High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease

Aim. Excessive postoperative inflammatory response, which is characterized by overproduction of cytokines, often leads to complications after colorectal surgery. However, the impact of body composition on postoperative inflammatory response is largely unknown. The aim of this study is to elucidate w...

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Main Authors: Yao Wei, Feng Zhu, Jianfeng Gong, Jianbo Yang, Tenghui Zhang, Lili Gu, Weiming Zhu, Zhen Guo, Yi Li, Ning Li, Jieshou Li
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/6270514
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author Yao Wei
Feng Zhu
Jianfeng Gong
Jianbo Yang
Tenghui Zhang
Lili Gu
Weiming Zhu
Zhen Guo
Yi Li
Ning Li
Jieshou Li
author_facet Yao Wei
Feng Zhu
Jianfeng Gong
Jianbo Yang
Tenghui Zhang
Lili Gu
Weiming Zhu
Zhen Guo
Yi Li
Ning Li
Jieshou Li
author_sort Yao Wei
collection DOAJ
description Aim. Excessive postoperative inflammatory response, which is characterized by overproduction of cytokines, often leads to complications after colorectal surgery. However, the impact of body composition on postoperative inflammatory response is largely unknown. The aim of this study is to elucidate whether body fat amount and its distribution affects postoperative inflammation after colorectal surgery in IBD patients. Methods. Eighty-six patients undergoing colorectal resection for IBD from June 2014 to Jan 2017 were enrolled. Abdominal CT images within one week prior to surgery were assessed for visceral fat, subcutaneous fat, and muscle mass. Postoperative inflammatory response was evaluated using serum CRP, PCT, and IL-6 levels on postoperative days 1, 3, and 5. Univariate analysis was conducted to identify risk factors for infectious complications. The correlation between body composition and postoperative plasma concentration of inflammatory markers was analyzed using a linear regression model. ROC curve was applied to analyze the effect of different body composition parameters on postoperative infectious complications and to determine the relationship between inflammatory markers and infectious complications. Results. Neither volume of fat or muscle was related to postoperative plasma concentrations of CRP, IL-6, and PCT. However, visceral to subcutaneous fat ratio was associated with PCT levels on postoperative days (POD) 1, 3, and 5, with the highest regression coefficient on POD1 (β=0.360; 95% CI, 0.089–0.631; P=0.010). Body composition did not predict postoperative infectious complications, while CRP on POD 3 was predictive of infectious complications. Conclusion. Increased visceral to subcutaneous fat ratio was associated with postoperative inflammatory response in IBD patients undergoing colorectal resection. This may partly explain the increased incidence of postoperative complications in patients with visceral obesity.
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spelling doaj-art-d70c04a1fffc4bc1962d232b4e9b1edd2025-08-20T02:19:33ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/62705146270514High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel DiseaseYao Wei0Feng Zhu1Jianfeng Gong2Jianbo Yang3Tenghui Zhang4Lili Gu5Weiming Zhu6Zhen Guo7Yi Li8Ning Li9Jieshou Li10Department of Emergency and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Pinghai Road 900, Suzhou 215031, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, East Zhongshan Road 305, Nanjing 210002, ChinaAim. Excessive postoperative inflammatory response, which is characterized by overproduction of cytokines, often leads to complications after colorectal surgery. However, the impact of body composition on postoperative inflammatory response is largely unknown. The aim of this study is to elucidate whether body fat amount and its distribution affects postoperative inflammation after colorectal surgery in IBD patients. Methods. Eighty-six patients undergoing colorectal resection for IBD from June 2014 to Jan 2017 were enrolled. Abdominal CT images within one week prior to surgery were assessed for visceral fat, subcutaneous fat, and muscle mass. Postoperative inflammatory response was evaluated using serum CRP, PCT, and IL-6 levels on postoperative days 1, 3, and 5. Univariate analysis was conducted to identify risk factors for infectious complications. The correlation between body composition and postoperative plasma concentration of inflammatory markers was analyzed using a linear regression model. ROC curve was applied to analyze the effect of different body composition parameters on postoperative infectious complications and to determine the relationship between inflammatory markers and infectious complications. Results. Neither volume of fat or muscle was related to postoperative plasma concentrations of CRP, IL-6, and PCT. However, visceral to subcutaneous fat ratio was associated with PCT levels on postoperative days (POD) 1, 3, and 5, with the highest regression coefficient on POD1 (β=0.360; 95% CI, 0.089–0.631; P=0.010). Body composition did not predict postoperative infectious complications, while CRP on POD 3 was predictive of infectious complications. Conclusion. Increased visceral to subcutaneous fat ratio was associated with postoperative inflammatory response in IBD patients undergoing colorectal resection. This may partly explain the increased incidence of postoperative complications in patients with visceral obesity.http://dx.doi.org/10.1155/2018/6270514
spellingShingle Yao Wei
Feng Zhu
Jianfeng Gong
Jianbo Yang
Tenghui Zhang
Lili Gu
Weiming Zhu
Zhen Guo
Yi Li
Ning Li
Jieshou Li
High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease
Gastroenterology Research and Practice
title High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease
title_full High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease
title_fullStr High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease
title_full_unstemmed High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease
title_short High Visceral to Subcutaneous Fat Ratio Is Associated with Increased Postoperative Inflammatory Response after Colorectal Resection in Inflammatory Bowel Disease
title_sort high visceral to subcutaneous fat ratio is associated with increased postoperative inflammatory response after colorectal resection in inflammatory bowel disease
url http://dx.doi.org/10.1155/2018/6270514
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