Effects of visceral adipose tissue on anti-tumour necrosis factor-α in Crohn's disease

Kangrong Li; Pan Gong; Yongbin Zhang; Minji Liu; Zinan Zhang; Xiaoyu Yu; Mingmei Ye; Li Tian

doi:10.1177/17562848231171962

Effects of visceral adipose tissue on anti-tumour necrosis factor-α in Crohn's disease

Therap Adv Gastroenterol. 2023 May 6:16:17562848231171962. doi: 10.1177/17562848231171962. eCollection 2023.

Authors

Kangrong Li¹, Pan Gong¹, Yongbin Zhang², Minji Liu³, Zinan Zhang¹, Xiaoyu Yu¹, Mingmei Ye¹, Li Tian⁴

Affiliations

¹ Department of Gastroenterology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China.
² Department of Gastroenterology, The Central Hospital of Shaoyang, Shaoyang, Hunan, China.
³ Department of Gastroenterology, Zhuzhou Central Hospital, Zhuzhou, Hunan, China.
⁴ Department of Gastroenterology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Yuelu District, Changsha, Hunan 410013, China.

Abstract

Background: It remains unclear whether visceral adipose tissue (VAT) can predict the response of patients with Crohn's disease (CD) to anti-tumour necrosis factor-α (anti-TNF-α) therapy.

Objectives: This study aimed to investigate whether VAT predicts the efficacy of infliximab (IFX) for different sites of CD and its relationship with serum TNF-α levels and IFX serum trough concentration.

Design: This is a multicentre retrospective study.

Methods: Patients with CD treated with IFX from January 2014 to January 2021 were included. The perimeter of the visceral adipose area was obtained by a Computed Tomography (CT) scan. Participants were classified according to the lesion site (L₁, L₂, and L₃) and visceral fat area. The participants were divided into colon-uninvolved non-visceral obesity (L₁-VAT_L), colon-uninvolved visceral obesity (L₁-VAT_H), colon-involved non-visceral obesity (L₂ + L₃-VAT_L), and colon involved visceral obesity (L₂ + L₃-VAT_H) groups. The end points of this study were set as disease remission status at 6 and 12 months.

Results: The final cohort included 140 patients. Regarding efficacy at 6 and 12 months, there was a significant difference between L₁-VAT_L (73.8% versus 36.8%, p = 0.006) and L₁-VAT_H (81.0% versus 47.4%, p = 0.008) groups. In the analysis of serum TNF-α levels and IFX serum trough concentrations, there was a significant difference between L₁-VAT_L and L₁-VAT_H (59.5 pg/mL versus 236.0 pg/mL, p_TNF-α = 0.006), (10.0 μg/mL versus 0.4 μg/mL, p_IFX = 0.000), and L₁-VAT_H and L₂ + L₃-VAT_H (78.7 pg/mL versus 118.6 pg/mL, p_TNF-α = 0.031), (0.4 μg/mL versus 6.40 μg/mL, p_IFX = 0.017).

Conclusion: In L₁ patients, the VAT level predicted the efficacy of IFX, with high VAT values indicating poor efficacy. The VAT level may be a useful radiological marker to predict the efficacy of IFX in patients with various types of CD.

Keywords: Crohn’s disease; Remicade®; anti-tumour necrosis factor-α; infliximab; visceral adipose tissue.