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Clinical Studies and Practice

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

International Journal of Obesity volume 39, pages 480–487 (2015)Cite this article

Subjects

Abstract

Objectives:

Recent literature suggests that ectopic fat deposition in the pancreas may contribute to endocrine and exocrine organ dysfunction, such as type 2 diabetes (T2D), pancreatitis or pancreatic cancer. The aim of this study was to determine factors associated with pancreatic triglyceride content (PTGC), and to investigate the impact of bariatric surgery on ectopic fat pads, pancreatic fat (PTGC) and hepatic fat (HTGC).

Subjects:

In all, 45 subjects (13 lean, 13 obese nondiabetics and 19 T2D, matched for age and gender) underwent 1H-magnetic resonance spectroscopy, computed tomography of the visceral abdominal fat, metabolic and lipidomic analysis, including insulin-resistance homeostasis model assessment (HOMA-IR), insulin-secretion homeostasis model assessment (HOMA-B) and plasma fatty-acid composition. Twenty obese subjects were reassessed 6 months after the bariatric surgery.

Results:

PTGC was significantly higher in type 2 diabetic subjects (23.8±3.2%) compared with obese (14.0±3.3; P=0.03) and lean subjects (7.5±0.9%; P=0.0002). PTGC remained significantly associated with T2D after adjusting for age and sex (β=0.47; P=0.004) or even after adjusting for waist circumference, triglycerides and HOMA-IR (β=0.32; P=0.04). T2D, C18:1n-9 (oleic acid), uric acid, triglycerides and plasminogen activator inhibitor-1 were the five more important parameters involved in PTGC prediction (explained 80% of PTGC variance). Bariatric surgery induced a huge reduction of both HTGC (−51.2±7.9%) and PTGC (−43.8±7.0%) reaching lean levels, whereas body mass index remained greatly elevated. An improvement of insulin resistance HOMA-IR and no change in HOMA-B were observed after bariatric surgery. The PTGC or HTGC losses were not correlated, suggesting tissue-specific mobilization of these ectopic fat stores.

Conclusion:

Pancreatic fat increased with T2D and drastically decreased after the bariatric surgery. This suggests that decreased PTGC may contribute to improved beta cell function seen after the bariatric surgery. Further, long-term interventional studies are warranted to examine this hypothesis and to determine the degree to which ectopic fat mobilization may mediate the improvement in endocrine and exocrine pancreatic functions.

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Acknowledgements

We thank Gabrielle Belpassi, Valérie Griset, Sylvie Bourrely and Aurelia Mesnier, of the Centre d’Investigation Clinique at Marseille North Hospital, for their help in choosing patients for inclusion and for their biological technical assessment. We thank Patricia Ancel, Virginie Tassistro and Jacques Boukhalil for their technical help. We thank the nurses and all the staff of the endocrinology and digestive surgery department for their invaluable support.

Author information

Author notes

  1. B Gaborit and I Abdesselam: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, Metabolic Diseases and Nutrition, CHU Nord, Marseille, France

    B Gaborit, O Ronsin & A Dutour

  2. Inserm U1062, Inra U1260, Faculté de Médecine, Marseille, France

    B Gaborit, I Abdesselam, M-C Alessi, J C Martin & A Dutour

  3. Aix Marseille Université, Marseille, France

    B Gaborit, I Abdesselam, F Kober, A Jacquier, M-C Alessi, J C Martin, M Bernard & A Dutour

  4. Aix Marseille Université CNRS, Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR 7339, Marseille, France

    I Abdesselam, F Kober, A Jacquier & M Bernard

  5. Department of Radiology, CHU Timone, Marseille, France

    A Jacquier

  6. Department of Digestive Surgery, CHU Nord, Marseille, France

    O Emungania

  7. Centre d’investigation Clinique (CIC), CHU Nord, Marseille, France

    N Lesavre

  8. Gastroenterology Department, CHU Nord, Marseille, France

    N Lesavre

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Correspondence to B Gaborit.

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Gaborit, B., Abdesselam, I., Kober, F. et al. Ectopic fat storage in the pancreas using 1H-MRS: importance of diabetic status and modulation with bariatric surgery-induced weight loss. Int J Obes 39, 480–487 (2015). https://doi.org/10.1038/ijo.2014.126

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