Methods for measuring abdominal obesity in the prediction of severe acute pancreatitis, and their correlation with abdominal fat areas assessed by computed tomography
Methods for measuring abdominal obesity in the prediction of severe acute pancreatitis, and their correlation with abdominal fat areas assessed by computed tomography
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DOI：
10.1111/j.1365-2036.2010.04321.x
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发表时间：
2010-07-15
影响因子：
7.6
通讯作者：
Robles-Diaz, G.
中科院分区：
文献类型：
--
作者：
Duarte-Rojo, A.;Sosa-Lozano, L. A.;Robles-Diaz, G.
背景：肥胖增加严重急性胰腺炎的风险，尽管腹部肥胖可能是一个更好的预后指标。目的确定单一人体测量参数是否能最好地预测严重急性胰腺炎并与腹内脂肪相关。方法对99例急性胰腺炎患者进行前瞻性研究。人体测量包括身体质量指数（BMI）和腰围（脐/最小腰、髂/髋粗隆、大腿）。构建了几种腰臀比/腰大腿比（WHR/WTR）。对37例进行了ct扫描，并计算了腹部横断脂肪面积。结果25例患者发生严重急性胰腺炎。腰围（WC）、腰宽比（WHR）和腰宽比（wtr）均以脐带为参照，最能准确预测重症急性胰腺炎。在多变量分析中，仅保留脐带WC：严重急性胰腺炎的风险每增加1厘米增加16% （OR 1.16, 95% CI: 1.1-1.3）。腹部肥胖导致风险增加6倍。脐部腰围与皮下脂肪面积相关性最好（r = 0.791, P < 0.001），腹部腰围与腹腔脂肪面积相关性最好（r = 0.594, P < 0.001）。结论脐带腰围比BMI、最低腰围、腰重比和腰重比更能预测重症急性胰腺炎的发生。人体测量的规程必须标准化，因为它可能影响结果。皮下脂肪和腹内脂肪似乎都影响严重后果的可能性。
BackgroundObesity increases the risk for severe acute pancreatitis, although abdominal obesity may be a better prognostic marker.AimTo determine if a single anthropometric parameter best predicts severe acute pancreatitis and correlates with intra-abdominal fat.MethodsNinety-nine patients with acute pancreatitis were studied prospectively. Anthropometry included body mass index (BMI) and girths (umbilical/minimum waist, iliac/trochanter hip, thigh). Several waist-to-hip/waist-to-thigh ratios (WHR/WTR) were constructed. A CT-scan with calculation of cross-sectional abdominal fat areas was obtained in 37 cases.ResultsSevere acute pancreatitis occurred in 25 patients. Waist circumference (WC), WHR and WTR-all using the umbilical reference-most accurately predicted severe acute pancreatitis. Only umbilical WC was retained in multivariate analysis: the risk for severe acute pancreatitis increased 16% with every 1 cm (OR 1.16, 95% CI: 1.1-1.3). Abdominal obesity caused a 6-fold increase in risk. Umbilical WC correlated best with subcutaneous fat area (r = 0.791, P < 0.001), whereas WHR with intra-abdominal (r = 0.594, P < 0.001).ConclusionsAbdominal obesity according to umbilical WC is a better predictor for development of severe acute pancreatitis than BMI, minimum WC, WHR and WTR. The protocol for anthropometry must be standardized as it may affect results. Both subcutaneous and intra-abdominal fat appears to affect the likelihood of a severe outcome.