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Hepatic triglyceride content and its relation to body adiposity: a magnetic resonance imaging and proton magnetic resonance spectroscopy study
  1. E L Thomas1,
  2. G Hamilton1,
  3. N Patel1,
  4. R O’Dwyer1,
  5. C J Doré3,
  6. R D Goldin4,
  7. J D Bell1,
  8. S D Taylor-Robinson2
  1. 1Robert Steiner MR Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, UK
  2. 2Division of Medicine (Medicine A), Faculty of Medicine, Hammersmith Hospital, Imperial College London, London, UK
  3. 3MRC Clinical Trials Unit, London, UK
  4. 4Histopathology Department, St Mary’s Hospital, London, UK
  1. Correspondence to:
    Dr J D Bell
    MRI Unit, Hammersmith Hospital, Du Cane Rd, London W12 0HS, UK; jimmy.bellcsc.mrc.ac.uk

Abstract

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.

  • ALP, alkaline phosphatase
  • ALT, alanine aminotransferase
  • γGT, γ 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
  • steatosis
  • adipose tissue
  • fatty liver
  • intrahepatocellular lipids
  • magnetic resonance imaging
  • spectroscopy

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Footnotes

  • Conflict of interest: None declared.

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