{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:34:04Z","timestamp":1793428444121,"version":"4.5.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While cholelithiasis is common, predicting which patients will develop acute cholecystitis (AC) remains a clinical challenge, as traditional risk factors like Body Mass Index (BMI) lack specificity. This study aimed to determine if CT-derived visceral adiposity and sarcopenia can predict the transition from asymptomatic cholelithiasis to clinical AC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included 622 adult patients with cholelithiasis, identified via CT scans performed between 2015 and 2025. Patients were divided into an AC group (\n                      <jats:italic>n<\/jats:italic>\n                      = 164), who developed AC during follow-up, and a control group (\n                      <jats:italic>n<\/jats:italic>\n                      = 458) who did not. Body composition metrics, including visceral fat area (VFA) and skeletal muscle index (SMI), were quantified from axial CT images at the L3 vertebral level. A multivariate logistic regression analysis was performed to identify independent predictors of developing AC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The AC group had significantly higher VFA and lower SMI compared to the control group. Multivariate analysis identified several independent predictors for developing AC, including hypertension (OR: 2.71,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), hyperlipidemia (OR: 2.88,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), and a 10 cm\n                      <jats:sup>2<\/jats:sup>\n                      increase in VFA (OR: 1.34,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). In contrast, a per-unit increase in SMI was found to be protective (OR: 0.94,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001). The predictive model demonstrated strong discriminatory power with an Area Under the Curve (AUC) of 0.857.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Visceral adiposity and sarcopenia are strong, independent predictors of the development of AC. These findings suggest that AC is a complication of a systemic metabolic state and that CT-based body composition analysis is a valuable tool for risk stratification in patients with cholelithiasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1724416","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T06:39:14Z","timestamp":1764743954000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["High visceral adiposity and low skeletal muscle mass independently predict the development of acute cholecystitis in patients with gallstones: a retrospective cohort study"],"prefix":"10.3389","volume":"12","author":[{"given":"Abdullah 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