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Liver steatosis (LS) evaluated through chemical-shift magnetic resonance imaging liver enzymes in morbid obesity; effect of weight loss obtained with intragastric balloon gastric banding

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Abstract

The aim of this study was to evaluate in morbid obesity clinical and metabolic effects related to weight loss on liver steatosis (LS), measured through chemical-shift magnetic resonance imaging (MRI) and liver enzymes. Forty obese subjects (8 M/32 W; BMI 42.8 ± 7.12 kg/m2, mean ± SD) were evaluated for LS through ultrasound (US-LS), chemical-shift MRI (MRI-LS), liver enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyltransferase (GGT), alkaline phosphatase (ALP)], anthropometric parameters [weight, BMI, waist circumference (WC)], lipids, insulin, insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), oral glucose tolerance test, and body composition [fat mass (FM) and fat-free mass (FFM) at bio-impedance analysis (BIA)]. Anthropometric measures, MRI-LS, BIA, and biochemical parameters were reevaluated 6 months later in 18 subjects undergoing restrictive bariatric approach, i.e., intragastric balloon (BIB, n = 13) or gastric banding (LAGB, n = 5), and in 13 subjects receiving hypocaloric diet. At baseline, US-LS correlates only with MRI-LS, and the latter correlates with ALT, AST, and GGT. After 6 months, subjects undergoing BIB or LAGB had significant changes of BMI, weight, WC, ALT, AST, GGT, ALP, HbA1c, insulin, HOMA-IR, FM, FFM, and MRI-LS. Diet-treated obese subjects had no significant change of any parameter under study; change of BMI, fat mass, and fat-free mass was significantly greater in LAGB/BIB subjects than in diet-treated subjects. Change of MRI-LS showed a significant correlation with changes in weight, BMI, WC, GGT, ALP, and basal MRI-LS. Significant weight loss after BIB or LAGB is associated with decrease in chemical-shift MRI-LS and with reduction in liver enzymes; chemical-shift MRI and liver enzymes allow monitoring of LS in follow-up studies.

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Acknowledgments

Progetto PRIN, Ministero Italiano dell’Università e della Ricerca Scientifica e Tecnologica.

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Authors and Affiliations

  1. Divisione di Medicina Generale II, Dipartimento di Scienze della Salute (DISS) Ospedale San Paolo, Università degli Studi di Milano, via antonio di rudinì 8, 20142, Milan, Italy

    Laura Folini, Annamaria Veronelli, Alberto Benetti & Antonio E. Pontiroli

  2. Dipartimento di Radiologia, Servizio di Radiologia, Ospedale San Paolo, Milan, Italy

    Carlo Pozzato

  3. Servizio di Diagnostica per Immagini, Casa di Cura Igea, Milan, Italy

    Marco Cappelletti

  4. Divisione di Endoscopia Digestiva, Ospedale San Paolo, Milan, Italy

    Enzo Masci

  5. Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Istituto Clinico Sant’Ambrogio, INCO e Unità Operativa di Chirurgia Generale, Milan, Italy

    Giancarlo Micheletto

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  1. Laura Folini
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  8. Antonio E. Pontiroli
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Correspondence to Antonio E. Pontiroli.

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Communicated by Massimo Federici.

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Folini, L., Veronelli, A., Benetti, A. et al. Liver steatosis (LS) evaluated through chemical-shift magnetic resonance imaging liver enzymes in morbid obesity; effect of weight loss obtained with intragastric balloon gastric banding. Acta Diabetol 51, 361–368 (2014). https://doi.org/10.1007/s00592-013-0516-4

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  • DOI: https://doi.org/10.1007/s00592-013-0516-4

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