The Effects of the Fat Distribution of Body, Skeletal Muscle Mass and Muscle Quality on Acute Pancreatitis Severity: A Retrospective Cross-Sectional Study

Aktürk, Yeliz; Güneş, Serra Özbal; Hekįmoğlu, Baki

doi:10.1097/rct.0000000000001175

Cited by 4 publications

(5 citation statements)

References 31 publications

(78 reference statements)

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“… 34 Evaluation of the relationship between AP and CT-determined muscle parameters showed that the TPI was significantly higher in patients with MAP than with MSAP and SAP, as well as being substantially lower in patients with severe pancreatic necrosis than in those without necrosis. 35 To date, however, no studies have evaluated the relationship between PMA and AP. To our knowledge, the current study is the first to investigate the predictive value of PMA in patients with AP.…”

Section: Discussionmentioning

confidence: 99%

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Fu¹,

Li²,

Xing³

et al. 2023

IJGM

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Objective The Global Leadership Initiative on Malnutrition (GLIM) has proposed criteria for the diagnosis of malnutrition, one of which is reduced muscle mass. Computed tomography (CT) assessment of psoas muscle area (PMA) has been used to estimate muscle mass in patients, including those with acute pancreatitis (AP). The present study aimed to define the cutoff value of PMA indicative of reduced muscle mass in patients with AP and to assess the impact of reduced muscle mass on the severity and early complications of AP. Methods Clinical data of 269 patients with AP were analyzed retrospectively. The severity of AP was determined according to the revised Atlanta classification. PMA was evaluated by CT and used to calculate the psoas muscle index (PMI). Cutoff values for reduced muscle mass were calculated and validated. Logistic regression analysis was performed to assess the relationship between PMA and the severity of AP. Results PMA was a better indicator of reduced muscle mass than PMI, with cutoff values of 11.50 cm 2 for men and 8.22 cm 2 for women. Rates of local complications, splenic vein thrombosis, and organ failure were significantly higher in AP patients with low than high PMA (all p < 0.05). PMA showed good ability to predict splenic vein thrombosis in women, with an area under the receiver operating characteristic curve of 0.848 (95% confidence interval 0.768–0.909, sensitivity 100%, specificity 83.64%). Multivariate logistic regression revealed that PMA was an independent risk factor for moderately severe plus severe AP (odds ratio 5.639, p = 0.001) and severe AP (odds ratio 3.995, p = 0.038). Conclusion PMA is a good predictor of the severity and complications of AP. The PMA cutoff value is a good indicator of reduced muscle mass.

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Section: Discussionmentioning

confidence: 99%

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Fu¹,

Li²,

Xing³

et al. 2023

IJGM

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show abstract

“…PE is important for assessing the severity and prognosis of AP and is the main symptom of extrapancreatic involvement of AP [ 29 ]. Although PE can also be detected radiologically early, most of them occur earlier than the date of pancreatic injury, and the incidence of PE increases with increasing CTSI score [ 30 ]. This revealed that PE can be recommended as a reference technical index for the diagnosis of severe pancreatitis, especially if PE is found within 24 hours after onset, and the mortality rate will be significantly improved.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Inflammatory Infiltration in the Retroperitoneal Space of Acute Pancreatitis Using Computer Tomography and Its Correlation with Clinical Severity

Teng

2023

Contrast Media & Molecular Imaging

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This paper investigates the correlation between the degree and severity of CT inflammatory infiltration in the retroperitoneal space of acute pancreatitis (AP). A total of 113 patients were included based on diagnostic criteria. The general data of the patients and the relationship between the computed tomography severity index (CTSI) and pleural effusion (PE), involvement, degree of inflammatory infiltration of retroperitoneal space (RPS), number of peripancreatic effusion sites, and degree of pancreatic necrosis on contrast-enhanced CT at different times were studied. The results showed that the mean age of onset in females was later than that in males; 62 cases involved RPS to varying degrees, with a positive rate of 54.9% (62/113), and the total involvement rates of only the anterior pararenal space (APS); both APS and perirenal space (PS); and APS, PS, and posterior pararenal space (PPS) were 46.9% (53/113), 53.1% (60/113), and 17.7% (20/113), respectively. The degree of inflammatory infiltration in the RPS worsened with the increase in CTSI score; the incidence of PE was higher in the group greater than 48 hours than in the group less than 48 hours; necrosis >50% grade was predominant (43.2%) 5 to 6 days after onset, with a higher detection rate than other time periods ( P < 0.05). Thus, when the PPS was involved, the patient’s condition can be treated as severe acute pancreatitis (SAP); the higher the degree of inflammatory infiltration in the retroperitoneum, the higher the severity of AP. Enhanced CT examination 5 to 6 days after onset in patients with AP revealed the greatest extent of pancreatic necrosis.

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“…21 In the very early stage of severe patients, there is more fluid sequestration, and consequently, edema gives false-high values by affecting measurements. 26 However, limited significant data have been reported for diuretics, enteral nutrition, comorbidities and time since the onset of HTGP. Although myosteatosis is associated with different pathological conditions, its pathogenesis remains uncertain.…”

Section: Discussionmentioning

confidence: 99%

“…The latter is much more common in patients during the course of AP 21 . In the very early stage of severe patients, there is more fluid sequestration, and consequently, edema gives false‐high values by affecting measurements 26 . However, limited significant data have been reported for diuretics, enteral nutrition, comorbidities and time since the onset of HTGP.…”

Section: Discussionmentioning

confidence: 99%

The modified computed tomography severity index combined with low skeletal muscle mass can better predict the severity of hypertriglyceridemia‐induced pancreatitis

Chen

et al. 2022

J Hepato Biliary Pancreat

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Background: Body composition parameters are associated with hypertriglyceridemia-induced pancreatitis (HTGP). This study investigated the association between the quantity of muscle assessed using computed tomography (CT) and the severity of HTGP. Methods:The modified CT severity index (MCTSI) was calculated from admission examination data. Patients' characteristics and body composition parameters were collected. Univariate and multivariate logistic regression analyses were also performed. The receiver operating characteristic curves and corresponding area under the curves (AUC) were calculated to test the efficiency of the model. A nomogram was then constructed.Results: Of the 175 included patients, 138 were male, of which 85 had moderately severe to severe HTGP. Patients with low skeletal muscle mass (LSMM) and high MCTSI were significantly more likely to have moderately severe to severe HTGP. Patients with LSMM had lower body mass index, lower HDL-C level, higher amylase level, prevalence of surgery, shorter umbilical waist circumference, and longer length of hospital stay. Univariate and multivariate logistic regression analyses confirmed that female sex, lipase, total cholesterol, LSMM-MCTSI (P = .004, odds ratio = 23.105), and albumin were risk factors. The TOTAL model that combined LSMM-MCTSI and clinical risk parameters performed best (AUCs = 0.875), followed by other models (LSMM-MCTSI: AUCs = 0.762, MCTSI: AUCs = 0.728). The Delong test revealed significant difference. Finally, a nomogram was developed to predict the severity of HTGP. Conclusion:The performance of MCTSI in predicting severity can be improved by considering LSMM, which is a promising strategy for the treatment of HTGP.

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The Effects of the Fat Distribution of Body, Skeletal Muscle Mass and Muscle Quality on Acute Pancreatitis Severity: A Retrospective Cross-Sectional Study

Cited by 4 publications

References 31 publications

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Cutoff Value of Psoas Muscle Area as Reduced Muscle Mass and Its Association with Acute Pancreatitis in China

Evaluation of Inflammatory Infiltration in the Retroperitoneal Space of Acute Pancreatitis Using Computer Tomography and Its Correlation with Clinical Severity

The modified computed tomography severity index combined with low skeletal muscle mass can better predict the severity of hypertriglyceridemia‐induced pancreatitis

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