Premium
Development and validation of visceral fat quantification as a surrogate marker for differentiation of Crohn's disease and intestinal tuberculosis
Author(s) -
Yadav Dawesh Prakash,
Madhusudhan Kumble Seetharama,
Kedia Saurabh,
Sharma Raju,
Pratap Mouli Venigalla,
Bopanna Sawan,
Dhingra Rajan,
Pradhan Rajesh,
Goyal Sandeep,
Sreenivas Vishnubhatla,
Vikram Naval K,
Makharia Govind,
Ahuja Vineet
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13535
Subject(s) - medicine , gastroenterology , cohort , crohn's disease , visceral fat , retrospective cohort study , tuberculosis , cohort study , pathology , disease , obesity , insulin resistance
Background and Aim Crohn's disease (CD) and intestinal tuberculosis (ITB) have close phenotypic resemblance. Mesenteric fat (a component of visceral fat [VF]) hypertrophy and fat wrapping, which is visible radiologically as fibrofatty proliferation, is seen more commonly in CD than in ITB. Aim The present study was conducted to study the role of VF in differentiating CD and ITB. Methods Visceral fat area and subcutaneous (SC) fat area were measured on computed tomography in two cohorts (development and validation). VF/SC ratio was also calculated for all patients. In the development cohort, retrospective data collection was carried out for 75 patients with CD and ITB who were on follow‐up from January 2012 to November 2014. In the validation cohort, 82 patients were recruited prospectively from December 2014 to December 2015 and were diagnosed as CD or ITB according to standard diagnostic criteria. Results Visceral fat area and VF/SC ratio were significantly higher in CD patients ( n = 42: development, n = 46: validation) than in ITB patients ( n = 33: development, n = 36: validation) in both the development (106.2 ± 63.5 vs 37.3 ± 22, P = <0.001; 1.1 ± 0.57 vs 0.43 ± 0.24, P = <0.001) and validation cohorts (102.2 ± 69.8 vs 55.8 ± 44.9, P = 0.01; 1.2 ± 0.68 vs 0.56 ± 0.33, P = <0.001). A cut‐off of 0.63 for VF/SC ratio in the development cohort had a high sensitivity (82%) and specificity (81%) in differentiating CD and ITB. Similar sensitivity (81%) and specificity (78%) were seen when this cut‐off was applied in the validation cohort. Conclusion The VF/SC ratio is a simple, cost‐effective, non‐invasive and single objective parameter with a good sensitivity and specificity to differentiate CD and ITB.