Greater Peripouch Fat Area on CT Image Is Associated with Chronic Pouchitis and Pouch Failure in Inflammatory Bowel Diseases Patients.

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Tytuł:: Greater Peripouch Fat Area on CT Image Is Associated with Chronic Pouchitis and Pouch Failure in Inflammatory Bowel Diseases Patients.
Autorzy:: Gao XH; Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA.; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
Yu GY; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
Khan F; Department of Gastroenterology/Hepatology, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Li JQ; Department of Colorectal Surgery, Changhai Hospital, Shanghai, China.
Stocchi L; Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Hull TL; Department of Colorectal Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Shen B; Department of Gastroenterology/Hepatology, The Cleveland Clinic Foundation, Cleveland, OH, USA. .; The Inflammatory Bowel Disease Center at Columbia, Columbia University Irving Medical Center, 161 Fort Washington Ave Suite 843, New York, NY, 10032, USA. .
Źródło:: Digestive diseases and sciences [Dig Dis Sci] 2020 Dec; Vol. 65 (12), pp. 3660-3671. Date of Electronic Publication: 2020 Jun 04.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 2005- : New York, NY : Springer Science + Business Media
Original Publication: New York, Plenum Pub. Corp.
MeSH Terms:: Colonic Pouches*/adverse effects
Colonic Pouches*/pathology
Colonic Pouches*/statistics & numerical data
Inflammatory Bowel Diseases*/diagnosis
Inflammatory Bowel Diseases*/physiopathology
Intra-Abdominal Fat*/diagnostic imaging
Intra-Abdominal Fat*/pathology
Mesentery*/diagnostic imaging
Mesentery*/pathology
Pouchitis*/diagnosis
Pouchitis*/epidemiology
Pouchitis*/etiology
Pouchitis*/physiopathology
Proctocolectomy, Restorative/*adverse effects
Autoimmune Diseases/diagnosis ; Autoimmune Diseases/epidemiology ; China/epidemiology ; Cohort Studies ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Overweight/diagnosis ; Overweight/epidemiology ; Risk Factors ; Tomography, X-Ray Computed/methods
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Grant Information:: 81572332 International National Natural Science Foundation of China; Shanghai Pujiang Program (#2019PJD052) International Shanghai Association for Science and Technology
Contributed Indexing:: Keywords: Chronic antibiotic refractory pouchitis (CARP); Ileal pouch anal anastomosis (IPAA); Inflammatory bowel disease; Peripouch fat; Pouch failure
Entry Date(s):: Date Created: 20200606 Date Completed: 20210204 Latest Revision: 20210204
Update Code:: 20240105
DOI:: 10.1007/s10620-020-06363-7
PMID:: 32500285
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Background: The causes of chronic antibiotic refractory pouchitis (CARP) and pouch failure in inflammatory bowel disease (IBD) patients remain unknown. Our previous small study showed peripouch fat area measured by MRI was associated with pouchitis.
Aims: To explore the relationship between peripouch fat area on CT imaging and pouch outcomes.
Methods: This is a historical cohort study. Demographic, clinical, and radiographic data of IBD patients with abdominal CT scans after pouch surgery between 2002 and 2017 were collected. Peripouch fat areas and mesenteric peripouch fat areas were measured on CT images at the middle pouch level.
Results: A total of 435 IBD patients were included. Patients with higher peripouch fat areas had a higher prevalence of CARP. Univariate analyses demonstrated that long duration of the pouch, high weight or body mass index, the presence of primary sclerosing cholangitis or other autoimmune disorders, and greater peripouch fat area or mesenteric peripouch fat area were risk factors for CARP. Multivariable analyses demonstrated that the presence of primary sclerosing cholangitis or autoimmuned disorders, and greater peripouch fat area (odds ratio [OR] 1.031; 95% confidence interval [CI] 1.016-1.047, P < 0.001) or mesenteric peripouch fat area were independent risk factors for CARP. Of the 435 patients, 139 (32.0%) had two or more CT scans. Multivariable Cox proportional hazard analyses showed that "peripouch fat area increase ≥ 15%" (OR 3.808, 95%CI 1.703-8.517, P = 0.001) was an independent predictor of pouch failure.
Conclusions: A great peripouch fat area measured on CT image is associated with a higher prevalence of CARP, and the accumulation of peripouch fat is a risk factor for pouch failure. The assessment of peripouch fat may be used to monitor the disease course of the ileal pouch.

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