Intest Res.  2014 Jan;12(1):42-47. 10.5217/ir.2014.12.1.42.

Visceral Fat as a Useful Parameter in the Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis

• Ko JK
• Lee HL
• Kim JO
• Song SY
• Lee KN
• Jun DW
• Lee OY
• Han DS
• Yoon BC
• Choi HS
• Hahm JS
• Kim SY

• KMID: 2174336
• DOI: http://doi.org/10.5217/ir.2014.12.1.42

Abstract

BACKGROUND/AIMS
Because of the similarities in the clinical presentations of Crohn's disease (CD) and intestinal tuberculosis (ITB), differential diagnosis is critical. Mesenteric adipose tissue hypertrophy and creeping fat are characteristic features of CD. The purpose of this study was to assess the usefulness of visceral fat for the differential diagnosis of CD and ITB.
METHODS
We conducted a retrospective review of 50 patients with findings of CD or ITB between January 2005 and July 2008. Abdominal computed tomography (CT) was performed on all subjects during their first evaluation. The abdominal fat area was assessed using quantitative abdominal CT.
RESULTS
The ratio of visceral fat to total fat (VF/TF) was significantly higher in male CD patients than in male ITB patients. The ratio of visceral fat to subcutaneous fat (VF/SF) was also higher in CD patients than in patients with ITB. For a VF/TF cut-off value of 0.46, the sensitivity and specificity for the diagnosis of CD were 42.1% and 93.3% respectively, with positive and negative predictive values of 88.9% and 56.0%, respectively.
CONCLUSION
Measurement of the abdominal fat area using CT can be clinically useful for the differential diagnosis of CD and ITB.

Keyword

Crohn's disease; Intra-abdominal fat

MeSH Terms

Abdominal Fat
Adipose Tissue
Crohn Disease*
Diagnosis
Diagnosis, Differential*
Humans
Hypertrophy
Intra-Abdominal Fat*
Male
Retrospective Studies
Sensitivity and Specificity
Subcutaneous Fat
Tomography, X-Ray Computed
Tuberculosis*

Figure

• 

  Fig. 1 Abdominal fat in female patients. (A) Total fat (TF) (P=0.144). (B) Visceral fat (VF) (P=0.360). (C) Subcutaneous fat (SF) (P=0.112). (D) VF/TF (P=0.911). (E) VF/SF (P=0.814). ITB, intestinal tuberculosis.

• 

  Fig. 2 Abdominal fat in male patients. (A) Total fat (TF) (P=0.172). (B) Visceral fat (VF) (P=0.249). (C) Subcutaneous fat (SF) (P=0.078). (D) VF/TF (P=0.007), (E) VF/SF (P=0.009). ITB, intestinal tuberculosis.

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