Visceral adipose tissue and acute pancreatitis: a systematic review and meta-analysis

Visceral adipose tissue (VAT) contributes to the severity of acute pancreatitis (AP) through systemic inflammation and metabolic dysregulation, but its predictive value remains unclear.

PubMed, Embase, Cochrane Library, and Web of Science databases were searched to collect related studies until April 9, 2025, and the literature search was updated as of January 30, 2026. The quality of the included studies was assessed using the NIH scale. Statistical analysis was performed using Stata 15.0.

The meta-analysis comprised 13 articles in total with 2,917 patients, and the overall quality of the included articles was high. The meta-analysis indicated high VAT content in patients with moderately severe AP (MSAP) (standardized mean difference (SMD) = 0.61, 95% confidence interval (CI) [0.12-1.11]) and patients with severe AP (SAP) (SMD = 0.85, 95% CI [0.17-1.52]) than that of patients with mild AP (MAP). No statistical difference in VAT content was found between patients with MSAP and SAP (SMD = 0.36, 95% CI [-0.03-0.75]). VAT was an independent risk factor for SAP (OR = 2.12, 95% CI [1.34-3.36]), with moderate diagnostic efficacy for AP (AUC = 0.74, 95% CI [0.63-0.85]).

This systematic review suggests that VAT is associated with SAP and may have comparable diagnostic performance to established tools. However, these findings are based on observational studies with significant methodological limitations, including lack of blinding and substantial heterogeneity. Therefore, the evidence should be interpreted with caution, and the associations identified require confirmation in well-designed prospective studies incorporating rigorous blinding. VAT may serve as a potential reference for future precision assessment tools, but its clinical utility remains to be validated.