Department of Surgery, Institution of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Department of Internal Medicine I, Martin Luther University, Halle (Saale), Germany.
United European Gastroenterol J. 2019 Dec;7(10):1312-1320. doi: 10.1177/2050640619882520. Epub 2019 Oct 9.
Acute pancreatitis (AP) is a frequent disorder with considerable morbidity and mortality. Obesity has previously been reported to influence disease severity.
The aim of this study was to investigate the association of adipose and muscle parameters with the severity grade of AP.
In total 454 patients were recruited. The first contrast-enhanced computed tomography of each patient was reviewed for adipose and muscle tissue parameters at L3 level. Associations with disease severity were analysed through logistic regression analysis. The predictive capacity of the parameters was investigated using receiver operating characteristic (ROC) curves.
No distinct variation was found between the AP severity groups in either adipose tissue parameters (visceral adipose tissue and subcutaneous adipose tissue) or visceral muscle ratio. However, muscle mass and mean muscle attenuation differed significantly with -values of 0.037 and 0.003 respectively. In multivariate analysis, low muscle attenuation was associated with severe AP with an odds ratio of 4.09 (95% confidence intervals: 1.61-10.36, -value 0.003). No body parameter presented sufficient predictive capability in ROC-curve analysis.
Our results demonstrate that a low muscle attenuation level is associated with an increased risk of severe AP. Future prospective studies will help identify the underlying mechanisms and characterise the influence of body composition parameters on AP.
急性胰腺炎（AP）是一种常见的疾病，具有相当高的发病率和死亡率。肥胖先前被报道会影响疾病的严重程度。
本研究旨在探讨脂肪和肌肉参数与 AP 严重程度等级之间的关联。
共招募了 454 名患者。每位患者的第一次增强 CT 扫描均在 L3 水平进行了脂肪和肌肉组织参数的评估。通过逻辑回归分析研究了与疾病严重程度的相关性。使用受试者工作特征（ROC）曲线研究了参数的预测能力。
在 AP 严重程度组之间，脂肪组织参数（内脏脂肪组织和皮下脂肪组织）或内脏肌肉比率没有明显差异。然而，肌肉质量和平均肌肉衰减值存在显著差异，分别为 0.037 和 0.003。在多变量分析中，低肌肉衰减值与重症 AP 相关，优势比为 4.09（95%置信区间：1.61-10.36，p 值=0.003）。在 ROC 曲线分析中，没有任何身体参数具有足够的预测能力。
我们的结果表明，低肌肉衰减值与重症 AP 的风险增加相关。未来的前瞻性研究将有助于确定潜在的机制，并描述身体成分参数对 AP 的影响。
