Effects of visceral adipose tissue on anti-tumour necrosis factor-α in Crohn's disease.

Background: It remains unclear whether visceral adipose tissue (VAT) can predict the response of patients with Crohn's disease (CD) to anti-tumour necrosis factor-α (anti-TNF-α) therapy.

Objectives: This study aimed to investigate whether VAT predicts the efficacy of infliximab (IFX) for different sites of CD and its relationship with serum TNF-α levels and IFX serum trough concentration.

Design: This is a multicentre retrospective study.

Methods: Patients with CD treated with IFX from January 2014 to January 2021 were included. The perimeter of the visceral adipose area was obtained by a Computed Tomography (CT) scan. Participants were classified according to the lesion site (L, L, and L) and visceral fat area. The participants were divided into colon-uninvolved non-visceral obesity (L-VAT), colon-uninvolved visceral obesity (L-VAT), colon-involved non-visceral obesity (L + L-VAT), and colon involved visceral obesity (L + L-VAT) groups. The end points of this study were set as disease remission status at 6 and 12 months.

Results: The final cohort included 140 patients. Regarding efficacy at 6 and 12 months, there was a significant difference between L-VAT (73.8% 36.8%,  = 0.006) and L-VAT (81.0% 47.4%,  = 0.008) groups. In the analysis of serum TNF-α levels and IFX serum trough concentrations, there was a significant difference between L-VAT and L-VAT (59.5 pg/mL 236.0 pg/mL,  = 0.006), (10.0 μg/mL 0.4 μg/mL,  = 0.000), and L-VAT and L + L-VAT (78.7 pg/mL 118.6 pg/mL,  = 0.031), (0.4 μg/mL 6.40 μg/mL,  = 0.017).

Conclusion: In L patients, the VAT level predicted the efficacy of IFX, with high VAT values indicating poor efficacy. The VAT level may be a useful radiological marker to predict the efficacy of IFX in patients with various types of CD.