Proton MR spectroscopy in quantitative in vivo determination of fat content in human liver steatosis

Longo, Renata; Pollesello, Piero; Ricci, Claudio; Masutti, Flora; Kvam, Bjarne J.; Bercich, Luisa; Crocè, Lory Saveria; Grigolato, Piergiovanni; Paoletti, Sergio; Bernard, B. de; Tiribelli, Claudio; Palma, L. Dalla

doi:10.1002/jmri.1880050311

Cited by 344 publications

(305 citation statements)

References 17 publications

(1 reference statement)

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“…Quantitation of steatosis using 1 H MRS or MRI was closely correlated with histological assessment in patients with chronic liver disease of varying etiology and severity, and serial examinations showed a reduction in hepatic fat content with weight loss. This is consistent with previous studies reporting a correlation between MRS and histomorphometric data (9,10,24).…”

Section: Discussionsupporting

confidence: 93%

“…Results of MRS have shown to correlate closely with biochemical and histological assessments of liver triglyceride content (9,10), and to demonstrate a decrease in liver fat content following rosiglitazone therapy (11) or weight reduction (12,13). Other imaging modalities, such as ultrasonography and computed to-mography (CT), provide limited quantitative assessment (14,15).…”

mentioning

confidence: 99%

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Magnetic resonance imaging and spectroscopy for monitoring liver steatosis

Cowin

Jonsson

Bauer

et al. 2008

Magnetic Resonance Imaging

173

139

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Purpose:To compare noninvasive MRI and magnetic resonance spectroscopy (MRS) methods with liver biopsy to quantify liver fat content. Materials and Methods:Quantification of liver fat was compared by liver biopsy, proton MRS, and MRI using inphase/out-of-phase (IP/OP) and plus/minus fat saturation (ϮFS) techniques. The reproducibility of each MR measure was also determined. An additional group of overweight patients with steatosis underwent hepatic MRI and MRS before and after a six-month weight-loss program. Results:A close correlation was demonstrated between histological assessment of steatosis and measurement of intrahepatocellular lipid (IHCL) by MRS (r s ϭ 0.928, P Ͻ 0.0001) and MRI (IP/OP r s ϭ 0.942, P Ͻ 0.0001; FS r s ϭ 0.935, P Ͻ 0.0001). Following weight reduction, four of five patients with Ͼ5% weight loss had a decrease in IHCL of Ն50%. Conclusion:These findings suggest that standard MRI protocols provide a rapid, safe, and quantitative assessment of hepatic steatosis. This is important because MRS is not available on all clinical MRI systems. This will enable noninvasive monitoring of the effects of interventions such as weight loss or pharmacotherapy in patients with fatty liver diseases.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Magnetic resonance imaging and spectroscopy for monitoring liver steatosis

Cowin

Jonsson

Bauer

et al. 2008

Magnetic Resonance Imaging

173

139

View full text Add to dashboard Cite

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“…steatohepatitis, fibrosis), so we do not know if the observed improvement in hepatic steatosis is associated with histological improvement. Yet hepatic biopsies are not clinically recommended in our study population, and the method used has the advantage of being noninvasive, well tolerated by patients, as well valid and reproducible (14,24).…”

Section: Discussionmentioning

confidence: 99%

Effect of insulin–metformin combination on hepatic steatosis in patients with type 2 diabetes

Lingvay¹,

Raskin²,

Szczepaniak³

2007

Journal of Diabetes and its Complications

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Objective-Hepatic steatosis occurs in up to 78% of patients with type 2 diabetes. Studies evaluating the effect of metformin on hepatic steatosis are conflicting. Insulin is believed to be detrimental due to its lipogenic effect. Since insulin and metformin combination is commonly used for the treatment diabetes, it is important to assess the effect of this combined therapy on hepatic steatosis. We evaluated the change in hepatic steatosis following initiation of insulin and metformin in patients with type 2 diabetes.Methods-Newly-diagnosed, treatment-naïve patients with type 2 diabetes had their hepatic triglyceride (TG) content measured by magnetic resonance spectroscopy at baseline and after 3 months of treatment with BiAsp 30 insulin in combination with metformin. Insulin was administered twice daily and titrated to achieve normal capillary blood glucose levels. Metformin was titrated during the first month from 500 mg daily to 1000 mg twice-daily.Results-The average hepatic TG content in the 19 subjects enrolled was 11.83%±7.61% (range 0.93% to 23.16%)] and correlated with BMI (r=0.567). Three months of treatment reduced hepatic steatosis by 45%, with 75% of the study subjects achieving a normal level. The change in hepatic TG content was partially explained by the change in HbA1c (p=0.006) and change in cholesterol level (p=0.003).Conclusions-The combined treatment with insulin and metformin reduced significantly hepatic steatosis in patients with newly-diagnosed type 2 diabetes. Keywords type 2 diabetes; hepatic steatosis; insulin treatment; metformin Non-alcoholic fatty liver disease (NAFLD) is characterized by fatty infiltration of the liver. This diagnosis represents a disease spectrum from simple steatosis to steatohepatitis. The prevalence of NAFLD has risen in the last decade parallel with the obesity and type 2 diabetes epidemics. (1). Previous studies suggest that one-third of the population has NAFLD (2). The prevalence of NAFLD in patients with type 2 diabetes is even higher. In the Dallas Heart Study,

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“…7 Data were converted into absolute concentrations expressed as percent fat per volume, 28,29 using the equations by Longo et al 29 Hepatic lipid volume fraction (HLVF), calculated as HCL hepatocellular lipids/ (1.138 Ϫ 0.339 HCL) is tightly correlated with biopsymeasured liver fat concentrations. 29 were calculated by dividing the tracer infusion rate times tracer enrichment by percent of tracer enrichment in plasma and subtracting tracer infusion rate. 7 Clamp-R a was calculated using Steele's non-steady state equations.…”

Section: Methodsmentioning

confidence: 99%

Abnormal hepatic energy homeostasis in type 2 diabetes

et al. 2009

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Increased hepatocellular lipids relate to insulin resistance and are typical for individuals with type 2 diabetes mellitus (T2DM). Steatosis and T2DM have been further associated with impaired muscular adenosine triphosphate (ATP) turnover indicating reduced mitochondrial fitness. Thus, we tested the hypothesis that hepatic energy metabolism could be impaired even in metabolically well-controlled T2DM. We measured hepatic lipid volume fraction (HLVF) and absolute concentrations of ␥ATP, inorganic phosphate (Pi), phosphomonoesters and phosphodiesters using noninvasive 1 H/ 31 P magnetic resonance spectroscopy in individuals with T2DM (58 ؎ 6 years, 27 ؎ 3 kg/m 2 ), and age-matched and body mass index-matched (mCON; 61 ؎ 4 years, 26 ؎ 4 kg/m 2 ) and young lean humans (yCON; 25 ؎ 3 years, 22 ؎ 2 kg/m 2 , P < 0.005, P < 0.05 versus T2DM and mCON). Insulin-mediated whole-body glucose disposal (M) and endogenous glucose production (iEGP) were assessed during euglycemic-hyperinsulinemic clamps. Individuals with T2DM had 26% and 23% lower ␥ATP (1.68 ؎ 0.11; 2.26 ؎ 0.20; 2.20 ؎ 0.09 mmol/L; P < 0.05) than mCON and yCON individuals, respectively. Further, they had 28% and 31% lower Pi than did individuals from the mCON and yCON groups (0.96 ؎ 0.06; 1.33 ؎ 0.13; 1.41 ؎ 0.07 mmol/L; P < 0.05). Phosphomonoesters, phosphodiesters, and liver aminotransferases did not differ between groups. HLVF was not different between those from the T2DM and mCON groups, but higher (P ‫؍‬ 0.002) than in those from the yCON group. T2DM had 13-fold higher iEGP than mCON (P < 0.05). Even after adjustment for HLVF, hepatic ATP and Pi related negatively to hepatic insulin sensitivity (iEGP) (r ‫؍‬ ؊0.665, P ‫؍‬ 0.010, r ‫؍‬ ؊0.680, P ‫؍‬ 0.007) but not to whole-body insulin sensitivity. Conclusion: These data suggest that impaired hepatic energy metabolism and insulin resistance could precede the development of steatosis in individuals with T2DM. (HEPATOLOGY

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Proton MR spectroscopy in quantitative in vivo determination of fat content in human liver steatosis

Cited by 344 publications

References 17 publications

Magnetic resonance imaging and spectroscopy for monitoring liver steatosis

Magnetic resonance imaging and spectroscopy for monitoring liver steatosis

Effect of insulin–metformin combination on hepatic steatosis in patients with type 2 diabetes

Abnormal hepatic energy homeostasis in type 2 diabetes

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