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Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn's disease

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Author(s)
Phillip GuShishir DubeNorman GelladaSo Yung ChoiSusan WinYoo Jin LeeShaohong YangTalin HarituniansGil Y MelmedEric A VasiliauskasNiru BonthalaGaurav SyalAndres J YarurDavid ZiringShervin RabizadehPhillip FleshnerCindy KallmanSuzanne DevkotaStephan R TarganDalin LiDermot Pb McGovern
Keimyung Author(s)
Lee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
World J Gastrointest Surg
Issued Date
2024
Volume
16
Issue
3
Keyword
Crohn’s diseaseSurgeryVisceral adipose tissueMesenteric adipose tissueCreeping fatComputed tomography
Abstract
BACKGROUND:
Evidence suggests inflammatory mesenteric fat is involved in post-operative recurrence (POR) of Crohn’s disease (CD). However, its prognostic value is uncertain, in part, due to difficulties studying it non-invasively.

AIM:
To evaluate the prognostic value of pre-operative radiographic mesenteric parameters for early endoscopic POR (ePOR).

METHODS:
We conducted a retrospective cohort study of CD subjects ≥ 12 years who underwent ileocecal or small bowel resection between 1/1/2007 to 12/31/2021 with computerized tomography abdomen/pelvis ≤ 6 months pre-operatively and underwent ileocolonoscopy ≤ 15 months post-operatively. Visceral adipose tissue (VAT) volume (cm3), ratio of VAT:subcutaneous adipose tissue (SAT) volume, VAT radiodensity, and ratio of VAT:SAT radiodensity were generated semiautomatically. Mesenteric lymphadenopathy (LAD, largest lymph node > 10 mm) and severe vasa recta (VR) engorgement (diameter of the VR supplying diseased bowel ≥ 2 × VR supplying healthy bowel) were derived manually. The primary outcome was early ePOR (Rutgeert’s score ≥ i2 on first endoscopy ≤ 15 months post-operatively) and the secondary outcome was ePOR severity (Rutgeert’s score i0-4). Regression analyses were performed adjusting for demographic and disease-related characteristics to calculate adjusted odds ratio (aOR) and 95% confidence interval (CI).

RESULTS:
Of the 139 subjects included, 45% of subjects developed early ePOR (n = 63). VAT radiodensity (aOR 0.59, 95%CI: 0.38-0.90) and VAT:SAT radiodensity (aOR 8.54, 95%CI: 1.48-49.28) were associated with early ePOR, whereas, VAT volume (aOR 1.23, 95%CI: 0.78-1.95), VAT:SAT volume (aOR 0.80, 95%CI: 0.53-1.20), severe VR engorgement (aOR 1.53, 95%CI: 0.64-3.66), and mesenteric LAD (aOR 1.59, 95%CI: 0.67-3.79) were not. Similar results were observed for severity of ePOR.

CONCLUSION:
VAT radiodensity is potentially a novel non-invasive prognostic imaging marker to help risk stratify CD patients for POR.
Keimyung Author(s)(Kor)
이유진
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1948-9366
Source
https://www.wjgnet.com/1948-9366/full/v16/i3/740.htm
DOI
10.4240/wjgs.v16.i3.740
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45675
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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