Araştırma Makalesi
Bilgisayarlı Tomografide Ölçülebilir Vücut Yağ ve Kas Bileşimi Parametreleri ile Visseral Yağ Dokusunun COVİD-19 Şiddetiyle Korelesi
Öz
Arka Plan/Amaçlar: Obezite, COVID-19’a yakalanma riskini artırır. Amacımız bilgisayarlı tomografide (BT) vücut yağı, kas bileşimi ve iç organ yağ dokusu ile COVID-19 hastalık şiddetiyle arasındaki ilişkiyi değerlendirmektir.
Gereç ve Yöntem: Toraks BT’si olan ve ters transkriptaz-polimeraz zincir reaksiyonu testi pozitif olan 149 hasta çalışmaya dahil edildi. Epikardiyal yağ dokusu kalınlığını (EAT) ve karaciğer dansitesi (LD), torasik deri altı yağ dokusu/pektoralis majör (TSAT/PMJ), karın deri altı yağ dokusu/psoas majör kası (ASAT/PSM), karın deri altı yağ dokusu/erector spina kas (ASAT/ESM) kalınlık oranlarını Toraks BT’den ölçtük. Lenfosit, trombosit, nötrofil sayısı, lenfosit/nötrofil oranı ve CRP kaydedildi.
Bulgular: Klinik gidişi kötü olan hastalarda ortalama EAT yüksekti (ağır hastalarda: 7,06±2,39 mm, kritik hastalarda: 7,89±2,08 mm). Yoğun bakım grubunun ortalama EAT’si 7,70±2,14 mm, ölen hastalarda ise 8,50±2,10 mm idi. Ölen hastalarda TSAT/PMJ daha düşüktü (0,90±0,36, p=0,038). ASAT/PSM ve ASAT/ESM de orta grupta (2,27±1,60 ve 0,51±0,25) (p=0,003 ve p=0,019), hafif gruptan (1,59±1,80 ve p=0,019) daha yüksekti. 0,40±0,26). DM, malignite ve cinsiyet açısından fark yoktu.
Sonuç: YBÜ’ye başvuran ve ölen hastalarda EAT yüksekti ve kötü prognozun bir göstergesi olarak kullanılabilir.
Anahtar Kelimeler
Kaynakça
- Chandarana H, Pisuchpen N, Krieger R, Dane B, Mikheev A, Feng Y, et al. Association of body composition parameters measured on CT with risk of hospitalization in patients with Covid-19. Eur J Radiol 2021;145:110031.
- Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care 2020;43:1392–8.
- Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007;116:39–48.
- Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol 2020; 20:355–62.
- Haines MS, Dichtel LE, Santoso K, Torriani M, Miller KK, Bredella MA. Association between muscle mass and insulin sensitivity independent of detrimental adipose depots in young adults with overweight/obesity. Int J Obes 2020;44:1851–8.
- Viddeleer AR, Raaphorst J, Min M, Beenen LFM, Scheerder MJ, Vlaar APJ. Intramuscular adipose tissue at level Th12 is associated with survival in COVID-19. J Cachexia Sarcopenia Muscle 2021;12:823–7.
- Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA 2020;323:2052–9.
- Petrilli CM, Jones SA, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study BMJ 2020; 369:m1966.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
- Liang T, Cai H, Chen Y, et al. Handbook of COVID-19 prevention and treatment.1 st edition.China: The First Affiliated Hospital, Zhejiang University School of Medicine.2020. P.1-84.
- Yuan M, Yin W, Tao Z, Tan W, Hu Y. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PLoS One 2020;15:e0230548.
- Diaz AA, Martinez CH, Harmouche R, Young TP, McDonald ML, Ross JC, et al. Pectoralis muscle area and mortality in smokers without airflow obstruction, Respir. Res 2018;19: 62.
- Wang TD, Lee WJ, Shih FY, Huang CH, Chang YC, Chen WJ,et al. Relations of epicardial adipose tissue measured by multidetector computed tomography to components of the metabolic syndrome are region-specific and independent of anthropometric indexes and intraabdominal visceral fat. J Clin Endocrinol Metab 2009; 94: 662–9.
- Kim J, Lim H, Lee SI, Kim YJ. The thickness of Rectus Abdominis Muscle and Abdominal Subcutaneous Fat Tissue in Adult Women: Correlation with Age, Pregnancy, Laparotomy, and Body Mass Index. Arch Plast Surg 2012; 39:528-33.
- Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumors of the respiratory and gastrointestinal tracts: a population-based study. The Lancet Oncology 2008; 9:629–35.
- Monjardim RDF, Costa DMC, Romano RFT, Salvadori, PS, Santos, JDVCD, Atzingen, ACV, et al. Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography. Radiol Bras 2013; 46:134–8.
- Speliotes EK, Massaro JM, Hoffmann U, Foster MC, Sahani DV, Hirschhorn JN, et al. Liver fat is reproducibly measured using computed tomography in the Framingham Heart Study. J Gastroenterol Hepatol 2008;23:894-9.
- Iacobellis G, Corradi D & Sharma, AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat. Clin. Pract. Cardiovasc. Med 2005; 2:536–43.
- Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol 2015; 11:363-71.
- Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003; 108:2460–6.
- Briand-M´esange F, Trudel S, Salles J, Ausseil J, Salles JP, Chap H. Possible role of adipose tissue and the endocannabinoid system in coronavirus disease 2019 pathogenesis: can rimonabant return? Obesity 2020; 28:1580–1.
- Kruglikov IL, Scherer PE. The role of adipocytes and adipocyte-like cells in the severity of COVID-19 infections, Obesity 2020; 28:1187–90.
- Zbinden-Foncea H, Francaux M, Deldicque L, Hawley JA. Does high cardiorespiratory fitness confer some protection against pro-inflammatory responses after infection by SARS-CoV-2?. Obesity 2020; 28:1378–81.
- Iacobellis G, Secchi F, Capitanio G, Basilico S, Schiaffino S, Boveri S, et al. Epicardial Fat Inflammation in Severe COVID-19. Obesity 2020;28:2260-2.
- Turker Duyuler P, Duyuler S, Demirtaş B, Çayhan V. Epicardial and pericoronary adipose tissue in severe COVID-19 infection. Acta Cardiol 2021;6:1-8.
- Parlak S, Çıvgın E, Beşler MS, Kayıpmaz AE. The effect of hepatic steatosis on COVID-19 severity: Chest computed tomography findings. Saudi J Gastroenterol. 2021;27:105-10.
- Hsu CW. Glycemic control in critically ill patients, World J. Crit. Care Med 2012; 4: 31–9.
- Marik PE, Raghavan M. Stress-hyperglycemia, insulin, and immunomodulation in sepsis, Intensive Care Med 2004;30:748–56.
- Gusev E, Sarapultsev A, Solomatina L, Chereshnev V. SARS-CoV-2-Specific Immune Response and the Pathogenesis of COVID-19. Int J Mol Sci. 2022;23(3):1716.
- Hocaoglu E, Ors S, Yildiz O, Inci E. Correlation of Pectoralis Muscle Volume and Density with Severity of COVID-19 Pneumonia in Adults. Acad Radiol 2021 ;28:166-72.
- Meyer HJ, Wienke A, Surov A. Computed tomography-defined low skeletal muscle mass as a prognostic marker for short-term mortality in critically ill patients: a systematic review and meta-analysis. Nutrition 2021;91–92:111417.
- Meyer HJ, Wienke A, Surov A. Computed tomography-defined body composition as prognostic markers for unfavorable outcomes and in-hospital mortality in coronavirus disease 2019. J Cachexia Sarcopenia Muscle 2022 ;13:159-68.
Correlation of Measurable Body Fat and Muscle Composition Parameters and Visceral Adipose Tissue on Computed Tomography with COVID-19 Severity
Öz
Background/Aims: Obesity increases the risk of having COVID-19. To evaluate the relationship between body fat, muscle composition, and visceral adipose tissue on computed tomography (CT) with COVID-19 outcome.
Materials and Methods: 149 patients were included who had chest CT and a positive reverse transcriptase-polymerase chain reaction test. We measured the epicardial adipose tissue thickness (EAT) and liver density (LD), thoracic subcutaneous adipose tissue /pectoralis major (TSAT/PMJ), abdominal subcutaneous adipose tissue /psoas major muscle (ASAT/PSM), abdominal subcutaneous adipose tissue/erector spina muscle (ASAT/ESM) thickness ratios from thorax CT. Lymphocyte, platelet, neutrophil count, lymphocyte/neutrophil ratio, and CRP were recorded.
Results: The mean EAT was high in the patients with a poor clinical course (in severe patients: 7.06±2.39 mm, in critical patients: 7.89±2.08 mm). The mean EAT of the ICU group was 7.70±2.14 mm, it was 8.50±2.10 mm in the deceased patients. TSAT/PMJ was lower in deceased patients (0.90±0.36, p=0.038). ASAT/PSM and ASAT/ESM were also higher in the moderate group (2,27±1,60 and 0,51±0,25) (p=0.003. and p=0.019) than mild one (1.59±1.80, and 0.40±0.26). There was no difference in terms of DM, malignancy, or gender.
Conclusion: EAT was high in ICU-admitted and deceased patients and can be used as a predictor of poor prognosis.
Anahtar Kelimeler
Kaynakça
- Chandarana H, Pisuchpen N, Krieger R, Dane B, Mikheev A, Feng Y, et al. Association of body composition parameters measured on CT with risk of hospitalization in patients with Covid-19. Eur J Radiol 2021;145:110031.
- Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, et al. Obesity and COVID-19 severity in a designated hospital in Shenzhen, China. Diabetes Care 2020;43:1392–8.
- Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007;116:39–48.
- Merad M, Martin JC. Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages. Nat Rev Immunol 2020; 20:355–62.
- Haines MS, Dichtel LE, Santoso K, Torriani M, Miller KK, Bredella MA. Association between muscle mass and insulin sensitivity independent of detrimental adipose depots in young adults with overweight/obesity. Int J Obes 2020;44:1851–8.
- Viddeleer AR, Raaphorst J, Min M, Beenen LFM, Scheerder MJ, Vlaar APJ. Intramuscular adipose tissue at level Th12 is associated with survival in COVID-19. J Cachexia Sarcopenia Muscle 2021;12:823–7.
- Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA 2020;323:2052–9.
- Petrilli CM, Jones SA, Yang J, Rajagopalan H, O'Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study BMJ 2020; 369:m1966.
- Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
- Liang T, Cai H, Chen Y, et al. Handbook of COVID-19 prevention and treatment.1 st edition.China: The First Affiliated Hospital, Zhejiang University School of Medicine.2020. P.1-84.
- Yuan M, Yin W, Tao Z, Tan W, Hu Y. Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China. PLoS One 2020;15:e0230548.
- Diaz AA, Martinez CH, Harmouche R, Young TP, McDonald ML, Ross JC, et al. Pectoralis muscle area and mortality in smokers without airflow obstruction, Respir. Res 2018;19: 62.
- Wang TD, Lee WJ, Shih FY, Huang CH, Chang YC, Chen WJ,et al. Relations of epicardial adipose tissue measured by multidetector computed tomography to components of the metabolic syndrome are region-specific and independent of anthropometric indexes and intraabdominal visceral fat. J Clin Endocrinol Metab 2009; 94: 662–9.
- Kim J, Lim H, Lee SI, Kim YJ. The thickness of Rectus Abdominis Muscle and Abdominal Subcutaneous Fat Tissue in Adult Women: Correlation with Age, Pregnancy, Laparotomy, and Body Mass Index. Arch Plast Surg 2012; 39:528-33.
- Prado CM, Lieffers JR, McCargar LJ, Reiman T, Sawyer MB, Martin L, et al. Prevalence and clinical implications of sarcopenic obesity in patients with solid tumors of the respiratory and gastrointestinal tracts: a population-based study. The Lancet Oncology 2008; 9:629–35.
- Monjardim RDF, Costa DMC, Romano RFT, Salvadori, PS, Santos, JDVCD, Atzingen, ACV, et al. Diagnosis of hepatic steatosis by contrast-enhanced abdominal computed tomography. Radiol Bras 2013; 46:134–8.
- Speliotes EK, Massaro JM, Hoffmann U, Foster MC, Sahani DV, Hirschhorn JN, et al. Liver fat is reproducibly measured using computed tomography in the Framingham Heart Study. J Gastroenterol Hepatol 2008;23:894-9.
- Iacobellis G, Corradi D & Sharma, AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat. Clin. Pract. Cardiovasc. Med 2005; 2:536–43.
- Iacobellis G. Local and systemic effects of the multifaceted epicardial adipose tissue depot. Nat Rev Endocrinol 2015; 11:363-71.
- Mazurek T, Zhang L, Zalewski A, Mannion JD, Diehl JT, Arafat H, et al. Human epicardial adipose tissue is a source of inflammatory mediators. Circulation 2003; 108:2460–6.
- Briand-M´esange F, Trudel S, Salles J, Ausseil J, Salles JP, Chap H. Possible role of adipose tissue and the endocannabinoid system in coronavirus disease 2019 pathogenesis: can rimonabant return? Obesity 2020; 28:1580–1.
- Kruglikov IL, Scherer PE. The role of adipocytes and adipocyte-like cells in the severity of COVID-19 infections, Obesity 2020; 28:1187–90.
- Zbinden-Foncea H, Francaux M, Deldicque L, Hawley JA. Does high cardiorespiratory fitness confer some protection against pro-inflammatory responses after infection by SARS-CoV-2?. Obesity 2020; 28:1378–81.
- Iacobellis G, Secchi F, Capitanio G, Basilico S, Schiaffino S, Boveri S, et al. Epicardial Fat Inflammation in Severe COVID-19. Obesity 2020;28:2260-2.
- Turker Duyuler P, Duyuler S, Demirtaş B, Çayhan V. Epicardial and pericoronary adipose tissue in severe COVID-19 infection. Acta Cardiol 2021;6:1-8.
- Parlak S, Çıvgın E, Beşler MS, Kayıpmaz AE. The effect of hepatic steatosis on COVID-19 severity: Chest computed tomography findings. Saudi J Gastroenterol. 2021;27:105-10.
- Hsu CW. Glycemic control in critically ill patients, World J. Crit. Care Med 2012; 4: 31–9.
- Marik PE, Raghavan M. Stress-hyperglycemia, insulin, and immunomodulation in sepsis, Intensive Care Med 2004;30:748–56.
- Gusev E, Sarapultsev A, Solomatina L, Chereshnev V. SARS-CoV-2-Specific Immune Response and the Pathogenesis of COVID-19. Int J Mol Sci. 2022;23(3):1716.
- Hocaoglu E, Ors S, Yildiz O, Inci E. Correlation of Pectoralis Muscle Volume and Density with Severity of COVID-19 Pneumonia in Adults. Acad Radiol 2021 ;28:166-72.
- Meyer HJ, Wienke A, Surov A. Computed tomography-defined low skeletal muscle mass as a prognostic marker for short-term mortality in critically ill patients: a systematic review and meta-analysis. Nutrition 2021;91–92:111417.
- Meyer HJ, Wienke A, Surov A. Computed tomography-defined body composition as prognostic markers for unfavorable outcomes and in-hospital mortality in coronavirus disease 2019. J Cachexia Sarcopenia Muscle 2022 ;13:159-68.
Toplam 32 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Original Article |
| Yazarlar | |
| Erken Görünüm Tarihi | 29 Aralık 2023 |
| Yayımlanma Tarihi | 31 Aralık 2023 |
| Gönderilme Tarihi | 25 Nisan 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 33 Sayı: 6 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.