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Visceral Adiposity Predicts Severity of Acute Pancreatitis
Ashwinee Natu1, Tyler Stevens, Lorna Kang
1From the *Department of Internal Medicine, University Hospitals Cleveland Medical Center; †Department of Gastroenterology, Digestive Disease Institute, Cleveland Clinic; ‡Case Western Reserve University School of Medicine; §Department of Quantitative Health Sciences, Cleveland Clinic; ∥Department of Gastroenterology, Digestive Disease Institute, University Hospitals Cleveland Medical Center; ¶Department of Abdominal Imaging, Imaging Institute, Cleveland Clinic; #Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH.
Objectives:
The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP).
Methods:
This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity.
Results:
Five hundred and seventy four patients were admitted during the study period, of which 252 had a computed tomography scan available. Patients with severe AP had a larger VAT area compared with those with mild or moderate AP (mean: 184.9 cm vs 79.9 cm, P = 0.006). Patients who developed multisystem organ failure or had acute necrotic collections had a larger VAT area than those who did not (150.6 cm vs 91.0 cm, P = 0.004 and 174.0 cm vs 91.9 cm, P = 0.003, respectively). Visceral adipose tissue area demonstrated superior discrimination of severe AP compared with other severity predictors.
Conclusions:
Increased VAT area is a strong predictor of severe pancreatitis, necrosis, and multisystem organ failure.
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