title: A large volume of visceral adipose tissue leads to severe acute pancreatitis.
abstract: BACKGROUND
  Obesity plays an important role in acute pancreatitis. Assuming that the volume of visceral adipose tissue (VAT) directly influences the severity of acute pancreatitis, we investigated the relationship between VAT and acute pancreatitis.
  
  
  METHODS
  Data were collected consecutively from 124 patients who were diagnosed with acute pancreatitis. Body mass index (BMI) was calculated from the database. Computed tomography was performed in all patients, and VAT, subcutaneous adipose tissue (SAT), and waist circumference (WC) were measured at the level of the intervertebral disk between L2 and L3. Atlanta criteria were adopted to define severe acute pancreatitis. Clinical courses were investigated, and the Ranson and acute physiology and chronic health evaluation II (APACHE II) scores were calculated for all patients.
  
  
  RESULTS
  Forty-eight patients had severe acute pancreatitis (38.7%), and 76 were mild cases. BMI, VAT, SAT, and WC were correlated with the severity of acute pancreatitis in a univariate analysis, but only VAT had a strong correlation with severe acute pancreatitis in the multivariate analysis. In a trend analysis, not only severity but also the presence of pseudocysts (local complication) and prognostic factors (Ranson and APACHE II scores) were significantly related to VAT volume. In particular, the presence of a pancreatic pseudocyst was strongly related to VAT volume (p < 0.001).
  
  
  CONCLUSIONS
  In acute pancreatitis, peripancreatic VAT has a stronger correlation with severe acute pancreatitis than BMI or WC. VAT volume is strongly correlated with the formation of a pseudocyst and with systemic inflammatory response syndrome in patients with acute pancreatitis and high VAT volume may lead to severe acute pancreatitis.
authors.affiliation: Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yashima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Isayama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsujino
authors.forename: Rie
authors.initials: R
authors.lastname: Nagano
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Suguru
authors.initials: S
authors.lastname: Mizuno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagioka
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Kawakubo
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kogure
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Nakai
authors.forename: Kenji
authors.initials: K
authors.lastname: Hirano
authors.forename: Naoki
authors.initials: N
authors.lastname: Sasahira
authors.forename: Minoru
authors.initials: M
authors.lastname: Tada
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010192:Pancreatic Pseudocyst / Q000209:etiology* / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference