Impact of body composition, measured by computed tomography scan, on acute pancreatitis course

Severe acute pancreatitis occurs in 15-25% of all patients with acute pancreatitis (AP), and has a dismal prognosis. Recognition of severe AP risk factors could provide identification and resuscitation of patients with impending severe course of disease. Our study aim was to analyse body composition, measured by computed tomography (CT) scans, in acute pancreatitis patients and its impact on disease severity. The study was a prospective cohort study carried out in the period from January 2015 - April 2016. In total 100 patients underwent CT imaging. Body constitution was analysed by CT examinations using the ImageJ v1.49q standard software. The third lumbar vertebra was selected as the landmark measurement. Muscular, visceral, subcutaneous, and intramuscular adipose tissue area were measured. Values were normalised for stature to obtain lumbar skeletal muscle and adipose tissue indexes (cm²/m²). Acute pancreatitis severity was determined by Atlanta revised criteria (2012). Among the included patients, moderately severe AP occurred in 83% (83 patients) cases, and severe AP in 17% (17 patients). 38% of the patients had normal weight according to BMI, 33% were overweight 33%, and 28% were obese. Sarcopenia was detected in 51%. Sarcopenia was found in six patients (35%) with severe AP and in 45 patients (54%) with moderately severe AP. General linear model analysis showed that obesity (p value = 0.026) and increased intramuscular fat area (p value = 0.029) had effect on severe AP. In conclusion, body composition analysis showed that adiposity is a risk factor for severe AP, and higher intramuscular fat area seemed to be another risk factor for severe AP.