Zhou Ziling, Xiong Ziman, Xie Qingguo, Xiao Peng, Zhang Qingpeng, Gu Jian, Li Jing, Hu Daoyu, Hu Xuemei, Shen Yaqi, Li Zhen
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, Hubei, China.
Biomedical Engineering Department, College of Life Sciences and Technology, Huazhong University of Science and Technology, Wuhan, China.
Insights Imaging. 2021 Sep 25;12(1):135. doi: 10.1186/s13244-021-01083-6.
The efficacy of computed tomography-based multiple body composition parameters in assessing disease behavior and prognosis has not been comprehensively evaluated in Crohn's disease. This study aimed to assess the association of body composition parameters with disease behavior and outcomes in Crohn's disease and to compare the efficacies of indexes derived from body and lumbar spinal heights in body composition analysis.
One hundred twenty-two patients with confirmed Crohn's disease diagnoses and abdominal computed tomography scans were retrospectively included in this study. Skeletal muscle, visceral, and subcutaneous fat indexes were calculated by dividing each type of tissue area by height and lumbar spinal height. Parameters reflecting the distribution of adiposity were also assessed. Principal component analysis was used to deal with parameters with multicollinearity. Patients were grouped according to their disease behavior (inflammatory vs. structuring/penetrating) and outcomes. Adverse outcome included need for intestinal surgery or anti-TNF therapy. Predictors of disease course from multiple parameters were evaluated using multivariate analysis. Indexes derived from body and lumbar spinal heights were strongly correlated (r, 0.934-0.995; p < 0.001). Low skeletal muscle-related parameters were significantly associated with complicated disease behavior in multivariate analysis (p = 0.048). Complicated disease behavior (p < 0.001) and adipose tissue parameters-related first principal component (p = 0.029) were independent biomarkers for predicting adverse outcomes.
Skeletal muscle and adipose tissue principle component were associated with complicated Crohn's disease behavior and adverse outcome, respectively. Indexes derived from body and lumbar spinal heights have similar efficacies in body composition analysis.
基于计算机断层扫描的多种身体成分参数在评估克罗恩病的疾病行为和预后方面的疗效尚未得到全面评估。本研究旨在评估身体成分参数与克罗恩病的疾病行为和结局之间的关联，并比较身体高度和腰椎高度衍生指标在身体成分分析中的疗效。
本研究回顾性纳入了122例确诊为克罗恩病且有腹部计算机断层扫描的患者。通过将每种组织面积除以身高和腰椎高度来计算骨骼肌、内脏和皮下脂肪指数。还评估了反映肥胖分布的参数。采用主成分分析处理具有多重共线性的参数。根据患者的疾病行为（炎症性与狭窄/穿透性）和结局进行分组。不良结局包括需要进行肠道手术或抗TNF治疗。使用多变量分析评估多个参数对疾病进程的预测因素。身体高度和腰椎高度衍生的指标高度相关（r，0.934 - 0.995；p < 0.001）。在多变量分析中，低骨骼肌相关参数与复杂的疾病行为显著相关（p = 0.048）。复杂的疾病行为（p < 0.001）和脂肪组织参数相关的第一主成分（p = 0.029）是预测不良结局的独立生物标志物。
骨骼肌和脂肪组织主成分分别与复杂的克罗恩病行为和不良结局相关。身体高度和腰椎高度衍生的指标在身体成分分析中具有相似的疗效。
