Abstract
BackgroundMorbid 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.ObjectiveTo investigate changes before and after bariatric surgery using whole organ MRI quantification of liver, visceral, and subcutaneous fat.SettingUniversity of Basel Hospital and St. Clara Research Ltd, Basel, Switzerland.MethodsSixteen 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.ResultsThe 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.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.
Highlights
Obesity has become one of the greatest public health challenges in the twenty-first century, with an epidemic prospect that > 50% of the world’s adult population will be overweight and obese by 2030 [1]
Decrease in %-LF and visceral adipose tissue (VAT) is associated with decrease in total cholesterol, LDL, and plasma insulin
Liver biopsy is still regarded as the gold standard in the assessment of liver fat content, the diagnosis of NAFLD, and monitoring of progression [10]— because of the big advantage that liver biopsy can differentiate between NAFLD, NASH, cirrhosis, and other histologic changes [11]
Summary
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 measured
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