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Psoas muscle size as a magnetic resonance imaging biomarker of progression of pancreatitis

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

Pancreatitis often represents a continuous inflammatory process, from the first episode of acute pancreatitis (FAP) to recurrent acute pancreatitis (RAP) to chronic pancreatitis (CP). Psoas muscle size is a validated surrogate for global skeletal mass, changes in which are associated with inflammation. The objective was to investigate psoas muscle size in individuals following FAP, RAP, and CP, as well as its associations with pro-inflammatory cytokines.

Methods

Individuals following pancreatitis and healthy individuals were recruited. All participants underwent magnetic resonance imaging, from which psoas muscle volume was derived independently by two raters in a blinded fashion. Circulating levels of four major cytokines (interleukin-6, tumour necrosis factor-α, C-C motif chemokine ligand 2, and leptin) were measured. Five linear regression additive models were built to adjust for possible confounders (age, sex, body composition, physical activity, tobacco smoking, alcohol consumption, comorbidities, and endocrine and exocrine pancreatic functions).

Results

A total of 145 participants were enrolled. A significant downward trend in psoas muscle volume was observed between healthy controls and individuals following FAP, RAP, and CP in all adjusted models (p = 0.047, 0.005, 0.004, and < 0.001). Leptin was significantly associated with psoas muscle volume in all models (β = − 0.16, p = 0.030 in the most adjusted model). The other studied cytokines were not significantly associated with psoas muscle volume.

Conclusions

Psoas muscle size is significantly reduced along the continuum from FAP to RAP to CP. Leptin appears to be one of the factors implicated in this. Further studies are warranted to investigate the relationship between skeletal muscle and inflammation of the pancreas.

Key Points

• First acute pancreatitis, recurrent acute pancreatitis, and chronic pancreatitis were associated with progressively reduced psoas muscle size.

• The findings were independent of age, sex, body fat composition, physical activity, tobacco smoking, alcohol consumption, comorbidities, and exocrine and endocrine functions of the pancreas.

• The mechanism underlying the observed findings may involve hyperleptinaemia.

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Abbreviations

ACCI:

Age-adjusted Charlson comorbidity index

BMI:

Body mass index

CCL2:

C-C motif chemokine ligand 2

CI:

Confidence interval

CP:

Chronic pancreatitis

FAP:

First episode of acute pancreatitis

HbA1c:

Glycated haemoglobin

ICC:

Intraclass correlation coefficient

IL-6:

Interleukin 6

IQR:

Interquartile range

PMI:

Psoas muscle index

PMV:

Psoas muscle volume

RAP:

Recurrent acute pancreatitis

TNFα:

Tumour necrosis factor-α

SFV:

Subcutaneous fat volume

VFV:

Visceral fat volume

V/S:

Visceral to subcutaneous (fat volume ratio)

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Acknowledgements

This study was part of the Clinical and epidemiOlogical inveStigations in Metabolism, nutritiOn, and pancreatic diseaseS (COSMOS) program.

Funding

COSMOS is supported, in part, by the Royal Society of New Zealand (Rutherford Discovery Fellowship to Associate Professor Max Petrov).

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Authors and Affiliations

  1. School of Medicine, University of Auckland, Auckland, New Zealand

    Andre E. Modesto, Charlotte E. Stuart, Jaelim Cho, Juyeon Ko, Ruma G. Singh & Maxim S. Petrov

  2. Auckland City Hospital, Room 12.085A, Level 12, Auckland, 1023, New Zealand

    Maxim S. Petrov

Authors
  1. Andre E. Modesto
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  2. Charlotte E. Stuart
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  3. Jaelim Cho
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  4. Juyeon Ko
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  5. Ruma G. Singh
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  6. Maxim S. Petrov
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Correspondence to Maxim S. Petrov.

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Guarantor

The scientific guarantor of this publication is Associate Professor Max Petrov, MD, MPH, PhD.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Two of the authors have significant statistical expertise.

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Written informed consent was obtained from all participants in this study.

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Health and Disability Ethics Committee approval was obtained.

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• Cross-sectional study

• Performed at one institution

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Modesto, A.E., Stuart, C.E., Cho, J. et al. Psoas muscle size as a magnetic resonance imaging biomarker of progression of pancreatitis. Eur Radiol 30, 2902–2911 (2020). https://doi.org/10.1007/s00330-019-06633-7

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  • DOI: https://doi.org/10.1007/s00330-019-06633-7

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