Visceral adiposity predicts post-operative Crohn's disease recurrence
© 2017 John Wiley & Sons Ltd..
BACKGROUND: Excessive visceral adipose tissue has been associated with poorer outcomes in patients with inflammatory bowel disease.
AIM: To determine whether body composition is associated with outcome in a prospective study of post-operative Crohn's disease patients.
METHODS: The POCER study evaluated management strategies for prevention of post-operative Crohn's disease recurrence; subjects were enrolled after resection of all macroscopic Crohn's disease and were randomised to early endoscopy and possible treatment escalation, or standard care. The primary endpoint was endoscopic recurrence at 18 months. 44 subjects with cross-sectional abdominal imaging were studied, and body composition analysis performed using established techniques to measure visceral adipose tissue area, subcutaneous adipose tissue area, and skeletal muscle area.
RESULTS: The body composition parameter with the greatest variance was visceral adipose tissue. Regardless of treatment, all subjects with visceral adipose tissue/height2 >1.5 times the gender-specific mean experienced endoscopic recurrence at 18 months (compared to 47%) [relative risk 2.1, 95% CI 1.5-3.0, P = 0.012]. Waist circumference correlated strongly with visceral adipose tissue area (ρ = 0.840, P < 0.001). Low skeletal muscle was prevalent (41% of patients), but did not predict endoscopic recurrence; however, appendicular skeletal muscle indices correlated inversely with faecal calprotectin (ρ = 0.560, P = 0.046).
CONCLUSIONS: Visceral adiposity is an independent risk factor for endoscopic recurrence of Crohn's disease after surgery. Sarcopenia correlates with inflammatory biomarkers. Measures of visceral adipose tissue may help to stratify risk in post-operative management strategies.
| Errataetall: |
CommentIn: Aliment Pharmacol Ther. 2017 Jun;45(12 ):1552-1553. - PMID 28503865 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Alimentary pharmacology & therapeutics - 45(2017), 9 vom: 28. Mai, Seite 1255-1264 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Holt, D Q [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers |
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| Anmerkungen: |
Date Completed 15.08.2017 Date Revised 11.03.2022 published: Print-Electronic CommentIn: Aliment Pharmacol Ther. 2017 Jun;45(12 ):1552-1553. - PMID 28503865 Citation Status MEDLINE |
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| doi: |
10.1111/apt.14018 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM269360468 |
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| 500 | |a CommentIn: Aliment Pharmacol Ther. 2017 Jun;45(12 ):1552-1553. - PMID 28503865 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2017 John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Excessive visceral adipose tissue has been associated with poorer outcomes in patients with inflammatory bowel disease | ||
| 520 | |a AIM: To determine whether body composition is associated with outcome in a prospective study of post-operative Crohn's disease patients | ||
| 520 | |a METHODS: The POCER study evaluated management strategies for prevention of post-operative Crohn's disease recurrence; subjects were enrolled after resection of all macroscopic Crohn's disease and were randomised to early endoscopy and possible treatment escalation, or standard care. The primary endpoint was endoscopic recurrence at 18 months. 44 subjects with cross-sectional abdominal imaging were studied, and body composition analysis performed using established techniques to measure visceral adipose tissue area, subcutaneous adipose tissue area, and skeletal muscle area | ||
| 520 | |a RESULTS: The body composition parameter with the greatest variance was visceral adipose tissue. Regardless of treatment, all subjects with visceral adipose tissue/height2 >1.5 times the gender-specific mean experienced endoscopic recurrence at 18 months (compared to 47%) [relative risk 2.1, 95% CI 1.5-3.0, P = 0.012]. Waist circumference correlated strongly with visceral adipose tissue area (ρ = 0.840, P < 0.001). Low skeletal muscle was prevalent (41% of patients), but did not predict endoscopic recurrence; however, appendicular skeletal muscle indices correlated inversely with faecal calprotectin (ρ = 0.560, P = 0.046) | ||
| 520 | |a CONCLUSIONS: Visceral adiposity is an independent risk factor for endoscopic recurrence of Crohn's disease after surgery. Sarcopenia correlates with inflammatory biomarkers. Measures of visceral adipose tissue may help to stratify risk in post-operative management strategies | ||
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| 700 | 1 | |a De Cruz, P |e verfasserin |4 aut | |
| 700 | 1 | |a Kamm, M A |e verfasserin |4 aut | |
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