Karsh Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Inflamm Bowel Dis. 2023 Mar 1;29(3):458-469. doi: 10.1093/ibd/izac120.
Mesenteric adipose tissue (MAT) has gained substantial attention as an active player in Crohn's disease (CD), but its clinical significance is poorly understood and likely reflects, in part, difficulties assessing MAT noninvasively. Recent radiologic studies have identified candidate surrogate markers that may reflect inflammatory alterations of MAT in CD and have found that certain features including visceral adipose tissue may inform risk of complicated disease behavior, risk for surgery, and postoperative outcomes. Additionally, emerging surgical data have suggested MAT may even be a therapeutic target to mitigate postoperative recurrence of CD. However, the current studies have variable results, reduced sample sizes, and methodological limitations that preclude incorporating the radiologic and surgical findings into clinical practice. Nonetheless, the results are promising and potentially have important implications for the medical and surgical management of CD, which merits that additional studies are warranted. Thus, we have reviewed the available literature on the medical and surgical implications of MAT in CD to summarize our current understanding and identify gaps in knowledge to inform future investigations.
肠系膜脂肪组织（MAT）作为克罗恩病（CD）的一个活跃参与者，已经引起了广泛关注，但它的临床意义尚不清楚，这可能部分反映了评估 MAT 非侵入性的困难。最近的放射学研究已经确定了一些候选替代标志物，这些标志物可能反映了 CD 中 MAT 的炎症改变，并发现某些特征，包括内脏脂肪组织，可能提示复杂疾病行为、手术风险和术后结果的风险。此外，新兴的手术数据表明，MAT 甚至可能是一个治疗靶点，以减轻 CD 的术后复发。然而，目前的研究结果存在差异，样本量较小，方法学上存在局限性，无法将放射学和手术结果纳入临床实践。尽管如此，这些结果还是很有希望的，可能对 CD 的医学和手术管理具有重要意义，值得进一步研究。因此，我们回顾了关于 MAT 在 CD 中的医学和手术意义的现有文献，以总结我们目前的认识，并确定知识空白，为未来的研究提供信息。
