Visceral Adipose Tissue in Patients with Crohnʼs Disease Correlates with Disease Activity, Inflammatory Markers, and Outcome

Abstract

VAT accumulation could be a prospective risk factor for increased disease activity in CD.

Visceral adiposity predicts post‐operative Crohn's disease recurrence

“…Crohn's disease patients in clinical remission have been found three times more likely than healthy controls to have sarcopenia, with a recent systematic review finding that body composition parameters often varied from population norms, including lower bone mineral density, lower body mass index (BMI) and lower fat‐free mass . Expansion of the visceral adipose tissue compartment in Crohn's disease is also described, with a four‐fold increase in adipocyte number compared to controls and an increased volume of visceral adipose tissue …”

“…We do not have data regarding these surgical factors in our study. An observational cohort study found that penetrating or stricturing Crohn's disease was associated with an increased visceral adipose tissue/fat mass ratio, and that a high visceral adipose tissue/fat mass ratio was associated with increased disease activity at follow‐up . High mesenteric fat index, but not BMI nor abdominal circumference, was associated with 30‐day morbidity in a retrospective cohort of 143 patients .…”

“…There is considerable variation in the anatomical deposition of fat among individuals of the same body mass index and same total fat mass, with cross‐sectional abdominal imaging providing accurate measurement of fat area and volume . Patients with Crohn's disease are known to have a higher ratio of intra‐abdominal to total abdominal fat, and higher visceral adipose tissue area, than controls . Pro‐inflammatory genes are up‐regulated with increasing visceral adipose tissue volume .…”

“…[10][11][12][13] Patients with Crohn's disease are known to have a higher ratio of intra-abdominal to total abdominal fat, and higher visceral adipose tissue area, than controls. 14,15 Pro-inflammatory genes are up-regulated with increasing visceral adipose tissue volume. 16 In the obese state, visceral adipose tissue is infiltrated by inflammatory cells; adipose tissue macrophages can account for as much as 40 per cent of the cellular mass.…”

Visceral Adiposity, Genetic Susceptibility, and Risk of Complications Among Individuals with Crohnʼs Disease

“…Similarly, Bunning and colleagues demonstrated a good correlation between index of VAT accumulation (VAT/total fat mass) and disease activity and complications in small cohort of adult women with CD (N = 31). 19 Interestingly, a number of recent studies have also demonstrated an association between visceral adiposity and post-operative morbidity and disease recurrence in CD. 20,21 Because these prior studies have small sample sizes and limited information on other key risk factors, our analysis which benefited from nearly 500 well-characterized CD patients and carefully adjusted for important confounders significantly extends these prior findings.…”