Mean muscle attenuation correlates with severe acute pancreatitis unlike visceral adipose tissue and subcutaneous adipose tissue

Abstract

Background Acute pancreatitis (AP) is a frequent disorder with considerable morbidity and mortality. Obesity has previously been reported to influence disease severity. Objective The aim of this study was to investigate the association of adipose and muscle parameters with the severity grade of AP. Methods In total 454 patients were recruited. The first contrast-enhanced computed tomography of each patient was reviewed for adipose and muscle tissue parameters at L3 level. Associations with disease severity were analysed through logistic regression analysis. The predictive capacity of the parameters was investigated using receiver operating characteristic (ROC) curves. Results No distinct variation was found between the AP severity groups in either adipose tissue parameters (visceral adipose tissue and subcutaneous adipose tissue) or visceral muscle ratio. However, muscle mass and mean muscle attenuation differed significantly with p-values of 0.037 and 0.003 respectively. In multivariate analysis, low muscle attenuation was associated with severe AP with an odds ratio of 4.09 (95% confidence intervals: 1.61–10.36, p-value 0.003). No body parameter presented sufficient predictive capability in ROC-curve analysis. Conclusions Our results demonstrate that a low muscle attenuation level is associated with an increased risk of severe AP. Future prospective studies will help identify the underlying mechanisms and characterise the influence of body composition parameters on AP.

The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis

“…A recent systematic review, which included 11 studies, concluded that VAT is an important prognostic indicator for the severity of AP and may be incorporated into the prognostic scoring systems of AP [ 21 ]. Nevertheless, muscle radiodensity, rather than VAT and subcutaneous adipose tissue (SAT), correlated with severe acute pancreatitis [ 22 ]. Notably, by stratifying AP into HTGP and non-HTGP, it was revealed that VAT and VAT/SAT were valuable factors for predicting the severity in HTGP, but not in non-HTGP [ 23 ].…”

Assessment of Computed Tomography-Defined Muscle and Adipose Tissue Features in Relation to Length of Hospital Stay and Recurrence of Hypertriglyceridemic Pancreatitis

“…O'Leary et al showed a similar nding in 214 patients with AP [30]. However, many studies have suggested that VAT is not signi cantly associated with AP [31][32][33]. Duarte-Rojo et al have shown that both SAT and VAT independently predict a severe outcome of AP [34].…”

Quantitative Imaging of Body Composition

“…Beyond oncology, there is evidence that sarcopenia and/or decreased muscle attenuation are associated with osteoporosis, 9 metabolic syndrome in middle-aged and older nonobese people, 64 development of depression, 65 increased risk of severe acute pancreatitis, 66 poor outcome after traumatic injuries, 11 and degenerative disk and facet joint disease. 67 Abdomen: Subcutaneous and Visceral Adipose Tissue Several prior studies showed increased cardiometabolic risk is strongly associated with increased abdominal fat.…”