Android fat distribution as predictor of severity in acute pancreatitis

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Abstract
Obesity is considered an independent risk factor for the development of severe acute pancreatitis (AP). The purpose of this study was to define the type of fat distribution related to severity in AP. Eighty-eight patients with first-time AP underwent measurements of weight, height, waist and hip circumferences, and skinfold thickness on admission. Severity was defined according to Atlanta criteria. AP was severe in 27 (31%) patients. There was a tendency for obese patients to develop severe AP (p = 0.11). Android fat distribution by waist-to-hip ratio and waist circumference above ideal cut-off value (ROC curves analysis) were significantly associated with severity (RR: 5.54, 95% CI 1.39-22.04, and RR: 4.36, 95% CI 1.40-13.57, respectively). After adjusting for potential confounders, both measurements remained predictors of severity in the logistic regression model (OR: 9.23, 95% CI 1.67-51.07, and OR: 13.41, 95% CI 2.43-73.97, respectively). Body fat percentage was not associated with incidence of severity. Patients with android fat distribution and higher waist circumference are at greater risk for developing severe AP. Findings could be related to the amount of abdominal fat but also to an overactive systemic inflammatory response that tend to be upregulated in android fat distribution.