Body fat distribution in obese trauma patients is not linked to increased inflammation, infections, or mortality
The distribution of body fat, whether predominantly just below the skin (subcutaneous) or predominantly around the internal organs (visceral), is not associated with increased inflammation or poorer outcome in trauma patients, according to a new study. Previous research had indicated that visceral obesity was linked to chronic, low-grade inflammation and such diseases as high blood pressure, diabetes, and stroke. The new study of 281 obese trauma patients (140 with predominantly visceral body fat and 141 with predominantly subcutaneous fat) found no significant difference between the two groups in terms of inflammatory cytokines in the blood (interleukins 1, 2, 4, 6, 8, 10, and tumor necrosis factor). However, patients with more subcutaneous body fat had significantly higher white blood cell counts.
Clinical outcomes (such as multiorgan dysfunction scores, infection rates, or rates of adult respiratory distress syndrome) and mortality rates were not significantly different between the two groups. The findings suggest that the acute inflammation related to traumatic injury appears to overwhelm the chronic inflammation of obese individuals, note the researchers.
Their study was based on analysis of data on 281 obese patients out of 976 trauma patients who were treated at the Vanderbilt University Medical Center intensive care unit (ICU) and had computed tomography (CT) scans of their abdomen and pelvis. Subcutaneous fat was measured from comparable CT images as the area of fat between the skin and the abdominal wall muscles, and visceral fat was the area of fat within the abdominal wall. A blood sample was collected 48 hours after admission to the ICU to measure cytokines and white blood cell count. The study was funded in part by the Agency for Healthcare Research and Quality (T32 HS13833).
More details are in "Visceral adiposity is not associated with inflammatory markers in trauma patients," by Bryan Collier, D.O., Lesly Dossett, M.D., M.P.H., Jason Shipman, M.D., and others in the January 2010 Journal of Trauma Injury, Infection, and Critical Care 68(1), pp. 57-61.
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