Excessive visceral adipose tissue has been associated with poorer outcomes in patients with inflammatory bowel disease.
Dr Holt and colleagues determined whether body composition is associated with outcome in a prospective study of post-operative Crohn's disease patients.
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 randomized to early endoscopy and possible treatment escalation, or standard care.
The team's primary endpoint was endoscopic recurrence at 18 months.
|Appendicular skeletal muscle indices correlated inversely with fecal calprotectin|
|Alimentary Pharmacology & Therapeutics|
The research team studied 44 subjects with cross-sectional abdominal imaging, and performed body composition analysis using established techniques to measure visceral adipose tissue area, subcutaneous adipose tissue area, and skeletal muscle area.
The body composition parameter with the greatest variance was visceral adipose tissue.
Regardless of treatment, the researchers found that all subjects with visceral adipose tissue/height2 >2 times the gender-specific mean experienced endoscopic recurrence at 18 months.
The team noted that waist circumference correlated strongly with visceral adipose tissue area.
The research team found that low skeletal muscle was prevalent, but did not predict endoscopic recurrence.
However, appendicular skeletal muscle indices correlated inversely with fecal calprotectin.
Dr Holt's team concludes, "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."