Value of body fat parameters in predicting the severity of acute pancreatitis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the correlation between body fat parameters and the severity of acute pancreatitis (AP) and the value of body fat parameters in predicting the severity of AP. MethodsA retrospective analysis was performed for the clinical data of 229 patients with AP who were treated in Department of Gastroenterology in The Affiliated Hospital of Southwest Medical University from June 2016 to June 2019. According to the diagnostic criteria for AP, the patients were divided into mild acute pancreatitis (MAP) group, moderate-severe acute pancreatitis (MSAP) group(all P＜0.05), and severe acute pancreatitis (SAP) group, and CT images were used to calculate related body fat parameters ［visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), total adipose tissue (TAT), abdominal muscle area (AMA), VAT/TAT ratio (VTR), and visceral fat-to-muscle ratio (VMR)］. A one-way analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. A logistic regression analysis was used to investigate the correlation of the body fat parameters with AP severity. The receiver operating characteristic (ROC) curve was established for each body fat parameter and the area under the ROC curve (AUC) was calculated, and then the Youden index was calculated to determine the optimal cut-off value. ResultsThere were significant differences in age, VAT, TAT, AMA, VTR, and VMR between the three groups (F=4.15, 35.25, 73.02, 7.09, 462.30, and 139.4, all P＜0.05), and further comparison showed that compared with the MAP group, the MSAP group and the SAP group had significant increases in VAT, TAT, VTR, and VMR (all P＜0.05) and a significant reduction in AMA (all P＜0.05). The SAP group had significantly higher VAT, VTR, and VMR than the MSAP group(all P＜0.05). VMR had the largest AUC of 0.84(95% confidence interval: 0.76-0.92) in predicting MSAP and SAP, and had the cut-off value of 138 in predicting the severity of AP, with a sensitivity of 67.5% and a specificity of 90.6%. ConclusionBody fat parameters are correlated the severity of AP. VMR has a unique value in predicting the severity of AP and can be included in the future scoring models for predicting AP severity.