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 < 0.001 and %-LF vs. SAT p < 0.001). At certain time points, %-LF, VAT, and SAT were associated with changes in blood lipids and insulin. Conclusions MRI 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. Electronic supplementary material The online version of this article (10.1007/s11695-019-03897-2) contains supplementary material, which is available to authorized users.

The Influence of Laparoscopic Sleeve Gastrectomy on Body Composition and Fat Distribution in Obese Caucasian Men and Women

“…On the other hand, the authors of the Swiss study, which included 16 patients with morbid obesity (4 scheduled for LSG and 12 for RYGB), showed, that both visceral and subcutaneous fat, measured with MRI scanning, decreased with similar rate, up to 24 months after bariatric surgery [27]. Bazzocchi et al also found that visceral and subcutaneous abdominal adipose tissues had been reduced with similar rate, by 65.6 and 57.9%, respectively, in women over a period of 12 months following RYGB [20].…”

Are body surface area based estimates of liver volume applicable to children with overweight or obesity? An in vivo validation study

“…Studies in adults suggest that weight status may alter liver volume. For instance, liver volume significantly decreased with weight loss in adults following bariatric surgery 28 and following a low‐ or very‐low‐calorie diet prior to bariatric surgery. 29 Our data confirm that the published BSA‐dependent liver volume equation reliably estimates liver volume for children independent of weight status, with every child in our dataset having less than twofold error for estimated versus measured volume (Figures 4 and 5 ) as well as consistently low CVs (<30%) across weight strata (Table 2 ).…”

Circulating Levels of Sclerostin Predict Glycemic Improvement after Sleeve Gastrectomy

“…Our results also provided relevant information about the effects of metabolic surgery on adipose tissue dysfunction. Quantitative and qualitative changes in visceral and ectopic fat composition has been documented in magnetic resonance studies [ 9 , 24 , 25 , 26 ] and even molecular signatures of metabolic surgery have been recently described in the adipose tissue [ 27 ]. There would be then the opportunity for new adiposity-related biomarkers to emerge and address some of the current shortcomings in metabolic surgery.…”