Background
The association between abdominal visceral fatty area (VFA) and mortality is not fully understood despite the fact that being overweight is an established risk factor for the onset and severity of acute pancreatitis (AP). We assessed the effect of VFA on severe AP (SAP) mortality.
Methods
Between April 2011 and March 2021, 238 consecutive patients with SAP were assessed in this retrospective single-center cohort study.
We enrolled 454 patient subgroups for the first contrast-enhanced computed tomography for muscle tissue parameters besides adipose tissues and concluded that severity was analyzed through logistic regression analysis. The predictive capacity of the parameters was investigated using receiver operating characteristic (ROC) curves.
Computed tomography (CT) was used to evaluate VFA at umbilical level L1. The main goal of This study aimed to determine the effects of visceral adiposity and muscle parameters on AP mortality.
Results
Of the Egyptian participants, 66% were men and the median age was 126. Eighteen patients (7.5%) died during hospitalization. Twelve obese individuals had a body mass index (BMI) >30 kg/m2 (5%) with a median BMI of 22.2 kg/m2. The median VFA was 112 cm2, and waist measurement was 85.5 cm. A total of 176 (57.1%) individuals had VFA larger than 100 cm2. VFA (COV, 167 cm2; AUC = 0.679), accompanied by the prognostic factor score based on the Japanese guidelines for AP care (cutoff value [COV], 4; area under the curve [AUC] = 0.869] and age [COV, 72; AUC = 0.780]), demonstrated considerable accuracy in predicting death. Elevated VFA was associated with a significantly higher odds ratio (OR) for predicting mortality according to univariate regression analysis but not multivariate analysis (OR:4.38, P = 0.0406). There was no discernible difference in the survival periods of patients with SAP with and without an elevated VFA of 167 cm2.
Regurding to empolyed subroup's for asses the musvled mass effect we found no distinct variation was found between the AP severity groups in either adipose tissue parameters (visceral adipose tissue and subcutaneous adipose tissue) or visceral muscle ratio. However, the muscle mass and mean muscle attenuation differed significantly, with p-values of 0.037 and 0.003, respectively. In multivariate analysis, low muscle attenuation was associated with severe AP with an odds ratio of 4.09 (95% confidence intervals:1.61–10.36, p-value 0.003). No body parameters presented sufficient predictive capability in the ROC curve analysis.
Conclusions
Visceral obesity did not significantly affect the ability to predict mortality in SAP patients. Low muscle attenuation is associated with an increased risk of severe AP. Future prospective studies will help to identify the underlying mechanisms and characterize the influence of body composition parameters on AP.