Obesity: A prognostic factor of severity in acute pancreatitis

This study was conducted to assess the prognostic value of obesity in acute pancreatitis and to determine the role played by obesity-associated diseas es in the course of the disease. We prospectively studied 49 patients with acute pancreatitis who were divided into three groups according to their bo dy mass index (BMI). There were 22 patients in group I (BMI less than or eq ual to 25 kg/m(2), normal or low weight); 15 in group II (BMI >25 and less than or equal to 29 kg/m(2), overweight); and 12 in group III (BMI >29 kg/m (2), obese). Other anthropometric parameters also were measured. The severi ty of pancreatitis was assessed according to the Atlanta classification sys tem. Systemic complications were significantly more common among obese than nonobese patients (p < 0.05). Patients with severe pancreatitis had a high er body-fat percentage, measured by the subscapular skinfold thickness, and a larger abdominal circumference than patients with mild pancreatitis. Alt hough hypertensive or diabetic patients developed more systemic complicatio ns, the multivariate analysis demonstrated that the presence of these under lying diseases did not modify the prognostic role of obesity in acute pancr eatitis. We conclude that obesity is a prognostic factor of outcome in acut e pancreatitis. Obesity-associated diseases do not vary the prognostic valu e of obesity. It seems that truncal adiposity is the kind of obesity relate d to worse outcome of acute pancreatitis.