Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss

Gaborit, Bénédicte; Abdesselam, Inès; Kober, Frank; Jacquier, Alexis; Ronsin, O.; Emungania, Olivier; Lesavre, Nathalie; Alessi, Marie‐Christine; Martin, Jean‐Charles; Bernard, Monique; Dutour, Anne

doi:10.1038/ijo.2014.126

Cited by 91 publications

(86 citation statements)

References 47 publications

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“…Bariatric surgery has become the standard treatment for morbidly obese patients. It can decrease the size of PPF 40 . Long-term follow-up after bariatric surgery has confirmed significant weight loss as well as a decrease in the occurrence of multiple cancer types, in particular, breast and endometrial cancer 41–43 .…”

Section: Discussionmentioning

confidence: 99%

Robust Early Inflammation of the Peripancreatic Visceral Adipose Tissue During Diet-Induced Obesity in the KrasG12D Model of Pancreatic Cancer

Hertzer¹,

Xu²,

Moro³

et al. 2016

Pancreas

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Objectives Obesity increases the incidence of multiple types of cancer. Our previous work has shown that a high fat, high calorie diet (HFCD) leads to visceral obesity, pancreatic inflammation, and accelerated pancreatic neoplasia in KrasG12D (KC) mice. In this study we aimed to investigate the effects of a HFCD on visceral adipose inflammation with emphasis on potential differences between distinct visceral adipose depots. Methods We examined the weight and visceral obesity in both wild-type (WT) and KC mice on either control diet (CD) or HFCD. After three months, mice were sacrificed for histological examination. Multiplex assays were also performed to obtain cytokine profiles between different adipose depots. Results Both WT and KC mice on a HFCD exhibited significantly increased inflammation in the visceral adipose tissue (VAT), particularly in the peri-pancreatic fat (PPF), compared to animals on a CD. This was associated with significantly increased inflammation in the pancreas. Cytokine profiles were different between visceral adipose depots, and between mice on the HFCD and CD. Conclusions Our results clearly demonstrate that a HFCD leads to obesity and inflammation in the VAT, particularly the PPF. These data suggest that obesity-associated inflammation in PPF may accelerate pancreatic neoplasia in KC mouse.

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Section: Discussionmentioning

confidence: 99%

Robust Early Inflammation of the Peripancreatic Visceral Adipose Tissue During Diet-Induced Obesity in the KrasG12D Model of Pancreatic Cancer

Hertzer¹,

Xu²,

Moro³

et al. 2016

Pancreas

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“…Actually, important information must be taken in account: (1) some studies have found no correlation between NAFLD and NAFPD[80,156]; (2) hepatic fat is mainly intracellular, while NAFPD is a consequence of adipocytes infiltration[5,16]; (3) when patients are treated with bariatric surgery, fat loss in the liver and the pancreas seem to be independent, suggesting tissue-specific mobilization of these ectopic fat stores[77]; and (4) when corrected for BMI, the association between hepatic and pancreatic steatosis can’t be found anymore[33,134,137]. …”

Section: Pathogenesis and Risk Factorsmentioning

confidence: 99%

Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease

Catanzaro¹,

Cuffari²,

Italia³

et al. 2016

WJG

157

132

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After the first description of fatty pancreas in 1933, the effects of pancreatic steatosis have been poorly investigated, compared with that of the liver. However, the interest of research is increasing. Fat accumulation, associated with obesity and the metabolic syndrome (MetS), has been defined as “fatty infiltration” or “nonalcoholic fatty pancreas disease” (NAFPD). The term “fatty replacement” describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity, increasing age, male sex, hypertension, dyslipidemia, alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus, MetS, atherosclerosis, severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of “ectopic fat deposition”, which is a key element of nonalcoholic fatty liver disease and/or MetS. Moreover, in patients with fatty pancreas, pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula.

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“…Values of greater than 20% have been reported [8, 9, 11], well in excess of histological estimation [24, 27]. Quantification of the percentage of fat within the parenchyma of the pancreas is challenging as it depends upon delineating tissue entirely within the organ.…”

Section: Introductionmentioning

confidence: 99%

Quantification of intrapancreatic fat in type 2 diabetes by MRI

et al. 2017

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ObjectivesAccumulation of intrapancreatic fat may be important in type 2 diabetes, but widely varying data have been reported. The standard quantification by MRI in vivo is time consuming and dependent upon a high level of experience. We aimed to develop a new method which would minimise inter-observer variation and to compare this against previously published datasets.MethodsA technique of ‘biopsying’ the image to minimise inclusion of non-parenchymal tissues was developed. Additionally, thresholding was applied to exclude both pancreatic ducts and intrusions of visceral fat, with pixels of fat values of <1% or >20% being excluded. The new MR image ‘biopsy’ (MR-opsy) was compared to the standard method by 6 independent observers with wide experience of image analysis but no experience of pancreas imaging. The effect of the new method was examined on datasets from two studies of weight loss in type 2 diabetes.ResultsAt low levels of intrapancreatic fat neither the result nor the inter-observer CV was changed by MR-opsy, thresholding or a combination of the methods. However, at higher levels the conventional method exhibited poor inter-observer agreement (coefficient of variation 26.9%) and the new combined method improved the CV to 4.3% (p<0.03). Using either MR-opsy alone or with thresholding, the new methods indicated a closer relationship between decrease in intrapancreatic fat and fall in blood glucose.ConclusionThe inter-observer variation for quantifying intrapancreatic fat was substantially improved by the new method when pancreas fat levels were moderately high. The method will improve comparability of pancreas fat measurement between research groups.

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Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss

Cited by 91 publications

References 47 publications

Robust Early Inflammation of the Peripancreatic Visceral Adipose Tissue During Diet-Induced Obesity in the KrasG12D Model of Pancreatic Cancer

Robust Early Inflammation of the Peripancreatic Visceral Adipose Tissue During Diet-Induced Obesity in the KrasG12D Model of Pancreatic Cancer

Exploring the metabolic syndrome: Nonalcoholic fatty pancreas disease

Quantification of intrapancreatic fat in type 2 diabetes by MRI

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