Pancreas shrinkage following recurrent acute pancreatitis: an MRI study

DeSouza, Steve V.; Priya, Sunitha; Cho, Jaelim; Singh, Ruma G.; Petrov, Maxim S.

doi:10.1007/s00330-019-06126-7

Cited by 48 publications

(40 citation statements)

References 34 publications

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“…This cross-sectional study nested into a prospective cohort study was conducted as part of the ARIES project and was approved by the Health and Disability Ethics Committee [23][24][25][26]. From the prospective cohort, non-obese (BMI < 30.0 kg/m 2 ) adults with T2DM prior to AP and non-obese individuals with NODAP were identified.…”

Section: Study Populationmentioning

confidence: 99%

The Relationship between Abdominal Fat Phenotypes and Insulin Resistance in Non-Obese Individuals after Acute Pancreatitis

Skudder-Hill

Cho

et al. 2020

Nutrients

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Both type 2 prediabetes/diabetes (T2DM) and new-onset prediabetes/diabetes after acute pancreatitis (NODAP) are characterized by impaired tissue sensitivity to insulin action. Although the outcomes of NODAP and T2DM are different, it is unknown whether drivers of insulin resistance are different in the two types of diabetes. This study aimed to investigate the associations between abdominal fat phenotypes and indices of insulin sensitivity in non-obese individuals with NODAP, T2DM, and healthy controls. Indices of insulin sensitivity (homeostasis model assessment of insulin sensitivity (HOMA-IS), Raynaud index, triglyceride and glucose (TyG) index, Matsuda index) were calculated in fasting and postprandial states. Fat phenotypes (intra-pancreatic fat, intra-hepatic fat, skeletal muscle fat, visceral fat, and subcutaneous fat) were determined using magnetic resonance imaging and spectroscopy. Linear regression and relative importance analyses were conducted. Age, sex, and glycated hemoglobin A1c were adjusted for. A total of 78 non-obese individuals (26 NODAP, 20 T2DM, and 32 healthy controls) were included. Intra-pancreatic fat was significantly associated with all the indices of insulin sensitivity in the NODAP group, consistently in both the unadjusted and adjusted models. Intra-pancreatic fat was not significantly associated with any index of insulin sensitivity in the T2DM and healthy controls groups. The variance in HOMA-IS was explained the most by intra-pancreatic fat (R2 = 29%) in the NODAP group and by visceral fat (R2 = 21%) in the T2DM group. The variance in the Raynaud index was explained the most by intra-pancreatic fat (R2 = 18%) in the NODAP group and by visceral fat (R2 = 15%) in the T2DM group. The variance in the TyG index was explained the most by visceral fat in both the NODAP group (R2 = 49%) and in the T2DM group (R2 = 25%). The variance in the Matsuda index was explained the most by intra-pancreatic fat (R2 = 48%) in the NODAP group and by visceral fat (R2 = 38%) in the T2DM group. The differing association between intra-pancreatic fat and insulin resistance can be used to differentiate NODAP from T2DM. Insulin resistance in NODAP appears to be predominantly driven by increased intra-pancreatic fat deposition.

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Section: Study Populationmentioning

confidence: 99%

The Relationship between Abdominal Fat Phenotypes and Insulin Resistance in Non-Obese Individuals after Acute Pancreatitis

Skudder-Hill

Cho

et al. 2020

Nutrients

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“…RAP may run a milder clinical course than an index episode [15,16], but the fatality rate of which was signi cantly higher than that of patients with rst-episode AP [17]. Few reports have studied that the more frequent the onset of RAP, the more noticeable the decrease of the total pancreas volume and tail diameter, and the higher the incidence of CP [8,18]. Therefore, the prediction of short-term recurrence of RAP is worthwhile to the early intervention and treatment of CP.…”

Section: Discussionmentioning

confidence: 99%

“…RAP was described as AP occurring at least 3 months after the previous episode. The number of prior attacks was determined based on the admitting history and physical note and past Chronic renal insu ciency and multiple organ failure; (8) Abdominal trauma or surgery.…”

Section: Patientsmentioning

confidence: 99%

“…Clinical data from all over the world show that the recurrence rate of acute pancreatitis is 10-30% [2][3][4][5][6]. In addition to increasing the social burden and affecting the quality of life of the patient with RAP, current epidemiological and imaging data suggest that RAP has a higher risk of developing chronic pancreatitis(CP), and the more times of recurrence, the higher the risk of progression to CP [7,8]. However, most of the literatures around the world focus on the analysis of high risk factors and imaging changes of RAP [9,10] it has not been reported in the literature that there are high risk factors and predictive models related to short-term recurrence of RAP.…”

Section: Introductionmentioning

confidence: 99%

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Establishment of a Model for Predicting the Recurrence of Recurrent Acute Pancreatitis in A Short Period of Time

Yang

Liu

et al. 2020

Preprint

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Background Little is known about what factors affect recurrence of recurrent acute pancreatitis (RAP) in a short-term. We performed a retrospective study of patients with RAP, and used non-invasive and quantitative biomarkers to establish a predictive model, so as to provide a basis for effectively predicting and preventing recurrence of RAP. MethodsWe performed a retrospective study of 261 RAP patients admitted to Dazhou Central Hospital from January 2008 through December 2018. The short-term group (n=138) and the long-term group (n=123) were compared. Eight clinical patient characteristics and past medical history were collected from admission records. The prediction model was developed by independent risk factors，and the model to predict the effects were confirmed by the area under the ROC cure．ResultsThe study found that β2-microglobulin (β2-MG) (OR, 0.534; 95% CI, 0.329 to 0.866) and C-reactive protein (CRP) (OR, 1.01; 95% CI, 1.002 to 1.017) were the independent predictors of short-term recurrence. Based on these Independent risk factors，a predicted model for short-term recurrence in RAP patients was constructed．The model was L=β2-MG -0.016BCRP. The AUC for model was 0.651 and the optimal cut-off value was 0.7414, with a sensitivity of 65.9%and a specificity of 63.4%.ConclusionsA new biomarker-based model for predicting risk of short-term recurrence in patients with RAP was satisfactorily developed. The model utilizing β2-MG and CRP may assist physicians in patient education and decision-making when preventing from recurrent attacks with RAP.

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“…Axial T1-weighted volumetric interpolated breath-hold examination Dixon sequence was used. Sequential parameters were reported elsewhere [17].…”

Section: Methodsmentioning

confidence: 99%

Relationship of Anthropometric Indices to Abdominal Body Composition: A Multi-Ethnic New Zealand Magnetic Resonance Imaging Study

et al. 2019

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Background Conventional anthropometric indices (body mass index (BMI) and waist circumference (WC)) have limitations, in part, due to ethnic differences in fat distribution. Assessment of abdominal body composition using magnetic resonance imaging (MRI) is increasingly used to gain deeper insights into the pathophysiology of diabetes mellitus, cardiovascular diseases and metabolic syndrome, but the knowledge of abdominal volumes in indigenous populations is scarce. This study aimed to assess abdominal fat distribution and total abdominal volume using MRI in a multi-ethnic cohort that includes Maori (the indigenous people of New Zealand) and Pacific Islanders (PI). Methods MRI was used to quantify subcutaneous adipose tissue (SAT) volume, visceral adipose tissue (VAT) volume and total abdominal (TAb) volume by two independent raters in a blinded fashion. WC and BMI were also measured. Multinomial regression was used to compare the volumes between ethnic groups. Linear regression was used to investigate the ethnicity-specific associations between anthropometric indices and abdominal volumes. Three statistical models were built to adjust for age, sex, prediabetes/diabetes status and other covariates. Results A total of 87 individuals (37 Caucasians, 24 Maori/PI and 26 others) were studied. Maori/PI had a significantly higher VAT volume compared with Caucasians across all statistical models, with the highest odds ratio of 2.1 (95% confidence interval: 1.1 - 4.2; P = 0.026). SAT and TAb volumes did not differ significantly between the groups. WC explained up to 72.9% of variance in VAT volume among Maori/PI and up to 50.7% among Caucasians. BMI explained up to 67.6% of variance in VAT volume among Maori/PI and up to 52.1% among Caucasians. Conclusions Greater visceral fat deposition among Maori/PI might go some way towards explaining the increased rates of metabolic disorders observed in this ethnic group. Conventional anthropometric indices do not correspond to the same abdominal volumes across different ethnic groups.

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Pancreas shrinkage following recurrent acute pancreatitis: an MRI study

Cited by 48 publications

References 34 publications

The Relationship between Abdominal Fat Phenotypes and Insulin Resistance in Non-Obese Individuals after Acute Pancreatitis

The Relationship between Abdominal Fat Phenotypes and Insulin Resistance in Non-Obese Individuals after Acute Pancreatitis

Establishment of a Model for Predicting the Recurrence of Recurrent Acute Pancreatitis in A Short Period of Time

Relationship of Anthropometric Indices to Abdominal Body Composition: A Multi-Ethnic New Zealand Magnetic Resonance Imaging Study

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