Parameters of Body Composition Predict Clinical Course in Acute Colonic Diverticulitis

IF 9.1 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-06-16 DOI:10.1002/jcsm.13864

Alexey Surov, Mattes Hinnerichs, Iram Shahzadi, Nina P. Haag, Jan Robert Kröger, Berthold Gerdes, Saleem Elhabash, Jan Borggrefe

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Abstract

Background

Acute colonic diverticulitis (ACD) is the most common complication of colonic diverticulosis. Body composition, that is, proportion, distribution and quality of muscle and adipose tissues may play a relevant role in ACD. Previously, only few reports with small number of patients analysed the prognostic role of body composition in ACD. Our purpose was to analyse associations between the occurrence of complications and parameters of body composition in patients with ACD in a large sample.

Methods

This retrospective study included 646 patients with ACD. The duration of hospital stay (days) and occurrence of complications were recorded. Parameters of body composition were semiautomatically measured with the freely available ImageJ software. Skeletal muscle area (SMA), skeletal muscle density, visceral adipose tissue (VAT), subcutaneous adipose tissue and intramuscular adipose tissue were estimated. To assess the impact of body composition parameters on ACD complications, Cox regression model (adjusted for sex and age) was used.

Results

Low skeletal muscle area (sarcopenia) was found in 322 patients (49.8%). High VAT was observed in 525 patients (81.3%). Low skeletal muscle density or myosteatosis was identified in 322 patients (49.8%). Length of hospital stay was prolonged in patients with sarcopenia, myosteatosis and/or visceral adiposity. Sarcopenia was an independent predictor for occurrence of complicated ACD, OR = 1.48, 95% CI (1.03–2.13), p = 0.033. Myosteatosis predicted occurrence of free perforation, OR = 2.36, 95% CI (1.01–5.43), p = 0.033. Furthermore, visceral adiposity tended to be a strong predictor of free perforation, OR = 7.62, 95% CI (1.29–138.00), p = 0.05. Finally, sarcopenia predicted occurrence of macro abscesses, OR = 2.41, 95% CI (1.41–4.26), p = 0.002.

Conclusions

Patients with sarcopenia, myosteatosis and visceral adiposity have prolonged length of hospital stay. Macro abscesses occur more frequently in patients with sarcopenia. Myosteatosis and high VAT are associated with free perforation.

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机体组成参数预测急性结肠憩室炎的临床病程

背景急性结肠憩室炎（ACD）是结肠憩室病最常见的并发症。体成分，即肌肉和脂肪组织的比例、分布和质量可能在ACD中起相关作用。在此之前，只有少数报道和少数患者分析了机体成分在ACD中的预后作用。我们的目的是在大样本中分析ACD患者并发症发生与身体成分参数之间的关系。方法对646例ACD患者进行回顾性研究。记录住院时间（天）和并发症发生情况。使用免费的ImageJ软件半自动测量身体成分参数。评估骨骼肌面积（SMA）、骨骼肌密度、内脏脂肪组织（VAT）、皮下脂肪组织和肌内脂肪组织。为了评估身体成分参数对ACD并发症的影响，采用Cox回归模型（经性别和年龄调整）。结果322例患者出现骨骼肌面积低（骨骼肌减少），占49.8%。525例（81.3%）患者出现高增值率。322例（49.8%）患者发现骨骼肌密度低或骨骼肌骨化症。骨骼肌减少症、骨骼肌病和/或内脏肥胖患者的住院时间延长。肌少症是并发ACD发生的独立预测因子，OR = 1.48, 95% CI (1.03-2.13), p = 0.033。肌骨化病预测游离穿孔的发生，OR = 2.36, 95% CI (1.01 ~ 5.43), p = 0.033。此外，内脏脂肪倾向于是游离穿孔的一个强有力的预测因子，OR = 7.62, 95% CI (1.29-138.00), p = 0.05。最后，肌肉减少症预测大脓肿的发生，OR = 2.41, 95% CI (1.41-4.26), p = 0.002。结论骨骼肌减少症、骨骼肌增生症和内脏脂肪症患者住院时间延长。大脓肿更常见于肌肉减少症患者。骨骼肌病和高增值率与游离穿孔有关。

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.