Related Experiment Videos
Increase of Intra-abdominal Adipose Tissue in Pediatric Crohn Disease
Klara Frivolt1,2, Holger Hetterich3, Tobias Schwerd1
1Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany.
Insights
Intra-abdominal adipose tissue (IAAT) is elevated in pediatric Crohn disease (CD) and linked to longer disease duration. This finding may inform future MRI assessments for CD inflammation and damage.
Area of Science:
- Pediatric Gastroenterology
- Radiology
- Immunology
Background:
- Emerging evidence suggests intra-abdominal adipose tissue (IAAT) plays an active immunological role in Crohn disease (CD).
- Quantifying IAAT compartments via MRI in pediatric CD patients is crucial for understanding its role.
Purpose of the Study:
- To quantify abdominal adipose tissue compartments in pediatric CD patients using MRI.
- To compare IAAT, SCAT, and TAAT areas in CD patients versus controls.
- To analyze associations between IAAT measurements and disease duration, phenotype, or therapy.
Main Methods:
- Semiautomatic segmentation of MRI T1-weighted sequences to measure total (TAAT), subcutaneous (SCAT), and intra-abdominal (IAAT) adipose tissue areas.
- Calculation of IAAT/TAAT and IAAT/height ratios.
- Statistical analysis to compare groups and assess correlations.
Main Results:
- Pediatric CD patients exhibited significantly higher IAAT area compared to controls (P=0.0494).
- The IAAT/TAAT ratio was significantly higher in CD patients (P=0.0081) and correlated with disease duration.
- Increased IAAT/height ratio was associated with complicated disease in CD patients (P=0.043).
Conclusions:
- Intra-abdominal adipose tissue (IAAT) is increased in pediatric Crohn disease and correlates with disease duration.
- IAAT assessment could be valuable for future MRI scoring of inflammation and bowel damage in CD.
- Monitoring IAAT accumulation may aid in evaluating therapeutic interventions.
Background And Objective:
Recent evidence points toward an active immunological role of intra-abdominal adipose tissue in Crohn disease (CD). We quantified the abdominal adipose tissue compartments using magnetic resonance imaging (MRI) in 27 pediatric patients with CD compared with 14 controls undergoing MRI examination for other reasons.
Methods:
Total (TAAT), subcutaneous (SCAT) and intra-abdominal (IAAT) adipose tissue areas were measured by semiautomatic segmentation on a transverse slice centered on the umbilicus (mean ± standard deviation in square centimeter) using standard T1-weighted sequences. IAAT/TAAT and IAAT/height ratios were calculated and analyzed for associations with disease duration, phenotype, or therapy.
Results:
Patients with CD (median age 15.0 years, range 7.7-17.9, 18/27 boys, median disease duration 29 months, range 0-136) compared to controls (median age 13.9 years, range 3.3-17.8, 4/14 boys) had higher IAAT area (42.3 ± 21.0 vs 28.7 ± 11.6, P = 0.0494) but similar SCAT and TAAT areas (104.6 ± 72.8 vs 96.5 ± 50.8, P = 0.8170 and 146.9 ± 87.3 vs 125.3 ± 61.5, P = 0.7417, respectively). IAAT/TAAT ratio was higher in patients with CD compared to controls (0.32 ± 0.10 vs 0.24 ± 0.04, P = 0.0081). Patients with disease duration >2 years (n = 14) had higher IAAT/TAAT ratio than those with shorter disease and controls (0.35 ± 0.10 vs 0.28 ± 0.08, P = 0.0288 and 0.24 ± 0.04, P = 0.0009, respectively). In these patients, increased IAAT/height ratio was associated with complicated disease (P = 0.043, r = 0.573). No association was found between IAAT/TAAT ratio and actual disease activity or therapy.
Conclusions:
IAAT is increased in pediatric CD and correlates with disease duration. Assessment of IAAT accumulation may be considered in future MRI scores for inflammation and bowel damage in CD and during follow-up of different therapeutic interventions.