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Hepatic fat is superior to BMI, visceral and pancreatic fat as a potential risk biomarker for neurodegenerative disease

  • Magnetic Resonance
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Abstract

Objectives

Prior studies relating body mass index (BMI) to brain volumes suggest an overall inverse association. However, BMI might not be an ideal marker, as it disregards different fat compartments, which carry different metabolic risks. Therefore, we analyzed MR-based fat depots and their association with gray matter (GM) volumes of brain structures, which show volumetric changes in neurodegenerative diseases.

Methods

Warp-based automated brain segmentation of 3D FLAIR sequences was obtained in a population-based study cohort. Associations of temporal lobe, cingulate gyrus, and hippocampus GM volume with BMI and MR-based quantification of visceral adipose tissue (VAT), as well as hepatic and pancreatic proton density fat fraction (PDFFhepatic and PDFFpanc, respectively), were assessed by linear regression.

Results

In a sample of 152 women (age 56.2 ± 9.0 years) and 199 men (age 56.1 ± 9.1 years), we observed a significant inverse association of PDFFhepatic and cingulate gyrus volume (p < 0.05) as well as of PDFFhepatic and hippocampus volume (p < 0.05), when adjusting for age and sex. This inverse association was further enhanced for cingulate gyrus volume after additionally adjusting for hypertension, smoking, BMI, LDL, and total cholesterol (p < 0.01) and also alcohol (p < 0.01). No significant association was observed between PDFFhepatic and temporal lobe and between temporal lobe, cingulate gyrus, or hippocampus volume and BMI, VAT, and PDFFpanc.

Conclusions

We observed a significant inverse, independent association of cingulate gyrus and hippocampus GM volume with hepatic fat, but not with other obesity measures. Increased hepatic fat could therefore serve as a marker of high-risk fat distribution.

Key Points

• Obesity is associated with neurodegenerative processes.

• In a population-based study cohort, hepatic fat was superior to BMI and visceral and pancreatic fat as a risk biomarker for decreased brain volume of cingulate gyrus and hippocampus.

• Increased hepatic fat could serve as a marker of high-risk fat distribution.

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Abbreviations

AFNI:

Analyses of functional images

BMI:

Body mass index

FAST:

FMRIB’s automated segmentation tool

FLAIR:

Fluid attenuation inversion recovery

FLIR:

FMRIB’s linear registration tool

FMRIB:

Functional magnetic resonance imaging of the brain

FNIRT:

FMRIB’s non-linear image registration tool

GM:

Gray matter

KORA:

Cooperative Health Research in the Region of Augsburg

NAFLD:

Nonalcoholic fatty liver disease

PDFF:

Proton density fat fraction

TBV:

Total brain volume

VIBE:

Volume interpolated body examination

VAT:

Visceral adipose tissue

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Funding

This research was funded in-part by the German Research Foundation (DFG, Bonn, Germany; grant-number 245222810).​ The KORA study was initiated and financed by the Helmholtz Zentrum München—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The KORA-MRI sub-study was supported by an unrestricted research grant from Siemens Healthcare.

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Author notes

  1. Birgit Ertl-Wagner and Sophia Stoecklein contributed equally to this work.

Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University Hospital, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany

    Ebba Beller

  2. Department of Radiology, Ludwig-Maximilians University Munich, Munich, Germany

    Ebba Beller, Roberto Lorbeer, Daniel Keeser, Franziska Schoeppe, Sabine Sellner, Holger Hetterich, Birgit Ertl-Wagner & Sophia Stoecklein

  3. Department of Diagnostic and Interventional Radiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Fabian Bamberg & Christopher L. Schlett

  4. University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany

    Fabian Bamberg & Christopher L. Schlett

  5. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany

    Annette Peters

  6. Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada

    Birgit Ertl-Wagner

Authors
  1. Ebba Beller
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  2. Roberto Lorbeer
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Corresponding author

Correspondence to Ebba Beller.

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Guarantor

The scientific guarantor of this publication is Sophia Stoecklein.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Diagnostic or prognostic study

• Performed at one institution

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Beller, E., Lorbeer, R., Keeser, D. et al. Hepatic fat is superior to BMI, visceral and pancreatic fat as a potential risk biomarker for neurodegenerative disease. Eur Radiol 29, 6662–6670 (2019). https://doi.org/10.1007/s00330-019-06276-8

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  • DOI: https://doi.org/10.1007/s00330-019-06276-8

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