Visceral Adiposity Predicts Severity of Acute Pancreatitis

Natu, Ashwinee; Stevens, Tyler; Kang, Lorna; Yasinow, Scott; Mansoor, Emad; López, Rocío; Glessing, Brooke; Remer, Erick M.; Richards, Tyler; Gupta, Amit; Chak, Amitabh; Lee, Peter J.W.

doi:10.1097/mpa.0000000000000845

Cited by 46 publications

(38 citation statements)

References 47 publications

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“…In addition, the scoring tools do not distinguish between truncal obesity and visceral obesity. Some studies showed that VAT significantly correlates with poor outcomes in AP patients [10, 14–16]. Therefore, we investigated the relationship between body parameters, prognosis, and mortality in AP patients.…”

Section: Discussionmentioning

confidence: 99%

“…Yoon et al [10] found that high visceral fat with low skeletal muscle volume plays an important role in AP severity. Natu et al [16] found that VAT is closely associated with organ failure and necrosis in AP. However, there are some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, many parameters related to sarcopenic obesity, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), skeletal muscle tissue (SMT), and the VAT/SMT ratio, have been considered important risk factors of AP [10–13]. Some recent reports indicated that increased VAT is more closely associated with AP severity compared to BMI [10, 14–16]. However, it is unclear which parameter is the best predictor of AP severity [17].…”

Section: Introductionmentioning

confidence: 99%

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Impact of visceral adiposity on severity of acute pancreatitis: a propensity score-matched analysis

Xie

Pan

et al. 2019

BMC Gastroenterol

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Background The relationship between visceral adiposity and acute pancreatitis (AP) has not been completely elucidated. This study evaluated the significance of visceral adipose tissue (VAT) and the ratio of VAT to skeletal muscle tissue (VAT/SMT) in the prognosis of AP patients. Methods Based on a 1:2 propensity score matching, 306 hospitalized patients were enrolled in the study analysis from 2010 to 2017. VAT, subcutaneous adipose tissue (SAT), and SMT were measured using unenhanced computed tomography (CT). Cox proportional hazards models were applied for the analysis. Results VAT and the VAT/SMT ratio were significantly higher in the severe AP (SAP) and moderately severe AP (MSAP) groups compared to the mild AP (MAP) group (both p < 0.001). Intensive care transfer, AP severity, systemic complications, and prognostic scores (Acute Physiology and Chronic Health Evaluation II [APACHE-II] score ≥ 8, Ranson’s score ≥ 3, Bedside Index of Severity in Acute Pancreatitis [BISAP] score ≥ 3, and the systemic inflammatory response syndrome [SIRS] score ≥ 2) significantly correlated with VAT and the VAT/SMT ratio in AP patients. The multivariate adjusted hazard ratios (HRs) for VAT and the VAT/SMT ratio in the relationship of body parameters and AP mortality were 1.042 (95% confidence interval (CI), 1.019–1.066) and 7.820 (95% CI, 1.978–30.917), respectively. Compared with other prognostic scores, VAT had the highest area under the curve of receiver operating characteristics (ROC) (0.943, 95% CI, 0.909–0.976). Conclusion High VAT and VAT/SMT ratio are independent negative prognostic indicators of AP. Trial registration Clinical study registration number: NCT03482921 . Date of registration: 03/23/2018.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of visceral adiposity on severity of acute pancreatitis: a propensity score-matched analysis

Xie

Pan

et al. 2019

BMC Gastroenterol

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“…It may be caused by saturation of cholesterol in bile, which could consequently induce gallstone formation [42]. Moreover, visceral fat was also associated with severity of AP [43]. The level of adiponectin would paradoxically decrease due to excess viscera fat, which would subsequently increase the secretion of proin ammatory cytokines such as TNF-α and interleukin-6, and thus amplify the in ammatory response [44,45].…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome Components and Acute Pancreatitis: A Case-Control Study in China

Shen

Wang

Zhen

et al. 2020

Preprint

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Background: Acute pancreatitis (AP) is a common inflammatory disorder of the pancreas. Recent evidence has shown that metabolic syndrome is positively correlated with the severity of AP. However, only a few studies have revealed the relationship between metabolic syndrome and the occurrence of AP. We therefore elucidated the association between the components of metabolic syndrome and the occurrence of AP. Methods: A hospital-based case-control study was conducted. A total of 705 patients admitted to our hospital from January 2016 to December 2018 were included in the study. Subjects were divided into case and control groups according to their diagnosis: (1) According to the revised Atlanta classification from 2012, patients diagnosed with AP were enrolled in the case group. (2) Patients without a history of AP or any disease related to metabolic syndrome were allocated into the control group. Controls were matched to cases individually by sex and age (control/case ratio=1). Results: The incidence rate of metabolic syndrome in AP patients was 30.9%, which was more frequent than that in controls (13.2%) (OR=2.837; 95% CI 1.873-4.298, p<0.001). In the multivariate regression analysis, a history of smoking or alcohol consumption and biliary stones were significantly associated with AP (OR=2.441; 95% CI 1.865-5.172, p<0.001; OR=1.777; 95% CI 1.060-2.977, p=0.029; OR=28.995; 95% CI 13.253-63.435, p<0.001). In addition, the occurrence of AP was significantly associated with total cholesterol (TC) (OR=1.992; 95% CI 1.246-3.183, p=0.004), triglyceride (TG) (OR=2.134; 95% CI 1.403-3.245, p<0.001), hyperglycaemia (OR=2.261; 95% CI 1.367-3.742, p=0.001), and low values of apolipoprotein A (Apo A) (OR=0.270; 95% CI 0.163-0.447, p<0.001). Conclusions: Metabolic syndrome and its components were associated with AP occurrence.

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“…Further studies found that visceral fat, not peripheral fat, is closely related to the formation of pseudocysts in patients with AP and SIRS. In contrast, patients with excessive visceral fat are more likely to have SAP [9]. Apart from obesity; hypertriglyceridemia is another key lipid metabolism disease that affects AP [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Association of the hypertriglyceridemic waist phenotype and severity of acute pancreatitis

et al. 2019

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Background The aim of this study was to evaluate the effect of a simple visceral obesity phenotype, known as the hypertriglyceridemic waist phenotype and its quantitative indicator waist circumference index on the severity of acute pancreatitis. Materials and methods Diagnosis and severity analysis of acute pancreatitis were determined according to the Atlanta classification guidelines, revised in 2012. We considered the hypertriglyceridemic waist phenotype as characterized by increased waist circumference and elevated triglyceride concentrations. We investigated the association between the acute pancreatitis severity and hypertriglyceridemic waist phenotype, including waist circumference index. Results The hypertriglyceridemic waist phenotype was significantly associated with systemic inflammatory response syndrome, organ failure, and severe acute pancreatitis. The median waist circumference index and demonstration of hypertriglyceridemic waist phenotype were positively correlated with acute pancreatitis severity. In addition, multivariate logistic analysis showed that patients with the hypertriglyceridemic waist phenotype had 1.664 times the risk of organ failure and 1.891 times the risk of systemic inflammatory response syndrome, compared with the other groups. Conclusion Upon admission, the hypertriglyceridemic waist phenotype was strongly associated with acute pancreatitis in patients. This phenotype, including waist circumference index, might be a simple method for evaluating individuals at high risk of severe acute pancreatitis. Electronic supplementary material The online version of this article (10.1186/s12944-019-1019-2) contains supplementary material, which is available to authorized users.

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Visceral Adiposity Predicts Severity of Acute Pancreatitis

Abstract: Increased VAT area is a strong predictor of severe pancreatitis, necrosis, and multisystem organ failure.

Cited by 46 publications

References 47 publications

Impact of visceral adiposity on severity of acute pancreatitis: a propensity score-matched analysis

Impact of visceral adiposity on severity of acute pancreatitis: a propensity score-matched analysis

Metabolic Syndrome Components and Acute Pancreatitis: A Case-Control Study in China

Association of the hypertriglyceridemic waist phenotype and severity of acute pancreatitis

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