SUN-628 - Investigation of the Clinical and Muscle Fat Distribution Characteristics in Patients with Type 2 Diabetes Mellitus Complicating by First-Onset Acute Pancreatitis Based on Abdominal Computed Tomography

Objective Patients with type 2 diabetes mellitus (T2DM) are at greater risk of complications of acute pancreatitis (AP) with greater severity. Obesity is closely related to the development of T2DM and AP, and traditional methods such as body mass index (BMI) cannot distinguish fat distribution. Computed tomography (CT) is a routine imaging examination for AP patients on admission and can accurately quantify muscle fat parameters. In this study, we investigated patients with T2DM with first-onset AP by quantitatively assessing the muscle lipid composition by early abdominal CT in combination with clinical laboratory tests, with the aim of screening for risk factors to reduce the likelihood of AP in patients with T2DM.
Methods 241 patients with first-onset AP in T2DM and 57 T2DM without AP were retrospectively included. Clinical data such as gender, age, BMI, lipids, and blood glucose were collected. The abdominal muscle fat area was semi-automatically segmented using Slice-O-Matic. Risk factors for the first-onset AP in T2DM were analyzed, receiver operating characteristic (ROC) curves for each risk factor and combined multi-factors were plotted, and specificity, sensitivity, and area under curve (AUC) values were compared.
Results Patients in the T2DM with first-onset AP group had lower age, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and intermuscular adipose tissue, shorter duration of diabetes mellitus, and a lower proportion of comorbid chronic complications of T2DM, as well as hypertension (P < 0.05). While BMI, triglycerides (TG), total cholesterol, very low-density lipoprotein cholesterol, skeletal muscle tissue, visceral adipose tissue (VAT), subcutaneous adipose tissue, total adipose tissue, skeletal muscle density, visceral fat-to total fat ratio, visceral fat-to-muscle ratio, and skeletal muscle index at the third lumbar vertebra (L3-SMI) were higher. The proportion of combined fatty liver and alcohol consumption was higher (P < 0.05). There were no statistically significant differences between the two groups in terms of gender, proportion of smokers, proportion of acute complications of T2DM, mean blood glucose, and hemoglobin A1c (P > 0.05). Multi-factorial logistic regression analyses showed that BMI, TG, and VAT were independent risk factors for the first-onset AP in T2DM (P < 0.05). Receiver operating characteristic curve analyses show that the area under curve of the combination of BMI, TG, and VAT in predicting the first-onset AP in T2DM (0.937) is higher than the values of the tests of BMI, TG, and VAT alone (0.841, 0.814, 0.831).
Conclusion Abdominal body fat analysis combined with laboratory tests using CT examination can identify risk factors for first-onset AP in T2DM at an early stage, and VAT should be reduced in patients with T2DM, which is helpful to reduce their risk of concomitant AP.

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