Visceral Adipose Tissue Inflammation and Radiographic Visceral-to-Subcutaneous Adipose Tissue Ratio in Patients with Cirrhosis

Autor: Grace Jun, Nghiem B. Ha, Jennifer C. Lai, Randi Wong, Yara Mohamad, Vivek Swarnakar, Dorothea S Kent, Soo-Jin Cho, Jacquelyn J. Maher, Shezhang Lin
Rok vydání: 2020
Předmět:
Liver Cirrhosis
Cirrhosis
Physiology
medicine.medical_treatment
Adipose tissue
Liver transplantation
Gastroenterology
Body composition
Oral and gastrointestinal
Abdominal wall
0302 clinical medicine
Fibrosis
Liver transplant
Liver Disease
Liver Neoplasms
Greater omentum
medicine.anatomical_structure
Adipose Tissue
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Visceral adiposity
medicine.symptom
Adult
medicine.medical_specialty
Carcinoma
Hepatocellular
Subcutaneous adipose tissue
Chronic Liver Disease and Cirrhosis
Clinical Sciences
Subcutaneous Fat
Inflammation
Intra-Abdominal Fat
Article
03 medical and health sciences
Clinical Research
Internal medicine
medicine
Humans
Obesity
Transplantation
Gastroenterology & Hepatology
business.industry
Carcinoma
Hepatocellular
Organ Transplantation
Hepatology
medicine.disease
business
Digestive Diseases
Zdroj: Dig Dis Sci
Digestive diseases and sciences, vol 67, iss 7
ISSN: 1573-2568
Popis: BACKGROUND AND AIMS: Accumulation of visceral adipose tissue is associated with hepatic inflammation and fibrosis, suggestive of its metabolic and inflammatory properties. We aimed to examine the histologic findings of visceral and subcutaneous adipose tissue and to associate these findings with clinical and radiologic characteristics in patients with cirrhosis. METHODS: Included were 55 adults with cirrhosis who underwent liver transplantation from 3/2017–12/2018 and had an abdominal computed tomography (CT) scan within 6 months prior to transplant. Visceral-to-subcutaneous adipose tissue ratio (VSR) was calculated using visceral (VATI) and subcutaneous adipose tissue index (SATI) quantified by CT at the L3-vertebral level and normalized for height (cm(2)/m(2)). VAT (greater omentum), SAT (abdominal wall), and skeletal muscle (rectus abdominis) biopsies were collected at transplant. RESULTS: Majority of patients had VAT inflammation (71%); only one patient (2%) had SAT inflammation. Patients with VAT inflammation had similar median VATI (42 vs 41 cm(2)/m(2)), lower median SATI (64 vs 97 cm(2)/m(2)), and higher median VSR (0.63 vs 0.37, p = 0.002) than patients without inflammation. In univariable logistic regression, VSR was associated with VAT inflammation (OR 1.47, 95%CI 1.11–1.96); this association remained significant even after adjusting for age, sex, BMI, HCC, or MELD-Na on bivariable analyses. CONCLUSION: In patients with cirrhosis undergoing liver transplantation, histologic VAT inflammation was common, but SAT inflammation was not. Increased VSR was independently associated with VAT inflammation. Given the emerging data demonstrating the prognostic value of VSR, our findings support the value of CT-quantified VSR as a prognostic marker for adverse outcomes in the liver transplant setting.
Databáze: OpenAIRE
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