Pre-operative visceral adipose tissue radiodensity is a potentially novel prognostic biomarker for early endoscopic post-operative recurrence in Crohn's disease.
World J Gastrointest Surg
; 16(3): 740-750, 2024 Mar 27.
Article
de En
| MEDLINE
| ID: mdl-38577075
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 VATsubcutaneous adipose tissue (SAT) volume, VAT radiodensity, and ratio of VATSAT 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 VATSAT 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), VATSAT 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.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Langue:
En
Journal:
World J Gastrointest Surg
Année:
2024
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique
Pays de publication:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
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USA