Abstract Background Transmural healing (TH) is an emerging therapeutic target in Crohn’s disease. Visceral adipose tissue (VAT) is associated with prognosis of CD, but few study investigate the ability of VAT in predicting TH. Therefore, we aimed to quantitatively assessed VAT by magnetic resonance enterography (MRE) and evaluate the prediction of baseline VAT volume for TH in CD patients with Ustekinumab (UST) treatment. Methods We retrospectively included CD patients receiving UST treatment, with bowel wall thickness (BWT) 3mm assessed by MRE at baseline. Clinical characteristics, laboratory, endoscopic and MRE indicators were evaluated at baseline, week 26 (W26) and week 78 (W78) of the therapy. Quantification of VAT volume was assessed by MRE at baseline, and adjusted by body mass index (BMI). The TH was defined as BWT ⩽ 3 mm without any signs of inflammation at W26 and W78. Results 62 patients were included in our study. After UST treatment for W26 and W78, 8 (13.1%) and 13 (21.0%) patients achieved TH. Compared with baseline, laboratory indicators such as C-reactive protein and Erythrocyte Sedimentation Rate, simple endoscopic score for Crohn’s disease and BWT were significantly improved at W26 and W78. We divided patients into TH and non-TH group at both W26 and W78, and found that adjusted VAT volume at baseline was significantly lower in W26-TH (Figure 1A-B) and W78-TH group (Figure 1C-D). Adjusted VAT volume was then categorized into 4 scores by quartiles, and multi variable analysis showed that baseline VAT score could negatively predict W26-TH (odds ratio OR= 0.296, p = 0.018) and W78-TH (OR = 0.419, p = 0.012) (Figure 2). Conclusion Our study demonstrated that baseline VAT was the independent risk factor for predicting both short- and long-term TH in CD patients receiving UST. Patients with lower VAT volume at baseline were more likely to achieve TH after UST treatment. Conflict of interest: Dr. Wu, Xiaomin: No conflict of interest Fan, Cien: No conflict of interest Zheng, Qingzhu: No conflict of interest Wang, Yu: No conflict of interest Chen, Minhu: I have received speaker honoraria from Takeda China, Xian Janssen, and AbbVie China, as well as research funding from Takeda (China). Li, Xuehua: No conflict of interest Mao, Ren: None
Wu et al. (Thu,) studied this question.