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Noradrenaline transporter availability on [11C]MRB PET predicts weight loss success in highly obese adults

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Abstract

Purpose

Although the mechanisms by which the central noradrenaline (NA) system influences appetite and controls energy balance are quite well understood, its relationship to changes in body weight remains largely unknown. The main goal of this study was to further clarify whether the brain NA system is a stable trait or whether it can be altered by dietary intervention.

Methods

We aimed to compare central NA transporter (NAT) availability in ten obese, otherwise healthy individuals with a body mass index (BMI) of 42.4 ± 3.7 kg/m2 (age 34 ± 9 years, four women) and ten matched non-obese, healthy controls (BMI 23.9 ± 2.5 kg/m2, age 33 ± 10 years, four women) who underwent PET with the NAT-selective radiotracer (S,S)-[11C]O-methylreboxetine (MRB) before and 6 months after dietary intervention.

Results

MRI-based individual volume-of-interest analyses revealed an increase in binding potential (BPND) in the insula and the hippocampus of obese individuals, which correlated well with changes in BMI (−3.3 ± 5.3%; p = 0.03) following completion of the dietary intervention. Furthermore, voxel-wise regression analyses showed that lower BPND in these regions, but also in the midbrain and the prefrontal cortex, at baseline was associated with higher achieved weight loss (e.g., hippocampal area R2 = 0.80; p < 0.0001). No changes were observed in non-obese controls.

Conclusion

These first longitudinal interventional data on NAT availability in highly obese individuals indicate that the central NA system is modifiable. Our findings suggest that NAT availability before intervention could help predict the amount and success of weight loss in obese individuals and help adjust treatment options individually by allowing prediction of the benefit of a dietary intervention.

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Funding

This work was supported by the IFB Adiposity Diseases, Federal Ministry of Education and Research (BMBF), Germany; FKZ 01E01001 (http://www.bmbf.de).

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Authors and Affiliations

  1. Integrated Research and Treatment Center (IFB) AdiposityDiseases, University Medical Center, Leipzig, Germany

    Franziska J. Vettermann, Michael Rullmann, Franziska Zientek, Michael Stumvoll, Anja Hilbert, Osama Sabri & Swen Hesse

  2. Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany

    Franziska J. Vettermann, Michael Rullmann, Georg A. Becker, Julia Luthardt, Franziska Zientek, Marianne Patt, Philipp M. Meyer, Anke McLeod, Osama Sabri & Swen Hesse

  3. Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany

    Franziska J. Vettermann & Matthias Brendel

  4. Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany

    Matthias Blüher & Michael Stumvoll

  5. Department of Medical Psychology and Medical Sociology, Psychiatry and Chemistry New York University School of Medicine Faculty, New York, NY, USA

    Anja Hilbert

  6. Departments of Radiology, Psychiatry and Chemistry , New York University School of Medicine Faculty, New York, NY, USA

    Yu-Shin Ding

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  1. Franziska J. Vettermann
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Corresponding author

Correspondence to Franziska J. Vettermann.

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Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board. The study was approved by the Bundesamt für Strahlenschutz (BfS, Federal Office for Radiation Protection; local EC number 206-10-08032010; EudraCT 2012-000568-32) and was performed in accordance with the ICH Guideline for Good Clinical Practice (GCP) and with the principles of the Declaration of Helsinki. The study was registered with the German Clinical Trials Register (DRKS).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

This study was awarded the “Junge Wissenschaft im Focus” for young scientists at the 53rd Annual Meeting of the German Association of Nuclear Medicine (DGN).

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Vettermann, F.J., Rullmann, M., Becker, G.A. et al. Noradrenaline transporter availability on [11C]MRB PET predicts weight loss success in highly obese adults. Eur J Nucl Med Mol Imaging 45, 1618–1625 (2018). https://doi.org/10.1007/s00259-018-4002-7

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