Dataset Information

Quantification of Liver, Subcutaneous, and Visceral Adipose Tissues by MRI Before and After Bariatric Surgery.

ABSTRACT:

Background

Morbid obesity is a worldwide epidemic and is increasingly treated by bariatric surgery. Fatty liver is a common finding; almost half of all patients with non-alcoholic steatohepatitis develop steatohepatitis. Bariatric surgery improves steatohepatitis documented by liver biopsy and single voxel magnetic resonance imaging (MRI) techniques.

Objective

To investigate changes before and after bariatric surgery using whole organ MRI quantification of liver, visceral, and subcutaneous fat.

Setting

University of Basel Hospital and St. Clara Research Ltd, Basel, Switzerland.

Methods

Sixteen morbidly obese patients were evaluated by abdominal MRI-scanning before and 3, 6, 12, and 24 months after bariatric surgery to measure percentage liver fat (%-LF), total liver volume (TLV) and visceral and subcutaneous adipose tissues (VAT and SAT). Fasting plasma samples were taken for measurement of glucose, insulin, blood lipids, and liver biomarkers. In a control group of 12 healthy lean volunteers, the liver biomarker was also measured.

Results

The reproducibility of fat quantification by use of MRI was excellent. LF decreased significantly faster than VAT and SAT (%-LF vs. VAT p?ConclusionsMRI quantification offers excellently reproducible results in measurement of liver fat and visceral and subcutaneous adipose tissues. Liver fat decreased significantly faster than visceral or subcutaneous adipose tissue. Decrease in %-LF and VAT is associated with decrease in total cholesterol, LDL, and plasma insulin.

SUBMITTER: Meyer-Gerspach AC

PROVIDER: S-EPMC6713693 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Quantification of Liver, Subcutaneous, and Visceral Adipose Tissues by MRI Before and After Bariatric Surgery.

Meyer-Gerspach Anne Christin AC Peterli Ralph R Moor Michael M Madörin Philipp P Schötzau Andreas A Nabers Diana D Borgwardt Stefan S Beglinger Christoph C Bieri Oliver O Wölnerhanssen Bettina K BK

Obesity surgery 20190901 9

<h4>Background</h4>Morbid obesity is a worldwide epidemic and is increasingly treated by bariatric surgery. Fatty liver is a common finding; almost half of all patients with non-alcoholic steatohepatitis develop steatohepatitis. Bariatric surgery improves steatohepatitis documented by liver biopsy and single voxel magnetic resonance imaging (MRI) techniques.<h4>Objective</h4>To investigate changes before and after bariatric surgery using whole organ MRI quantification of liver, visceral, and sub ...[more]

PMID: 31089967

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Project description:Bariatric surgery and other therapeutic options for obese patients are often evaluated by the loss of weight, reduction of comorbidities or improved quality of life. However, little is currently known about potential therapy-related changes in the adipose tissue of obese patients. The aim of this study was therefore to quantify fat fraction (FF) and T1 relaxation time by magnetic resonance imaging (MRI) after Roux-en-Y gastric bypass surgery and compare the resulting values with the preoperative ones. Corresponding MRI data were available from 23 patients (16 females and 7 males) that had undergone MRI before (M0) and one month after (M1) bariatric surgery. Patients were 22-59 years old (mean age 44.3 years) and their BMI ranged from 35.7-54.6 kg/m2 (mean BMI 44.6 kg/m2) at M0. Total visceral AT volumes (VVAT-T, in L) were measured by semi-automatic segmentation of axial MRI images acquired between diaphragm and femoral heads. MRI FF and T1 relaxation times were measured in well-defined regions of visceral (VAT) and subcutaneous (SAT) adipose tissue using two custom-made analysis tools. Average BMI values were 45.4 kg/m2 at time point M0 and 42.4 kg/m2 at M1. Corresponding VVAT-T values were 5.94 L and 5.33 L. Intraindividual differences in both BMI and VVAT-T were highly significant (p<0.001). Average relaxation times T1VAT were 303.7 ms at M0 and 316.9 ms at M1 (p<0.001). Corresponding T1SAT times were 283.2 ms and 280.7 ms (p = 0.137). Similarly, FFVAT differences (M0: 85.7%, M1: 83.4%) were significant (p <0.01) whereas FFSAT differences (M0: 86.1, M1: 85.9%) were not significant (p = 0.517). In conclusion, bariatric surgery is apparently not only related to a significant reduction in common parameters of adipose tissue distribution, here BMI and total visceral fat volume, but also significant changes in T1 relaxation time and fat fraction of visceral adipose tissue. Such quantitative MRI measures may potentially serve as independent biomarkers for longitudinal and cross-sectional measurements in obese patients.

Project description:BackgroundAdipose tissue plays important roles in health and disease. Given the unique association of visceral adipose tissue with obesity-related metabolic diseases, the distribution of lipids between the major fat depots located in subcutaneous and visceral regions may shed new light on adipose tissue-specific roles in systemic metabolic perturbations.ObjectiveWe sought to characterize the lipid networks and unveil differences in the metabolic infrastructure of the 2 adipose tissues that may have functional and nutritional implications.MethodsPaired visceral and subcutaneous adipose tissue samples were obtained from 17 overweight patients undergoing elective abdominal surgery. Ultra-performance LC-MS was used to measure 18,640 adipose-derived features; 520 were putatively identified. A stem cell model for adipogenesis was used to study the functional implications of the differences found.ResultsOur analyses resulted in detailed lipid metabolic maps of the 2 major adipose tissues. They point to a higher accumulation of phosphatidylcholines, triacylglycerols, and diacylglycerols, although lower ceramide concentrations, in subcutaneous tissue. The degree of unsaturation was lower in visceral adipose tissue (VAT) phospholipids, indicating lower unsaturated fatty acid incorporation into adipose tissue. The differential abundance of phosphatidylcholines we found can be attributed at least partially to higher expression of phosphatidylethanolamine methyl transferase (PEMT). PEMT-deficient embryonic stem cells showed a dramatic decrease in adipogenesis, and the resulting adipocytes exhibited lower accumulation of lipid droplets, in line with the lower concentrations of glycerolipids in VAT. Ceramides may inhibit the expression of PEMT by increased insulin resistance, thus potentially suggesting a functional pathway that integrates ceramide, PEMT, and glycerolipid biosynthetic pathways.ConclusionsOur work unveils differential infrastructure of the lipid networks in visceral and subcutaneous adipose tissues and suggests an integrative pathway, with a discriminative flux between adipose tissues.

Dataset Information

Quantification of Liver, Subcutaneous, and Visceral Adipose Tissues by MRI Before and After Bariatric Surgery.

Background

Objective

Setting

Methods

Results

Publications

Quantification of Liver, Subcutaneous, and Visceral Adipose Tissues by MRI Before and After Bariatric Surgery.

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