中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 10
Oct.  2022
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(10): 2313-2319

Relationship between visceral fat related index and the severity of acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2022.10.021

  • Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China

Research funding:

National Natural Science Foundation of China (81970558);

Natural Science Foundation of Guangxi Province (2018GXNSFBA281078)

More Information
  • Corresponding author: TANG Guodu, tguodu02@126.com(ORCID: 0000-0002-2849-3244)
  • Received Date: 2022-03-08
  • Accepted Date: 2022-04-04
  • Published Date: 2022-10-20
    Abstract
  •   Objective  To investigate the relationship between visceral fat related index and the severity of acute pancreatitis (AP).  Methods  A total of 308 patients hospitalized with AP at the First Affiliated Hospital of Guangxi Medical University from September 2014 to October 2021 were included. They were divided into mild acute pancreatitis (MAP) (n=186), moderate severe acute pancreatitis (MSAP) (n=60) and severe acute pancreatitis (SAP) (n=62) for comparison in age, hospitalization cost and days, scoring systems and body mass indexes. Comparison of normally distributed continuous data with homogeneity of variance between groups was made by one-way analysis of variance, and intergroup and intragroup pairwise comparison of data with heterogeneity of variance was made by the Kruskal-Wallis H test. The receiver operating characteristic curves (ROCs) for each index were constructed and area under the curve (AUC) was calculated to evaluate the performance of each index. Univariable and multivariable logistic regression analyses were used to identify the independent risk factors of MSAP and SAP.  Results  There were significant differences among the three groups in terms of hospitalization costs and durations, TG, HDL-C, NLR, WBC, Alb, Cr, BUN, scoring systems, CMI, LAP, WTI and CVAI. Further pairwise comparisons revealed that CMI, LAP, WTI and CVAI were significantly higher in the MAP group than in MSAP and SAP groups. We also found correlation between CMI and the severity of AP (r=0.352, P < 0.001). By comparing the AUCs, CMI was found to be the most accurate in predicting the occurrence of MSAP and SAP. Univariable logistic regression analysis showed that CMI, LAP, WTI, CVAI and WC were the risk factors of MSAP and SAP. After adjusting for confounding factors, CMI and CVAI were identified as the independent risk factors of MSAP and SAP. The risk of MSAP and SAP with CMI ≥ 0.801 was 3.740 times that with CMI < 0.801 (95%CI: 1.983~7.056, P < 0.001).  Conclusions  Visceral fat is related to the severity of AP. Among the four visceral fat related indexes (CMI, LAP, WTI and CVAI), cardiometabolic index is the most valuable in predicting the severity of AP and they are positively correlated. CMI, an independent risk factor for MSAP and SAP, can be used to predict and assess the severity of AP.

     

    • FullText(HTML)
  • loading
    • References(32)
  • [1]
    LEE PJ, PAPACHRISTOU GI. New insights into acute pancreatitis[J]. Nat Rev Gastroenterol Hepatol, 2019, 16(8): 479-496. DOI: 10.1038/s41575-019-0158-2.
    [2]
    LANKISCH PG, APTE M, BANKS PA. Acute pancreatitis[J]. Lancet, 2015, 386(9988): 85-96. DOI: 10.1016/S0140-6736(14)60649-8.
    [3]
    ZHOU H, MEI X, HE X, et al. Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase: A retrospective study[J]. Medicine (Baltimore), 2019, 98(16): e15275. DOI: 10.1097/MD.0000000000015275.
    [4]
    KONG W, HE Y, BAO H, et al. Diagnostic value of neutrophil-lymphocyte ratio for predicting the severity of acute pancreatitis: A meta-analysis[J]. Dis Markers, 2020, 2020: 9731854. DOI: 10.1155/2020/9731854.
    [5]
    LI M, XING XK, LU ZH, et al. Comparison of scoring systems in predicting severity and prognosis of hypertriglyceridemia-induced acute pancreatitis[J]. Dig Dis Sci, 2020, 65(4): 1206-1211. DOI: 10.1007/s10620-019-05827-9.
    [6]
    UNAMUNO X, GÓMEZ-AMBROSI J, RODRÍGUEZ A, et al. Adipokine dysregulation and adipose tissue inflammation in human obesity[J]. Eur J Clin Invest, 2018, 48(9): e12997. DOI: 10.1111/eci.12997.
    [7]
    CHEN SM, XIONG GS, WU SM. Is obesity an indicator of complications and mortality in acute pancreatitis? An updated meta-analysis[J]. J Dig Dis, 2012, 13(5): 244-251. DOI: 10.1111/j.1751-2980.2012.00587.x.
    [8]
    WAKABAYASHI I, DAIMON T. The "cardiometabolic index" as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus[J]. Clin Chim Acta, 2015, 438: 274-278. DOI: 10.1016/j.cca.2014.08.042.
    [9]
    BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. DOI: 10.1136/gutjnl-2012-302779.
    [10]
    SINGH RG, CERVANTES A, KIM JU, et al. Intrapancreatic fat deposition and visceral fat volume are associated with the presence of diabetes after acute pancreatitis[J]. Am J Physiol Gastrointest Liver Physiol, 2019, 316(6): G806-G815. DOI: 10.1152/ajpgi.00385.2018.
    [11]
    PITT HA. Hepato-pancreato-biliary fat: the good, the bad and the ugly[J]. HPB (Oxford), 2007, 9(2): 92-97. DOI: 10.1080/13651820701286177.
    [12]
    FAIN JN, MADAN AK, HILER ML, et al. Comparison of the release of adipokines by adipose tissue, adipose tissue matrix, and adipocytes from visceral and subcutaneous abdominal adipose tissues of obese humans[J]. Endocrinology, 2004, 145(5): 2273-2282. DOI: 10.1210/en.2003-1336.
    [13]
    WANG C. Obesity, inflammation, and lung injury (OILI): the good[J]. Mediators Inflamm, 2014, 2014: 978463.
    [14]
    NATU A, STEVENS T, KANG L, et al. Visceral adiposity predicts severity of acute pancreatitis[J]. Pancreas, 2017, 46(6): 776-781. DOI: 10.1097/MPA.0000000000000845.
    [15]
    PATEL K, TRIVEDI RN, DURGAMPUDI C, et al. Lipolysis of visceral adipocyte triglyceride by pancreatic lipases converts mild acute pancreatitis to severe pancreatitis independent of necrosis and inflammation[J]. Am J Pathol, 2015, 185(3): 808-819. DOI: 10.1016/j.ajpath.2014.11.019.
    [16]
    KATUCHOVA J, BOBER J, HARBULAK P, et al. Obesity as a risk factor for severe acute pancreatitis patients[J]. Wien Klin Wochenschr, 2014, 126(7-8): 223-227. DOI: 10.1007/s00508-014-0507-7
    [17]
    SADR-AZODI O, ORSINI N, ANDRÉN-SANDBERG Å, et al. Abdominal and total adiposity and the risk of acute pancreatitis: a population-based prospective cohort study[J]. Am J Gastroenterol, 2013, 108(1): 133-139. DOI: 10.1038/ajg.2012.381.
    [18]
    CHEN L, HUANG Y, YU H, et al. The association of parameters of body composition and laboratory markers with the severity of hypertriglyceridemia-induced pancreatitis[J]. Lipids Health Dis, 2021, 20(1): 9. DOI: 10.1186/s12944-021-01443-7
    [19]
    YOON SB, CHOI MH, LEE IS, et al. Impact of body fat and muscle distribution on severity of acute pancreatitis[J]. Pancreatology, 2017, 17(2): 188-193. DOI: 10.1016/j.pan.2017.02.002
    [20]
    FANG H, BERG E, CHENG X, et al. How to best assess abdominal obesity[J]. Curr Opin Clin Nutr Metab Care, 2018, 21(5): 360-365. DOI: 10.1097/MCO.0000000000000485
    [21]
    O'LEARY DP, O'NEILL D, MCLAUGHLIN P, et al. Effects of abdominal fat distribution parameters on severity of acute pancreatitis[J]. World J Surg, 2012, 36(7): 1679-1685. DOI: 10.1007/s00268-011-1414-y.
    [22]
    BORKAN GA, GERZOF SG, ROBBINS AH, et al. Assessment of abdominal fat content by computed tomography[J]. Am J Clin Nutr, 1982, 36(1): 172-177. DOI: 10.1093/ajcn/36.1.172.
    [23]
    LEE SJ, JANSSEN I, HEYMSFIELD SB, et al. Relation between whole-body and regional measures of human skeletal muscle[J]. Am J Clin Nutr, 2004, 80(5): 1215-1221. DOI: 10.1093/ajcn/80.5.1215.
    [24]
    MADICO C, HERPE G, VESSELLE G, et al. Intra peritoneal abdominal fat area measured from computed tomography is an independent factor of severe acute pancreatitis[J]. Diagn Interv Imaging, 2019, 100(7-8): 421-426. DOI: 10.1016/j.diii.2019.03.008.
    [25]
    DUARTE-ROJO A, SOSA-LOZANO LA, SAU'L A, et al. Methods for measuring abdominal obesity in the prediction of severe acute pancreatitis, and their correlation with abdominal fat areas assessed by computed tomography[J]. Aliment Pharmacol Ther, 2010, 32(2): 244-253. DOI: 10.1111/j.1365-2036.2010.04321.x.
    [26]
    AMATO MC, GIORDANO C, GALIA M, et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk[J]. Diabetes Care, 2010, 33(4): 920-922. DOI: 10.2337/dc09-1825.
    [27]
    KAHN HS. The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison[J]. BMC Cardiovasc Disord, 2005, 5: 26. DOI: 10.1186/1471-2261-5-26.
    [28]
    LEMIEUX I, PASCOT A, COUILLARD C, et al. Hypertriglyceridemic waist: A marker of the atherogenic metabolic triad (hyperinsulinemia; hyperapolipoprotein B; small, dense LDL) in men?[J]. Circulation, 2000, 102(2): 179-184. DOI: 10.1161/01.cir.102.2.179.
    [29]
    XIA MF, CHEN Y, LIN HD, et al. A indicator of visceral adipose dysfunction to evaluate metabolic health in adult Chinese[J]. Sci Rep, 2016, 6: 38214. DOI: 10.1038/srep38214.
    [30]
    XIA W, YU H, HUANG Y, et al. The visceral adiposity index predicts the severity of hyperlipidaemic acute pancreatitis[J]. Intern Emerg Med, 2022, 17(2): 417-422. DOI: 10.1007/s11739-021-02819-4.
    [31]
    DING Y, ZHANG M, WANG L, et al. Association of the hypertriglyceridemic waist phenotype and severity of acute pancreatitis[J]. Lipids Health Dis, 2019, 18(1): 93. DOI: 10.1186/s12944-019-1019-2.
    [32]
    BEYDOGAN E, GULLE S, GEZER C, et al. Effect of abdominal fat distribution on severity of acute pancreatitis[J]. Clin Exp Hepatol, 2021, 7(3): 264-269. DOI: 10.5114/ceh.2021.109345
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(6)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (459) PDF downloads(58) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return