Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
PLoS One. 2021 Nov 22;16(11):e0260309. doi: 10.1371/journal.pone.0260309. eCollection 2021.
Liver cirrhosis and features of muscle or adipose tissues may affect the severity of acute pancreatitis (AP). We aimed to evaluate the impact of body composition parameters and liver cirrhosis on the severity of AP in patients with alcohol-induced AP (AAP).
Patients with presumed AAP who underwent CT within one week after admission were retrospectively enrolled. L3 sectional areas of abdominal fat and muscle, and mean muscle attenuations (MMAs) were quantified. The presence of liver cirrhosis was determined using clinical and CT findings. Factors potentially associated with moderately severe or severe AP were included in the multivariable logistic regression analysis.
A total of 242 patients (47.0 ± 12.6 years, 215 males) with presumed AAP were included. The mild and moderately severe/severe (MSS) groups included 137 (56.6%) and 105 patients (43.4%), respectively. Patients in the MSS group had higher rates of liver cirrhosis, organ failure, and local complications. Among body composition parameters, mean MMA (33.4 vs 36.8 HU, P<0.0001) and abdominal muscle mass (126.5 vs 135.1 cm2, P = 0.029) were significantly lower in the MSS group. The presence of liver cirrhosis (OR, 4.192; 95% CI, 1.620-10.848) was found to be a significant risk factor for moderately severe or severe AP by multivariable analysis.
The results of this study suggest that liver cirrhosis has a significant impact on the severity of AAP. Of the body composition parameters examined, MMA and abdominal muscle mass showed potential as promising predictors.
肝硬化和肌肉或脂肪组织的特征可能会影响急性胰腺炎（AP）的严重程度。我们旨在评估身体成分参数和肝硬化对酒精性 AP（AAP）患者 AP 严重程度的影响。
回顾性纳入入院后一周内接受 CT 检查的疑似 AAP 患者。定量分析腹部脂肪和肌肉的 L3 节段面积以及平均肌肉衰减值（MMAs）。使用临床和 CT 发现确定肝硬化的存在。将与中度或重度 AP 相关的潜在因素纳入多变量逻辑回归分析。
共纳入 242 例（47.0±12.6 岁，215 例男性）疑似 AAP 患者。轻度和中重度/重度（MSS）组分别包括 137（56.6%）和 105 例患者（43.4%）。MSS 组患者肝硬化、器官衰竭和局部并发症的发生率较高。在身体成分参数中，MSS 组的平均 MMA（33.4 与 36.8 HU，P<0.0001）和腹部肌肉量（126.5 与 135.1 cm2，P=0.029）显著降低。多变量分析发现，肝硬化的存在（OR，4.192；95%CI，1.620-10.848）是中重度 AP 的一个显著危险因素。
本研究结果表明，肝硬化对 AAP 的严重程度有显著影响。在检查的身体成分参数中，MMA 和腹部肌肉量具有成为有前途的预测指标的潜力。
