Can Creeping Fat Be a Prognostic Factor in Crohn's Disease?

Area of Science:

• Gastroenterology
• Radiology
• Medical Imaging

Background:

• Crohn's disease (CD) management requires accurate prognostic markers.
• Creeping fat (CF), an increase in mesenteric fat, is observed in CD patients.
• Computed tomography (CT) is a common imaging modality for CD assessment.

Purpose of the Study:

• To evaluate if creeping fat (CF) findings on CT scans can serve as a noninvasive marker for predicting Crohn's disease prognosis.
• To determine the association between CF characteristics and disease severity, specifically stenosis.

Main Methods:

• Retrospective analysis of CT scans from 128 Crohn's disease patients (aged 18-70).
• Patients categorized into groups based on stenosis: operated, unoperated, and no stenosis.
• Evaluation of CF Index (bowel surface area coverage ratio - BSACR), CF density, and visceral-subcutaneous fat ratio (VSFR).

Main Results:

• The visceral-subcutaneous fat ratio (VSFR) was significantly higher in patients with stenosis compared to those without (0.7 vs 0.4; P = .003).
• The CF Index BSACR was significantly higher in the stenosed group (27.1% vs 18.2%; P = .001).
• Odds of stenosis increased substantially with higher CF Index BSACR values (OR = 17.07 for ≥37.5%, OR = 184.57 for ≥50%).

Conclusions:

• The CF Index BSACR is a promising noninvasive radiologic marker for predicting Crohn's disease prognosis.
• CF findings on CT correlate with stricturing disease, aiding in prognosis assessment.
• CT-evaluated creeping fat may help identify patients at higher risk for stenosis.