Background. Visceral adipose tissue (VAT) contributes to the severity of acute pancreatitis (AP) through systemic inflammation and metabolic dysregulation, but its predictive value remains unclear.
Method. Literature searches were conducted in PubMed, Embase, Cochrane Library, and Web of Science databases until April 9, 2025. Study quality was appraised via the NIH scale. Statistical analysis was performed using Stata 15.0.
Result. The meta-analysis comprised 13 articles in total with 2917 patients, and the overall quality of the included articles was high. The meta-analysis illustrated high VAT content in patients with moderately severe AP (MSAP) (SMD=0.64, 95%CI: 00.18,1.10) and patients with severe AP (SAP) (SMD=0.85, 95% CI: 0.17,1.52) than that of patients with mild AP (MAP). VAT content in patients with MSAP and SAP was not statistically different (SMD = 0.36, 95% CI: -0.03, 0.75). VAT was an independent risk factor for non-MAP (OR = 1.79, 95% CI: 1.07, 3.00) with moderate predictive power (AUC = 0.74, 95% CI: 0.63, 0.85).
Conclusion. VAT is an independent risk factor for non-MAP, with moderate predictive power comparable to that of SIRS and APACHE II. It may serve as a potential reference for future precision prediction tools. Meanwhile, patients with MSAP and SAP have higher VAT than those with MAP, providing clinical insight for early severity assessment and guiding subsequent treatment decisions.
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