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

Autor:	Gu P; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States. phillipgu12@gmail.com., Dube S; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Gellada N; Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Choi SY; Department of Biostatistics Shared Resource, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Win S; Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Lee YJ; Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, South Korea., Yang S; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Haritunians T; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Melmed GY; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Vasiliauskas EA; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Bonthala N; Department of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, United States., Syal G; Department of Medicine, University of California at San Diego, San Diego, CA 92093, United States., Yarur AJ; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Ziring D; Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Rabizadeh S; Department of Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Fleshner P; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Kallman C; Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Devkota S; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Targan SR; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., Li D; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States., McGovern DP; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal surgery [World J Gastrointest Surg] 2024 Mar 27; Vol. 16 (3), pp. 740-750.
DOI:	10.4240/wjgs.v16.i3.740
Abstrakt:	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 (cm 3 ), 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. Competing Interests: Conflict-of-interest statement: Li D has received consulting fees from Prometheus Biosciences Inc; Syal G has received research support from Pfizer; Yarur AJ has received consulting fees from Bristol Myers Squibb, Arena, Pfizer, Takeda and Landos; Targan SR serves on the scientific advisory board for Seaver Foundation for Austim, and has stock options in Promethus Biosciences Inc; Ziring D is on the speaking bureau for AbbVie, Prometheus Labs, and Regeneron; Rabizadeh S has advised for Prometheus and Janssen; Melmed GY has received consulting fees from Abbvie, Arena Pharmaceuticals, Bristol-Myers Squibb, Boehringer-Ingelheim, Celgene, Dieta, Entasis, Fresenius Kabi, Genentech, Gilead, Janssen, Medtronic, Merck, Oshi, Prometheus Labs, Pfizer, Takeda, Techlab; Fleshner P has received consulting fees from Takeda; McGovern DPB has received consulting fees from Takeda, Prometheus Biosciences Inc, Prometheus Labs; Other authors have no conflicts of interests to disclose. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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