LIVER

Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study

E L Thomas¹, G Hamilton¹, N Patel¹, R O’Dwyer¹, C J Doré³, R D Goldin⁴, J D Bell¹, S D Taylor-Robinson²

¹ Robert Steiner MR Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, UK
² Division of Medicine (Medicine A), Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK
³ MRC Clinical Trials Unit, London, UK
⁴ Histopathology Department, St Mary’s Hospital, London, UK

Correspondence to:
Correspondence to:
Dr J D Bell
MRI Unit, Hammersmith Hospital, Du Cane Rd, London W12 0HS, UK; jimmy.bell{at}csc.mrc.ac.uk

Background: Hepatic steatosis is associated with obesity and type II diabetes. Proton magnetic resonance spectroscopy (¹H MRS) is a non-invasive method for measurement of tissue fat content, including intrahepatocellular lipids (IHCL) and intramyocellular lipids (IMCL).

Patients and methods: We used ¹H MRS and whole body magnetic resonance imaging (MRI) to assess the relationship between IHCL accumulation, total body adipose tissue (AT) content/distribution, and IMCL content in 11 subjects with biopsy proven hepatic steatosis and 23 normal volunteers.

Results: IHCL signals were detectable in all subjects but were significantly greater in hepatic steatosis (geometric mean (GM) 11.5 (interquartile range (IQR) 7.0–39.0)) than in normal volunteers (GM 2.7 (IQR 0.7–9.3); p = 0.02). In the study group as a whole, IHCL levels were significantly greater in overweight compared with lean subjects (body mass index (BMI) >25 kg/m² (n = 23): GM 7.7 (IQR 4.0–28.6) v BMI <25 kg/m² (n = 11): GM 1.3 (IQR 0.3–3.6; p = 0.004)). There was a significant association between IHCL content and indices of overall obesity (expressed as a percentage of body weight) for total body fat (p = 0.001), total subcutaneous AT (p = 0.007), and central obesity (subcutaneous abdominal AT (p = 0.001) and intra-abdominal AT (p = 0.001)), after allowing for sex and age. No correlation between IHCL content and IMCL was observed. A significant correlation was observed between serum alanine aminotransferase and liver fat content (r = 0.57, p = 0.006).

Conclusions: Our results suggest that hepatic steatosis appears to be closely related to body adiposity, especially central obesity. MRS may be a useful method for monitoring IHCL in future interventional studies.

Abbreviations: ALP, alkaline phosphatase; ALT, alanine aminotransferase; GT, glutamyl transferase; AT, adipose tissue; BMI, body mass index; CoV, coefficient of variation; CT, computerised tomography; GM, geometric mean; IHCL, intrahepatocellular lipids; IMCL, intramyocellular lipids; IQR, interquartile range; LFTs, liver function tests; MRI, magnetic resonance imaging; ¹H MRS, proton magnetic resonance spectroscopy; NASH, non-alcoholic steatohepatitis; TE, echo time; TR, repetition time

Keywords: steatosis; adipose tissue; fatty liver; intrahepatocellular lipids; magnetic resonance imaging; spectroscopy

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