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Body composition changes after left gastric artery embolization in overweight and obese individuals

  • Edwin A. Takahashi
  • Naoki Takahashi
  • Christopher J. Reisenauer
  • Michael R. Moynagh
  • Sanjay MisraEmail author
Interventional Radiology

Abstract

Purpose

To determine the effects of left gastric artery embolization (LGAE) on computed tomography (CT) body composition change.

Materials and methods

Sixteen overweight or obese patients who had abdominal CT scans before and after LGAE for gastric bleeding were retrospectively reviewed. Body composition analysis was performed with semiautomated imaging processing algorithms (MATLAB 13.0, Math Works, MA). Adipose tissue and lean skeletal muscle were measured using threshold attenuation values. Total body fat index (BFI), subcutaneous fat index (SFI), visceral fat index (VFI), intramuscular fat index (IMFI), and skeletal muscle index (SMI) were determined ([tissue area (cm)]2/[height (m)]2). Excess body weight (EBW) was determined based on the Lorentz formula for ideal body weight.

Results

Mean follow-up was 1.5 ± 0.8 months. Following LGAE, patients experienced significantly decreased body weight (p = 0.003), BMI (p = 0.005), EBW (p = 0.003), BFI (p = 0.03), SFI (p = 0.03), and SMI (p < 0.001). Changes in VFI and IMFI did not significantly change (p = 0.13 and p = 0.83, respectively).

Conclusions

Patients who underwent LGAE had significant unintended weight loss as a result of decreased body fat and skeletal muscle. Body composition analysis can readily assess the extent of fat loss and identify muscle wasting.

Keywords

Left gastric artery embolization Body composition Weight loss Obesity 

Notes

Funding

Sanjay Misra receives funding from National Institutes of Health Grant HL098967 from the National Heart, Lung, and Blood Institute and DK107870 from the National Institute of Diabetes and Digestive and Kidney Diseases.

References

  1. 1.
    Weiss CR, Gunn AJ, Kim CY, Paxton BE, Kraitchman DL, Arepally A (2015) Bariatric Embolization of the Gastric Arteries for the Treatment of Obesity. J Vasc Interv Radiol 26 (5):613-624.CrossRefGoogle Scholar
  2. 2.
    Weiss CR, Akinwande O, Paudel K, Cheskin LJ, Holly B, Hong K, Fischman AM, Patel RS, Shin EJ, Steele KE, Moran TH, Kaiser K, Park A, Shade DM, Kraitchman DL, Arepally A (2017) Clinical Safety of Bariatric Arterial Embolization: Preliminary Results of the BEAT Obesity Trial. Radiology 283 (2):598-608.CrossRefGoogle Scholar
  3. 3.
    Arepally A, Barnett BP, Montgomery E, Patel T (2007) Catheter-directed gastric artery chemical embolization for modulation of systemic ghrelin levels in a porcine model: Initial experience. Radiology 244 (1):138-143.CrossRefGoogle Scholar
  4. 4.
    Diana M, Pop R, Beaujeux R, Dallemagne B, Halvax P, Schlagowski I, Liu YY, Diemunsch P, Geny B, Lindner V, Marescaux J (2015) Embolization of arterial gastric supply in obesity (EMBARGO): an endovascular approach in the management of morbid obesity. proof of the concept in the porcine model. Obes Surg 25 (3):550-558.Google Scholar
  5. 5.
    Gunn AJ, Oklu R (2014) A preliminary observation of weight loss following left gastric artery embolization in humans. J Obes 2014:185349.CrossRefGoogle Scholar
  6. 6.
    Paxton BE, Kim CY, Alley CL, Crow JH, Balmadrid B, Keith CG, Kankotia RJ, Stinnett S, Arepally A (2013) Bariatric Embolization for Suppression of the Hunger Hormone Ghrelin in a Porcine Model. Radiology 266 (2):471-479.CrossRefGoogle Scholar
  7. 7.
    Andreoli A, Garaci F, Cafarelli FP, Guglielmi G (2016) Body composition in clinical practice. Eur J Radiol 85 (8):1461-1468.CrossRefGoogle Scholar
  8. 8.
    Kim DJ, Raman HS, Salter A, Ramaswamy R, Gunn AJ, Weiss CR, Akinwande O (2018) Analysis of weight changes after left gastric artery embolization in a cancer-naive population. Diagn Interv Radiol 24 (2):94-97.Google Scholar
  9. 9.
    Graffy PM, Pickhardt PJ (2016) Quantification of hepatic and visceral fat by CT and MR imaging: relevance to the obesity epidemic, metabolic syndrome and NAFLD. Br J Radiol 89 (1062):20151024.CrossRefGoogle Scholar
  10. 10.
    Gibson DJ, Burden ST, Strauss BJ, Todd C, Lal S (2015) The role of computed tomography in evaluating body composition and the influence of reduced muscle mass on clinical outcome in abdominal malignancy: a systematic review. Eur J Clin Nutr 69 (10):1079-1086.CrossRefGoogle Scholar
  11. 11.
    Samara A, Ventura EE, Alfadda AA, Goran MI (2012) Use of MRI and CT for fat imaging in children and youth: what have we learned about obesity, fat distribution and metabolic disease risk? Obes Rev 13 (8):723-732.CrossRefGoogle Scholar
  12. 12.
    Budzyński J, Tojek K, Czerniak B, Banaszkiewicz Z (2016) Scores of nutritional risk and parameters of nutritional status assessment as predictors of in-hospital mortality and readmissions in the general hospital population. Clin Nutr 35 (6):1464-1471.CrossRefGoogle Scholar
  13. 13.
    Kirihara Y, Takahashi N, Hashimoto Y, Sclabas GM, Khan S, Moriya T, Sakagami J, Huebner M, Sarr MG, Farnell MB (2013) Prediction of Pancreatic Anastomotic Failure After Pancreatoduodenectomy The Use of Preoperative, Quantitative Computed Tomography to Measure Remnant Pancreatic Volume and Body Composition. Ann Surg 257 (3):512-519CrossRefGoogle Scholar
  14. 14.
    Laferrere B, Reilly D, Arias S, Swerdlow N, Gorroochurn P, Bawa B, Bose M, Teixeira J, Stevens RD, Wenner BR, Bain JR, Muehlbauer MJ, Haqq A, Lien L, Shah SH, Svetkey LP, Newgard CB (2011) Differential Metabolic Impact of Gastric Bypass Surgery Versus Dietary Intervention in Obese Diabetic Subjects Despite Identical Weight Loss. Sci Transl Med 3 (80)Google Scholar
  15. 15.
    Dadson P, Ferrannini E, Landini L, Hannukainen JC, Kalliokoski KK, Vaittinen M, Honka H, Karlsson HK, Tuulari JJ, Soinio M, Salminen P, Parkkola R, Pihlajamäki J, Iozzo P, Nuutila P (2017) Fatty acid uptake and blood flow in adipose tissue compartments of morbidly obese subjects with or without type 2 diabetes: effects of bariatric surgery. Am J Physiol Endocrinol Metab 313 (2):E175-E182.CrossRefGoogle Scholar
  16. 16.
    Katsanos CS, Madura JA, Roust LR (2016) Essential amino acid ingestion as an efficient nutritional strategy for the preservation of muscle mass following gastric bypass surgery. Nutrition 32 (1):9-13.CrossRefGoogle Scholar
  17. 17.
    Carnero EA, Dubis GS, Hames KC, Jakicic JM, Houmard JA, Coen PM, Goodpaster BH (2017) Randomized trial reveals that physical activity and energy expenditure are associated with weight and body composition after RYGB. Obesity 25 (7):1206-1216.CrossRefGoogle Scholar
  18. 18.
    Maimoun L, Lefebvre P, Jaussent A, Fouillade C, Mariano-Goulart D, Nocca D (2017) Body composition changes in the first month after sleeve gastrectomy based on gender and anatomic site. Surg Obes Relat Dis 13 (5):780-787.CrossRefGoogle Scholar
  19. 19.
    Vassilev G, Hasenberg T, Krammer J, Kienle P, Ronellenfitsch U, Otto M (2017) The Phase Angle of the Bioelectrical Impedance Analysis as Predictor of Post-Bariatric Weight Loss Outcome. Obes Surg 27 (3):665-669.CrossRefGoogle Scholar
  20. 20.
    Hutcheon DA, Hale AL, Ewing JA, Miller M, Couto F, Bour ES, Cobb WS, Scott JD (2018) Short-Term Preoperative Weight Loss and Postoperative Outcomes in Bariatric Surgery. J Am Coll Surg 226 (4):514-524.CrossRefGoogle Scholar
  21. 21.
    Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC (2008) Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg 18 (6):648-651.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of RadiologyMayo ClinicRochesterUSA
  2. 2.Division of Vascular and Interventional RadiologyMayo ClinicRochesterUSA
  3. 3.Division of Abdominal RadiologyMayo ClinicRochesterUSA
  4. 4.Division of UltrasoundMayo ClinicRochesterUSA

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