title: Visceral fat area is associated with a high risk for early postoperative recurrence in Crohn's disease.
abstract: OBJECTIVE
  Mesenteric hypertrophy has been recognized as an indicator of the complicated course of Crohn's disease. The aim of this study was to investigate whether the visceral fat area (VFA) is associated with postoperative clinical and endoscopic recurrence.
  
  
  METHODS
  Computed tomography was used to measure the subcutaneous fat area and VFA, and the mesenteric fat index (MFI) was defined as the ratio of the VFA to the subcutaneous fat area. Associations between body mass index, subcutaneous fat area, VFA and MFI and postoperative clinical and endoscopic recurrence were investigated.
  
  
  RESULTS
  The factors associated with postoperative endoscopic recurrence at 6 months after surgery were a high VFA value (P = 0.019) and MFI values above the median (P = 0.008). VFA values were significantly correlated with endoscopic recurrence (r = 0.895, P = 0.040) and endoscopic lesions (r = 0.617, P < 0.0001). Additionally, MFI values correlated well with endoscopic recurrence (r = 0.918, P = 0.02) and endoscopic scores (r = 0.584, P < 0.0001). Multivariate analysis indicated that VFA values above the median (hazard ratio 2.63, 95% CI 1.03-6.74) were predictive of postoperative clinical recurrence in Crohn's disease.
  
  
  CONCLUSIONS
  A high VFA value is associated with postoperative recurrence of Crohn's disease and has clinical implications with respect to optimizing prophylaxis for each individual. However, further studies are needed to confirm the predictive role of this biomarker in a different data set.
authors.affiliation: Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.forename: W
authors.initials: W
authors.lastname: Zhu
authors.forename: J
authors.initials: J
authors.lastname: Gong
authors.forename: W
authors.initials: W
authors.lastname: Zhang
authors.forename: L
authors.initials: L
authors.lastname: Gu
authors.forename: Z
authors.initials: Z
authors.lastname: Guo
authors.forename: L
authors.initials: L
authors.lastname: Cao
authors.forename: B
authors.initials: B
authors.lastname: Shen
authors.forename: N
authors.initials: N
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D050218:Body Fat Distribution / Q000379:methods; D015992:Body Mass Index; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers
keywords: Crohn's disease; mesenteric adipose tissue; recurrence; risk factor; visceral fat