The effect of long-term weight-loss intervention strategies on the dynamics of pancreatic-fat and morphology: An MRI RCT study

Tene, Lilac; Shelef, Ilan; Schwarzfuchs, Dan; Gepner, Yftach; Meir, Anat Yaskolka; Tsaban, Gal; Zelicha, Hila; Bilitzky, Avital; Komy, Oded; Cohen, Noa; Bril, Nitzan; Rein, Michal; Serfaty, Dana; Kenigsbuch, Shira; Chassidim, Yoash; Sarusy, Benjamin; Ceglarek, Uta; Stümvoll, Michael; Blüher, Matthias; Thiery, Joachim; Stampfer, Meir J.; Rudich, Assaf; Shai, Iris

doi:10.1016/j.clnesp.2018.01.008

Cited by 19 publications

(21 citation statements)

References 39 publications

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“…The clinical significance of PFC is currently under debate. Previous studies revealed strong correlations between PFC, BMI, LFC, SAT, and VAT, the latter of which is in line with our results [11,15]. Heni et al [23] found that pancreatic fat is negatively associated with insulin secretion in participants with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), but not in individuals with normal glucose tolerance (NGT).…”

Section: Discussionsupporting

confidence: 92%

“…After applying a linear mixed model adjusted for sex, age, and VAT loss, our results showed that the PFC reduction was not independent from VAT loss. In contrast, a previous study by Tene et al [11] found that PFC loss was independent from VAT loss. Similarly, Van der Zijl et al [24] observed no significant association between VAT and steatotic pancreas.…”

Section: Discussionmentioning

confidence: 58%

“…Our analysis has revealed no relevant association between PFC and fasting glucose metabolism biomarkers (glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), HbA1c). Tene et al [11] discovered the same finding in 277 healthy obese participants. It has been proposed that dynamic glucose changes may be limited to diabetic participants [13].…”

Section: Discussionmentioning

confidence: 64%

“…Weight loss plays a central role in the management of overweight patients with metabolic syndrome [1], and several studies have been conducted to investigate the effects of weight loss on pancreatic fat content (PFC). Tene et al [11] and Gaborit et al [12] reported a decrease in PFC after bariatric surgery or exercise-induced weight loss. While Steven et al [13] and Vogt et al [14] found no PFC reduction after surgery or calorie restriction-induced weight loss.…”

Section: Introductionmentioning

confidence: 99%

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Changes in Pancreatic Fat Content Following Diet-Induced Weight Loss

et al. 2019

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Background: Obesity can lead to ectopic pancreatic fat accumulation and increase the risk for type 2 diabetes. Smaller intervention trials have shown a decrease in pancreatic fat content (PFC) with weight loss, and we intended to investigate the effects of weight loss on PFC in a larger trial. Methods: Data from the HELENA-Trial, a randomized controlled trial (RCT) among 137 non-diabetic obese adults were used. The study cohort was classified into 4 quartiles based on weight change between baseline and 12 weeks post-intervention. Changes in PFC (baseline, 12 weeks and 50 weeks post-intervention) upon weight loss were analyzed by linear mixed models. Spearman’s coefficients were used to obtain correlations between anthropometric parameters, blood biochemical markers, and PFC. Results: At baseline, PFC only showed a significant correlation with visceral adipose tissue (VAT) (r = 0.41). Relative changes in PFC were significantly (p = 0.01) greater in Q4 (−30.8 ± 5.7%) than in Q1 (1.3 ± 6.7%). These differences remained similar after one year. However, when adjusting the statistical analyses for changes in VAT, the differences in PFC between Q1 and Q4 were no longer statistically significant. Conclusion: Weight loss is associated with a decrease in PFC. However, the reduction of PFC is not independent from reductions in VAT. Unlike VAT, PFC was not associated with metabolic biomarkers.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

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Changes in Pancreatic Fat Content Following Diet-Induced Weight Loss

et al. 2019

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“…For example, studies on the association of pancreatic fat with impaired glucose metabolism and type 2 diabetes are inconclusive 30,53 . Other studies have reported that pancreatic fat content is associated with serum triglyceride and nutritional fat intake 54 and responsive to exercise and nutrition changes 55 . A recent meta-analysis of pancreatic steatosis found significant associations with metabolic syndrome, central obesity and hypertension, however with substantial heterogeneity between the studies 56 .…”

Section: Discussionmentioning

confidence: 98%

Association of longitudinal risk profile trajectory clusters with adipose tissue depots measured by magnetic resonance imaging

Rospleszcz

Lorbeer

Storz

et al. 2019

Sci Rep

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The objective of the study was to identify associations of longitudinal trajectories of traditional cardiometabolic risk factors with abdominal and ectopic adipose tissue depots measured by magnetic resonance imaging (MRI). We measured total abdominal, visceral, and subcutaneous adipose tissue in liter and intrahepatic, intrapancreatic and renal sinus fat as fat fractions by MRI in 325 individuals free of cardiovascular disease at Exam 3 of a population-based cohort. We related these MRI measurements at Exam 3 to longitudinal risk profile trajectory clusters, based on risk factor measurements from Exam 3, Exam 2 (seven years prior to MRI) and Exam 1 (14 years prior to MRI). Based on the levels and longitudinal trajectories of several risk factors (blood pressure, lipid profile, anthropometric measurements, HbA1c), we identified three different trajectory clusters. These clusters displayed a graded association with all adipose tissue traits after adjustment for potential confounders (e.g. visceral adipose tissue: βClusterII = 1.30 l, 95%-CI:[0.84 l;1.75 l], βClusterIII = 3.32 l[2.74 l;3.90 l]; intrahepatic: EstimateClusterII = 1.54[1.27,1.86], EstimateClusterIII = 2.48[1.93,3.16]. Associations remained statistically significant after additional adjustment for the risk factor levels at Exam 1 or Exam 3, respectively. Trajectory clusters provided additional information in explaining variation in the different fat compartments beyond risk factor profiles obtained at individual exams. In conclusion, sustained high risk factor levels and unfavorable trajectories are associated with high levels of adipose tissue; however, the association with cardiometabolic risk factors varies substantially between different ectopic adipose tissues. Trajectory clusters, covering longitudinal risk profiles, provide additional information beyond single-point risk profiles. This emphasizes the need to incorporate longitudinal information in cardiometabolic risk estimation.

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Effects of a Family-Based Lifestyle Intervention Plus Supervised Exercise Training on Abdominal Fat Depots in Children With Overweight or Obesity

et al. 2022

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ImportanceExcess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at preventing diabetes.ObjectivesTo examine the effect of added exercise to a family-based lifestyle intervention program designed to reduce VAT plus subcutaneous (ASAT), intermuscular (IMAAT), and pancreatic (PAT) adipose tissue in children with overweight or obesity and to explore the effect of changes in VAT on insulin resistance.Design, Setting, and ParticipantsThis 2-group, parallel-design clinical trial was conducted in Vitoria-Gasteiz, Spain. A total of 116 children with overweight or obesity participated and were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). Data were collected between September 1, 2014, and June 30, 2017, and imaging processing for fat depot assessments and data analysis were performed between May 1, 2019, and February 12, 2021.InterventionsThe compared interventions consisted of a family-based lifestyle and psychoeducation program (two 90-minute sessions per month) and the same program plus supervised exercise (three 90-minute sessions per week).Main Outcomes and MeasuresThe primary outcome of this study was the change in VAT between baseline and 22 weeks as estimated by magnetic resonance imaging. The secondary outcomes were changes in ASAT, IMAAT, and PAT. The effect of changes in VAT area on insulin resistance was also recorded.ResultsThe 116 participants included in the analysis (62 girls [53.4%]) had a mean (SD) age of 10.6 (1.1) years, and 67 (57.8%) presented with obesity. Significantly greater reductions were recorded for the exercise group in terms of reduction in VAT (−18.1% vs −8.5% for the control group; P = .004), ASAT (−9.9% vs −3.0%; P = .001), and IMAAT (−6.0% vs −2.6%; P = .02) fat fractions compared with the control group. Changes in VAT explained 87.6% of the improvement seen in insulin resistance (β = −0.102 [95% CI, −0.230 to −0.002]).Conclusions and RelevanceThese findings suggest that the addition of exercise to a lifestyle intervention program substantially enhanced the positive effects on abdominal fat depots in children with overweight or obesity. In addition, the reduction in VAT seemed to largely mediate the improvement of insulin sensitivity. These results highlight the importance of including exercise as part of lifestyle therapies aimed at treating childhood obesity and preventing the development of type 2 diabetes.Trial RegistrationClinicalTrials.gov Identifier: NCT02258126

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The effect of long-term weight-loss intervention strategies on the dynamics of pancreatic-fat and morphology: An MRI RCT study

Cited by 19 publications

References 39 publications

Changes in Pancreatic Fat Content Following Diet-Induced Weight Loss

Changes in Pancreatic Fat Content Following Diet-Induced Weight Loss

Association of longitudinal risk profile trajectory clusters with adipose tissue depots measured by magnetic resonance imaging

Effects of a Family-Based Lifestyle Intervention Plus Supervised Exercise Training on Abdominal Fat Depots in Children With Overweight or Obesity

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