Jayendra Seetharaman, Anshu Srivastava, Rajanikant R Yadav, Sumit K Singh, Prabhakar Mishra, Moinak Sen Sarma, Ujjal Poddar
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VF/SF and VF/TF ratios were calculated.</p><p><strong>Results: </strong>Thirty-four (age 14 years [10.8-17.0], 14 boys) children were recruited: 12 had CD [seven boys, age 13.0 years] and 22 had ITB [seven boys, age 14.5 years]. VF area was higher in CD compared to ITB (18.34 cm2 [15.62-40.01] vs 6.48 cm2 [2.65-21.96]; p = 0.012). The SF and TF area was similar in ITB and CD. The ratios of VF/SF (0.82 [0.57-1.5] vs 0.33 [0.16-0.48]; p = 0.004) and VF/TF (0.45 [0.36-0.60] vs 0.25 [0.13-0.32]; p = 0.004) were significantly higher in CD. On comparing CD and ITB in boys and girls separately, the difference was significant for boys but not for girls. A VF/SF ratio of 0.609 predicted CD with a good sensitivity [75%] and specificity [86.4%] [area under the curve 0.795, 95% confidence interval 0.636-0.955; p = 0.005].</p><p><strong>Conclusion: </strong>The VF/SF ratio is a simple, non-invasive, objective parameter to differentiate CD and ITB in children, particularly boys. Larger studies are needed to validate this in girls.</p>","PeriodicalId":15547,"journal":{"name":"Journal of Crohns & Colitis","volume":null,"pages":null},"PeriodicalIF":8.3000,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Visceral Fat Indices: Do They Help Differentiate Crohn's Disease and Intestinal Tuberculosis in Children?\",\"authors\":\"Jayendra Seetharaman, Anshu Srivastava, Rajanikant R Yadav, Sumit K Singh, Prabhakar Mishra, Moinak Sen Sarma, Ujjal Poddar\",\"doi\":\"10.1093/ecco-jcc/jjad109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Crohn's disease [CD] and intestinal tuberculosis [ITB] are often difficult to differentiate. Mesenteric fat hypertrophy is a feature of CD. We evaluated the utility of fat indices (visceral fat [VF] and subcutaneous fat [SF]) in differentiating CD and ITB in children.</p><p><strong>Methods: </strong>Symptomatic children diagnosed to have CD or ITB based on recommended criteria were enrolled. Clinical, anthropometric, and laboratory details were noted. Abdominal fat was measured on computed tomography in supine position at the level of L4 vertebrae. VF and SF area was measured separately by a radiologist, blinded to the diagnosis. The sum of VF and SF was taken as total fat [TF]. VF/SF and VF/TF ratios were calculated.</p><p><strong>Results: </strong>Thirty-four (age 14 years [10.8-17.0], 14 boys) children were recruited: 12 had CD [seven boys, age 13.0 years] and 22 had ITB [seven boys, age 14.5 years]. VF area was higher in CD compared to ITB (18.34 cm2 [15.62-40.01] vs 6.48 cm2 [2.65-21.96]; p = 0.012). The SF and TF area was similar in ITB and CD. 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引用次数: 0
摘要
背景和目的:克罗恩病 [CD] 和肠结核 [ITB] 通常很难区分。肠系膜脂肪肥厚是 CD 的一个特征。我们评估了脂肪指数(内脏脂肪[VF]和皮下脂肪[SF])在区分儿童克罗恩病和肠结核方面的效用:方法:根据推荐标准诊断为 CD 或 ITB 的无症状儿童入组。注意临床、人体测量和实验室细节。仰卧位时,在L4椎体水平通过计算机断层扫描测量腹部脂肪。VF和SF面积由一名放射科医生分别测量,该医生对诊断结果保密。VF和SF的总和为总脂肪[TF]。计算VF/SF和VF/TF比率:共招募了 34 名儿童(14 岁 [10.8-17.0],14 名男孩):其中 12 名儿童患有 CD(7 名男孩,13.0 岁),22 名儿童患有 ITB(7 名男孩,14.5 岁)。与 ITB 相比,CD 儿童的 VF 面积更大(18.34 平方厘米 [15.62-40.01] vs 6.48 平方厘米 [2.65-21.96];P = 0.012)。ITB 和 CD 的 SF 和 TF 面积相似。CD患儿的VF/SF(0.82 [0.57-1.5] vs 0.33 [0.16-0.48];p = 0.004)和VF/TF(0.45 [0.36-0.60] vs 0.25 [0.13-0.32];p = 0.004)之比明显高于ITB患儿。在分别比较男孩和女孩的 CD 和 ITB 时,男孩的差异显著,女孩则不显著。VF/SF比值为0.609可预测CD,具有良好的敏感性[75%]和特异性[86.4%][曲线下面积为0.795,95%置信区间为0.636-0.955;P = 0.005]:VF/SF比值是区分儿童(尤其是男孩)CD和ITB的一个简单、无创、客观的参数。需要进行更大规模的研究,以便在女孩中验证这一结果。
Visceral Fat Indices: Do They Help Differentiate Crohn's Disease and Intestinal Tuberculosis in Children?
Background and aims: Crohn's disease [CD] and intestinal tuberculosis [ITB] are often difficult to differentiate. Mesenteric fat hypertrophy is a feature of CD. We evaluated the utility of fat indices (visceral fat [VF] and subcutaneous fat [SF]) in differentiating CD and ITB in children.
Methods: Symptomatic children diagnosed to have CD or ITB based on recommended criteria were enrolled. Clinical, anthropometric, and laboratory details were noted. Abdominal fat was measured on computed tomography in supine position at the level of L4 vertebrae. VF and SF area was measured separately by a radiologist, blinded to the diagnosis. The sum of VF and SF was taken as total fat [TF]. VF/SF and VF/TF ratios were calculated.
Results: Thirty-four (age 14 years [10.8-17.0], 14 boys) children were recruited: 12 had CD [seven boys, age 13.0 years] and 22 had ITB [seven boys, age 14.5 years]. VF area was higher in CD compared to ITB (18.34 cm2 [15.62-40.01] vs 6.48 cm2 [2.65-21.96]; p = 0.012). The SF and TF area was similar in ITB and CD. The ratios of VF/SF (0.82 [0.57-1.5] vs 0.33 [0.16-0.48]; p = 0.004) and VF/TF (0.45 [0.36-0.60] vs 0.25 [0.13-0.32]; p = 0.004) were significantly higher in CD. On comparing CD and ITB in boys and girls separately, the difference was significant for boys but not for girls. A VF/SF ratio of 0.609 predicted CD with a good sensitivity [75%] and specificity [86.4%] [area under the curve 0.795, 95% confidence interval 0.636-0.955; p = 0.005].
Conclusion: The VF/SF ratio is a simple, non-invasive, objective parameter to differentiate CD and ITB in children, particularly boys. Larger studies are needed to validate this in girls.
期刊介绍:
Journal of Crohns and Colitis is concerned with the dissemination of knowledge on clinical, basic science and innovative methods related to inflammatory bowel diseases. The journal publishes original articles, review papers, editorials, leading articles, viewpoints, case reports, innovative methods and letters to the editor.