Visceral Adiposity Is Not Associated With Inflammatory Markers in Trauma Patients

被引:17
作者
Collier, Bryan [1 ]
Dossett, Lesly [1 ]
Shipman, Jason [2 ]
Day, Matthew [2 ]
Lawson, George [1 ]
Sawyer, Robert [3 ]
May, Addison [1 ]
机构
[1] Vanderbilt Univ, Dept Surg, Med Ctr, Div Trauma & Surg Crit Care, Nashville, TN 37240 USA
[2] Vanderbilt Univ, Med Ctr, Dept Radiol, Nashville, TN 37232 USA
[3] Univ Virginia Hlth Syst, Charlottesville, VA USA
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2010年 / 68卷 / 01期
关键词
Obesity; Trauma; Visceral adiposity; Visceral obesity; BODY-MASS INDEX; CRITICALLY-ILL; METABOLIC SYNDROME; US CHILDREN; OBESITY; TISSUE; INJURY; MORTALITY; IMPACT; DEATH;
D O I
10.1097/TA.0b013e3181c40262
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Excess visceral adiposity induces chronic subclinical inflamation resulting in the metabolic syndrome. Whether excess visceral adiposity impacts posttraumatic inflammatory profiles more is unknown. We hypothesized that obese patients (body mass index >30 kg/m(2)) with higher visceral to subcutaneous adipose tissue distribution would have increased inflammatory outcomes. Methods: A secondary analysis of a prospective cohort of adult trauma patients requiring >48 hours of intensive care unit care over a 55-month period was analyzed. Body fat distribution was determined by radiologist review of computed tomography scans at L1. Concentric freeform regions were defined manually, and area was calculated. Visceral adiposity was defined as subcutaneous fat area: visceral area > 1.35 (the median), whereas Subcutaneous adiposity was defined as a ratio < 1,35. Primary Outcomes were proinflammatory biomarkers known to be associated with chronic visceral obesity (white blood cell Count, interleukin 1, 2, 4, 6, 8, 10, and turner necrosis factor a). Secondary outcomes were all-cause in-hospital mortality, adult respiratory distress syndrome, and nosocomial infections. Results: Two hundred eighty-one (19%) obese patients with available computed tomography scans from 1,510 trauma patients were included. Visceral adiposity included 140 patients, Subcutaneous adiposity included 141 patients. The two groups were similar in regards to age, Trauma Injury Severity Score, and Acute Physiology and Chronic Health Evaluation 11 score, There was no difference (p > 0.05) in proinflammatory biomarkers. Patients with visceral adiposity had similar clinical Outcomes including mortality (p = 0.56), adult respiratory distress syndrome (p = 0.69), and infection (0.43). Conclusions: Visceral body fat distribution in obese patients is not associated with increased inflammatory profiles or clinical outcomes after trauma. The impact of injury severity on acute inflammation likely overwhelms the metabolic disturbances and subclinical inflammation associated with visceral obesity in the chronic setting.
引用
收藏
页码:57 / 61
页数:5
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