Overall 19 (20.0%) postoperative complications were observed, of whom 7 (7.4%) patients required surgical re-intervention. No significant difference was found with regard to visceral fat area between patients with an uneventful and eventful postoperative course (no complications: median visceral fat area 52.0 cm2 SD 59.7, complications: 41.3 cm2 SD 42.8; p = 0.465). In contrast to current literature, we cannot support the role of visceral fat area for predicting postoperative course in Crohn's disease. In addition, no correlation of the visceral fat area and disease behavior was detected.

摘要

计算机断层扫描测量的内脏脂肪在克罗恩病患者中的作用尚未明确。因此,本研究旨在评估内脏脂肪面积对术后短期结局和手术特征的影响。我们分析了 2003 年至 2008 年间在一家学术性三级转诊中心因症状性克罗恩病而行肠切除术的 95 例患者。术前 CT 扫描测量内脏脂肪面积。术后并发症根据 Clavien-Dindo 分级进行分级。内脏脂肪面积与基线特征、疾病表型和 30 天发病率相关。体重指数和年龄与较高的内脏脂肪面积显著相关(p = 0.001)。总体观察到 19 例(20.0%)术后并发症,其中 7 例(7.4%)患者需要再次手术干预。无并发症患者的内脏脂肪面积与有并发症患者无显著差异(中位数内脏脂肪面积分别为 52.0cm2,标准差为 59.7;41.3cm2,标准差为 42.8;p = 0.465)。与目前的文献相反,我们不能支持内脏脂肪面积在预测克罗恩病术后病程中的作用。此外,未检测到内脏脂肪面积与疾病行为之间的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b1/6104989/c7d5af6a0457/pone.0202220.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b1/6104989/c7d5af6a0457/pone.0202220.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b1/6104989/c7d5af6a0457/pone.0202220.g001.jpg

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本文引用的文献

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Obesity Does Not Impact Perioperative or Postoperative Outcomes in Patients with Inflammatory Bowel Disease.肥胖对炎症性肠病患者围手术期或术后结局无影响。
J Gastrointest Surg. 2016 Apr;20(4):725-33. doi: 10.1007/s11605-015-3060-4. Epub 2015 Dec 22.
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Body Mass Index Is Associated with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.
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Front Nutr. 2023 Aug 21;10:1251448. doi: 10.3389/fnut.2023.1251448. eCollection 2023.
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Creeping Fat in Crohn's Disease-Surgical, Histological, and Radiological Approaches.克罗恩病中的匐行脂肪——手术、组织学及放射学研究方法
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Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn's Disease.克罗恩病患者治疗期间身体成分的连续变化及其与疾病活动的关联
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