Creeping fat in patients with ileo‐colonic Crohn's disease correlates with disease activity and severity of inflammation: A preliminary study using energy spectral computed tomography

Feng, Qi; Xu, Xi; Zhou, Yi; Yan, Yun; Ran, Zhi Hua; Zhu, Jiong

doi:10.1111/1751-2980.12652

Cited by 18 publications

(17 citation statements)

References 28 publications

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“…CT body composition parameters have been used to reflect disease activity in CD patients and predict their prognosis. Feng et al found that the λ HU of creeping fat (CF) in CD patients increased with the severity of intestinal inflammation, and the λ HU of CF around the intestinal segments without lesions was significantly higher than that in the controls [ 20 ]. Zhou et al showed an increased risk of poor prognosis in CD patients with high SAT and VAT density [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

et al. 2022

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Objective The aim of this study was to analyze the relationship between abdominal adipose tissue and perianal fistula activity in patients with Crohn's disease (CD) using cross-sectional imaging. Methods Patients with perianal fistulizing CD who underwent pelvic magnetic resonance imaging (MRI) and abdominal computed tomography (CT) were retrospectively enrolled. We scored the fistulas in each patient's MRI images based on Van Assche's classification. The area and density of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) (at the third, fourth, and fifth lumbar (L3, L4, and L5) levels were measured by averaging five slices of measurements at each vertebral level in CT images, and areas were further standardized by the lumbar height2 (heightL1-5). The VAT/SAT ratio (VSR) and VAT/Total adipose tissue (VA/TA) index were calculated. Based on MRI scores, patients were divided into two groups with low and high activity, and their clinical, MRI features, and CT parameters were compared. We evaluated patients with follow-up MRI and compared the differences in clinical and radiological indicators among patients with different outcomes. Results Overall, 136 patients were included, 77 in the low-activity group and 59 in the high-activity group. Patients in the high activity group had lower subcutaneous adipose index (all levels, p < 0.05) and visceral adipose index (L3 level, p < 0.01), but higher SAT and VAT density (all levels, p < 0.01), VSR (L5 level, p = 0.07) and VA/TA index (L5 level, p < 0.05). Conclusion There were differences in adipose tissue composition among CD patients with different active perianal fistulas.

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Section: Discussionmentioning

confidence: 99%

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

et al. 2022

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“…Altered MAT near the affected intestinal area is considered to be characteristic of severe CD [6,[27][28][29][30]. Persistent alterations in this tissue even after endoscopic remission can be observed by magnetic resonance imaging [31], and may be associated with a complicated disease course and abdominal surgery in CD [32].…”

Section: Discussionmentioning

confidence: 99%

Whole transcriptional analysis identifies markers of B, T and plasma cell signaling pathways in the mesenteric adipose tissue associated with Crohn’s disease

et al. 2020

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Background: Crohn's disease (CD) is a multifactorial disease characterized by chronic intestinal inflammation. The increased visceral adiposity near the affected intestinal area, of which mesenteric adipose tissue (MAT) is the main component, is a feature of CD. Both protective and pathological roles have been attributed to this disease-associated tissue in CD. To understand the contribution of MAT to CD pathophysiology, a molecular and cellular signature of disease-associated MAT in CD patients was provided. Methods: We performed an observational study with whole transcriptional analysis by RNA sequencing (RNA-seq) of MAT and ileal mucosa from CD patients with active disease and controls. qPCR and immunohistology were performed for validation analysis. Results: RNA-seq identified 17 significantly regulated genes (|FC| > 1.5; FDR < 0.05) in CD-MAT compared to non-IBD controls, with a marked upregulation of plasma cell genes (i.e., IGLL5, MZB1, CD79A, POU2AF1, FCRL5, JCHAIN, DERL3, SDC1, PIM2). A less strict statistical cutoff value (|FC| > 1.5, nominal p ≤ 0.05) yielded a larger list of 651 genes in CD-MAT compared to controls. CD ileum showed the significant regulation compared to control ileum of 849 genes (|FC| > 1.5; FDR < 0.05) or 2654 genes (|FC| > 1.5, nominal p ≤ 0.05). Ingenuity Pathway Analysis revealed the significant regulation of pathways related to T-and B cell functionality in the MAT of CD patients. Despite the differences between the MAT and ileal signatures of CD patients, we identified a subset of 204 genes significantly modulated in both tissues compared to controls. This common signature included genes related to the plasma cell signature. Genes such as S100A8, S100A9 (calprotectin) and IL1B, which are associated with acute inflammatory response, were exclusively regulated in the ileal mucosa of CD disease. In contrast, some genes encoding for lymphocyte receptors

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“…Also referred to as “creeping fat”, this layer of tissue has been thought of as a physical barrier to inflammation & inflammatory markers, controlling host immune response to translocation of gut bacteria, and immunomodulation 18 , 19 . It is now, however, evident that mesenteric fat is implicated in both pathogenesis and treatment outcomes in CD 17 , 20 especially disease activity and severity of symptoms 21 , bowel damage and stricture formation 20 , 22 , 23 .…”

Section: Introductionmentioning

confidence: 99%

Adults with Crohn’s disease exhibit elevated gynoid fat and reduced android fat irrespective of disease relapse or remission

Dowling

Jakeman

Norton

et al. 2021

Sci Rep

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Crohn’s disease (CD) is a debilitating inflammatory bowel condition of unknown aetiology that is growing in prevalence globally. Large-scale studies have determined associations between female obesity or low body mass index (BMI) with risk of CD at all ages or 8– < 40 years, respectively. For males, low BMI entering adult life is associated with increased incidence of CD or ulcerative colitis up to 40 years later. Body composition analysis has shown that combinations of lean tissue loss and high visceral fat predict poor CD outcomes. Here, we assessed dietary intake, physical activity and whole or regional body composition of patients with CD relapse or remission. This anthropometric approach found people with CD, irrespective of relapse or remission, differed from a large representative healthy population sample in exhibiting elevated gynoid fat and reduced android fat. CD is associated with mesenteric adipose tissue, or “creeping fat”, that envelops affected intestine exclusive of other tissue; that fat is localised to the android region of the body. In this context, CD mesenteric adiposity represents a stark juxtaposition of organ-specific and regional adiposity. Although our study population was relatively small, we suggest tentatively that there is a rationale to refer to Crohn’s disease as a fatty intestine condition, akin to fatty liver conditions. We suggest that our data provide early insight into a subject that potentially warrants further investigation across a larger patient cohort.

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Creeping fat in patients with ileo‐colonic Crohn's disease correlates with disease activity and severity of inflammation: A preliminary study using energy spectral computed tomography

Abstract: The quantitative analysis of creeping fat using energy spectral CT is an effective method in inflammatory evaluation in patients with CD.

Cited by 18 publications

References 28 publications

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

The relationship between perianal fistula activity and abdominal adipose tissue in Crohn’s disease: an observational study

Whole transcriptional analysis identifies markers of B, T and plasma cell signaling pathways in the mesenteric adipose tissue associated with Crohn’s disease

Adults with Crohn’s disease exhibit elevated gynoid fat and reduced android fat irrespective of disease relapse or remission

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