The Individual and Joint Associations of Sarcopenic Obesity and Malnutrition on Predicting the Severity of Acute Pancreatitis.

IF 2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-08-30 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S540037

Ping Li, Qianchao Xing, Lei Wang, Junli Shi, Yue Xiao Zhang, Hao Fu

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Abstract

Purpose: This study aimed to evaluate the individual and joint associations of malnutrition and obesity on predicting the severity and prognosis of acute pancreatitis (AP).

Patients and methods: A retrospective analysis of 240 AP patients was conducted. Malnutrition was diagnosed using Global Leadership Initiative on Malnutrition (GLIM) criteria. Obesity was defined using body mass index (BMI) and different ratios of psoas muscle area (PMA) to BMI, of which PMA/BMI was used to define sarcopenic obesity. Patients were categorized into four groups: well-nourished non-obese (WN), malnourished non-obese (MN), well-nourished obese (WO), and malnourished obese (MO). Logistic regression, and trend analyses were employed to assess associations with different AP outcomes.

Results: The MO group exhibited the highest C-reactive protein levels, lowest albumin/hemoglobin, and worst clinical outcomes. Sarcopenic obesity (MO and WO) significantly increased risks of moderately severe/severe AP (OR ≥2.74), composite outcomes (OR ≥2.69) and AP severity (OR ≥3.27), with the MO group having a risk 5-7 times higher than the WN group. As the PMA/BMI quartiles increase, the risk of moderately severe AP (MSAP)+ severe AP (SAP), composite outcomes and the AP severity significantly increased (all p for trend<0.003), and the group with a median PMA/BMI above (sarcopenic obesity) was significantly correlated with MSAP+SAP (OR ≥3.41), composite outcomes (OR ≥3.26), and the severity of AP (OR ≥3.66). Malnutrition alone did not independently elevate risks. However, no such association was observed in BMI based grouping.

Conclusion: Sarcopenic obesity, quantified by PMA/BMI, is a superior predictor of AP severity compared to BMI. The coexistence of malnutrition and sarcopenic obesity synergistically exacerbates inflammation and poor outcomes, emphasizing the need for body composition-guided nutritional interventions.

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肌肉减少型肥胖和营养不良对预测急性胰腺炎严重程度的个体和联合关联。

目的：本研究旨在评估营养不良和肥胖在预测急性胰腺炎（AP）严重程度和预后方面的个体和联合关联。患者与方法：对240例AP患者进行回顾性分析。根据营养不良全球领导倡议（GLIM）的标准诊断营养不良。肥胖的定义采用体重指数（BMI）和腰肌面积（PMA）与BMI的不同比值，其中PMA/BMI用于定义肌肉减少型肥胖。患者被分为四组：营养良好的非肥胖（WN）、营养不良的非肥胖（MN）、营养良好的肥胖（WO）和营养不良的肥胖（MO）。采用逻辑回归和趋势分析来评估不同AP结果的相关性。结果：MO组c反应蛋白水平最高，白蛋白/血红蛋白水平最低，临床预后最差。肌少性肥胖（MO和WO）显著增加了中重度/重度AP （OR≥2.74）、综合结局（OR≥2.69）和AP严重程度（OR≥3.27）的风险，其中MO组的风险比WN组高5-7倍。随着PMA/BMI四分位数的增加，中重度AP (MSAP)+重度AP （SAP）、综合结局和AP严重程度的风险显著增加（趋势均为p）。结论：与BMI相比，PMA/BMI量化的肌少性肥胖是AP严重程度的更好预测指标。营养不良和肌肉减少性肥胖的共存协同加剧了炎症和不良结果，强调需要身体成分指导的营养干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.