Research Article: Dynamics of in-hospital body composition changes in mild and moderately severe acute pancreatitis: trajectories and predictors
Abstract:
Nutritional risk is common in pancreatitis, but body composition changes in mild to moderate cases are understudied. This research aimed to track these changes during hospitalization, identify influencing factors, and explore their link to complications like SIRS and peritonitis.
A prospective observational longitudinal study was conducted, enrolling 206 patients with mild and moderately severe acute pancreatitis admitted to a university-affiliated hospital. Body composition was longitudinally assessed at hospital admission, diet initiation day, and discharge. We employed linear mixed-effects models to analyze the trajectories of body composition changes and their influencing factors in patients with pancreatitis during hospitalization.
During hospitalization, average BMI decreased by 0.9?kg/m 2 , lean tissue mass (LTM) by 1.6?kg, and adipose tissue mass (ATM) by 0.9?kg. Significant changes in both LTM and ATM were observed over time during hospitalization, specifically across admission, diet initiation, and discharge ( p <?0.05). Multivariable linear mixed-effects model analysis identified length of hospital stay, age, sex, alcohol use history, and hemoglobin level as independent determinants of LTM changes, whereas length of hospital stay, diabetes mellitus, triglyceride level, and ALT were independent determinants for ATM changes. Peritonitis, SIRS, and ascites occurred in 58.5, 12.6, and 4.9% of patients, respectively. In all patients, LTM and ATM showed a consistent decrease with longer hospitalization, but the trends of change did not differ by complication status.
This study reaffirms the necessity of addressing nutritional risk in all pancreatitis patients, as even those with mild and moderate disease experience significant muscle tissue loss.
Introduction:
Acute pancreatitis (AP), a common digestive emergency frequently characterized by abdominal pain and electrolyte imbalances, may progress to multi-organ dysfunction and mortality in severe cases ( 1 ). The early disease phase typically manifests a hypermetabolic and hypercatabolic state, leading to negative nitrogen balance and substantial nutritional risk that adversely impacts clinical outcomes ( 1 ). The 2020 ESPEN guidelines on clinical nutrition emphasize that all AP patients should be considered at…
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