体成分和爬行脂肪的参数与克罗恩病的活动有关。

Parameters of body composition and creeping fat are associated with activity of Crohn's disease.

机构信息

University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.

Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, the Netherlands.

出版信息

Magn Reson Imaging. 2023 May;98:1-6. doi: 10.1016/j.mri.2023.01.005. Epub 2023 Jan 10.

DOI:10.1016/j.mri.2023.01.005

PMID:36634829

Abstract

AIM

This study aimed at assessing body composition parameters, creeping fat (CrF), and Crohn's disease's (CD) activity based on the Magnetic Resonance Index of Activity (MaRIA).

METHODS

114 CD patients who underwent magnetic resonance enterography (MRE) between June 2010 and April 2020 were retrospectively assessed. The semi-automated body composition segmentation, the qualitative evaluation of CrF, and MaRIA were performed. Based on their MaRIA score, patients were divided into two groups: mild-to-moderate disease (MaRIA <11, n = 50) and severe disease (MaRIA ≥11, n = 64). MRE parameters were analyzed between both groups. Patients were dichotomized according to body composition categories and the presence of CrF. Univariate regression analyses were performed to investigate the association between dichotomized variables and severe disease. Significant variables were incorporated into the multivariate logistic regression model.

RESULTS

The severe disease group exhibited higher serum C-reactive protein (CRP) levels compared to the mild-to-moderate disease group (p ≤0.001). In the mild-to-moderate disease group, a higher proportion of patients had a body mass index (BMI) ≥ 25 (kg/m) (32.0%) compared to the severe disease group (16.5%) (p = 0.04). The subcutaneous adipose tissue index (SATI) was significantly higher in the mild-to-moderate disease group (p = 0.04). The visceral to subcutaneous adipose tissue (VAT/SAT) ratio tended to be higher in the severe disease group (p = 0.09). There was no significant difference between both groups regarding total adipose tissue index (TATI) (p = 0.10), visceral adipose tissue index (VATI) (p = 0.51), intramuscular adipose tissue index (IMATI) (p = 0.38), skeletal muscle index (SMI) (p = 0.83), and sarcopenia (p = 0.75). In the multivariate analysis, CrF was significantly associated with severe disease (odds ratio [OR] 11.50, 95% confidence interval [CI] 3.13-42.17; p ≤0.001). Additionally, a BMI ≥ 25 (kg/m) was protective against severe disease (OR: 0.34, 95% CI 0.12-0.95; p = 0.04).

CONCLUSION

CrF is significantly associated with CD activity.

摘要

目的

本研究旨在基于磁共振活动指数（MaRIA）评估人体成分参数、爬行脂肪（CrF）和克罗恩病（CD）的活动。

方法

回顾性分析 2010 年 6 月至 2020 年 4 月期间接受磁共振肠造影术（MRE）的 114 例 CD 患者。对患者进行半自动体成分分割、CrF 定性评估和 MaRIA。根据 MaRIA 评分，患者被分为两组：轻度至中度疾病（MaRIA<11，n=50）和重度疾病（MaRIA≥11，n=64）。分析两组之间的 MRE 参数。根据体成分类别和 CrF 的存在将患者分为两类。对单变量回归分析进行了分析，以研究分类变量与重度疾病之间的关联。将显著变量纳入多变量逻辑回归模型。

结果

重度疾病组患者的血清 C 反应蛋白（CRP）水平明显高于轻度至中度疾病组（p≤0.001）。在轻度至中度疾病组中，BMI≥25（kg/m）的患者比例明显高于重度疾病组（32.0%比 16.5%）（p=0.04）。轻度至中度疾病组的皮下脂肪组织指数（SATI）明显较高（p=0.04）。重度疾病组的内脏脂肪组织与皮下脂肪组织（VAT/SAT）比值较高（p=0.09）。两组之间的总脂肪组织指数（TATI）无显著差异（p=0.10）、内脏脂肪组织指数（VATI）（p=0.51）、肌内脂肪组织指数（IMATI）（p=0.38）、骨骼肌指数（SMI）（p=0.83）和肌肉减少症（p=0.75）。在多变量分析中，CrF 与重度疾病显著相关（优势比 [OR] 11.50，95%置信区间 [CI] 3.13-42.17；p≤0.001）。此外，BMI≥25（kg/m）对重度疾病具有保护作用（OR：0.34，95%CI 0.12-0.95；p=0.04）。