Evaluation of the use of visceral and subcutaneous adipose tissue measurement technique in computerized tomogrophy to predict the severity of acute pancratitis with neutrophil lymphocyte rate as an inflammatory marker

Introduction and Purpose: Acute Pancreatitis is a condition associated with inflammation of the increased inflammation.It is a potential risk factor for the poor course of pancreatitis and the development of complications.Neutrophil-lymphocyte ratio is widely used as an inflammatory marker.In our study, we aimed to examine the relationship between the severity of acute pancreatitis with subcutaneous and visceral fat tissue ratios measured by abdominal computed tomography, neutrophil / lymphocyte ratio and other clinical and laboratory parameters. Material method:Within the scope of the study, patients who were admitted to Balıkesir University Hospital Internal Medicine Clinic with the diagnosis of acute pancreatitis between 15.04.2019 and 15.04.2022 were retrospectively screened and 79 patients who underwent abdominal computed tomography examination during their hospitalization were included in the study. Selected patients; demographic data, laboratory findings, pancreatitis classifications according to the Revised Atlanta Criteria, co-morbidities, acute pancreatitis etiologies, visceral and subcutaneous fat tissue measurement data at the level of L2-L3 vertebrae in abdominal computed tomography using Adobe Photoshop CS5 program were recorded and saved in SPSS 25.0 program.In all statistical analyses, p value below 0.05 was accepted as significant. Results: There are 45 men (57%) and 34 women (43%) in the research group. The patients were examined into two groups which define an imaging-based subgroup of the Revised Atalanta Classification; edematous interstitial pancreatitis and necrotizing pancreatitis. The number of patients with edematous pancreatitis was 59 (74.7%), and the number of patients with necrotizing pancreatitis was 20 (25.3%). In the computed tomography examination measured over the section taken from the L2 - L3 vertebra level, the value obtained by dividing the subcutaneous fat tissue area by the total tissue crosssectional area was not found to be statistically significant with the severity of pancreatitis (p= 0.443). In the same way, the ratio between subcutaneous + visceral adipose tissue area / total tissue section area did not show a significant variability with the severity of pancreatitis (p= 0.710). Neutrophil lymphocyte ratio was determined as 19.235 ± 21.58 in the necrotizing pancreatitis group and 10.588 ± 12.03 in the edematous pancreatitis group, and the difference was significant (p= 0.029). Conclusion: As a result of our study, there was not significant relationship between the differences in subcutaneous and visceral adipose tissue ratios and pancreatitis types obtained according to Atlanta Classification. Neutrophil lymphocyte ratio was found to be significantly higher in the necrotizing pancreatitis group. While it is predicted that NLR can be used to predict the severity of pancreatitis, we think that methods based on body fat calculation should be supported by prospective, large participant and multicenter studies that will contribute to the literature.