Hepatic fat is superior to BMI, visceral and pancreatic fat as a potential risk biomarker for neurodegenerative disease
Prior studies relating body mass index (BMI) to brain volumes suggest an overall inverse association. However, BMI might not be an ideal marker, as it disregards different fat compartments, which carry different metabolic risks. Therefore, we analyzed MR-based fat depots and their association with gray matter (GM) volumes of brain structures, which show volumetric changes in neurodegenerative diseases.
Warp-based automated brain segmentation of 3D FLAIR sequences was obtained in a population-based study cohort. Associations of temporal lobe, cingulate gyrus, and hippocampus GM volume with BMI and MR-based quantification of visceral adipose tissue (VAT), as well as hepatic and pancreatic proton density fat fraction (PDFFhepatic and PDFFpanc, respectively), were assessed by linear regression.
In a sample of 152 women (age 56.2 ± 9.0 years) and 199 men (age 56.1 ± 9.1 years), we observed a significant inverse association of PDFFhepatic and cingulate gyrus volume (p < 0.05) as well as of PDFFhepatic and hippocampus volume (p < 0.05), when adjusting for age and sex. This inverse association was further enhanced for cingulate gyrus volume after additionally adjusting for hypertension, smoking, BMI, LDL, and total cholesterol (p < 0.01) and also alcohol (p < 0.01). No significant association was observed between PDFFhepatic and temporal lobe and between temporal lobe, cingulate gyrus, or hippocampus volume and BMI, VAT, and PDFFpanc.
We observed a significant inverse, independent association of cingulate gyrus and hippocampus GM volume with hepatic fat, but not with other obesity measures. Increased hepatic fat could therefore serve as a marker of high-risk fat distribution.
• Obesity is associated with neurodegenerative processes.
• In a population-based study cohort, hepatic fat was superior to BMI and visceral and pancreatic fat as a risk biomarker for decreased brain volume of cingulate gyrus and hippocampus.
• Increased hepatic fat could serve as a marker of high-risk fat distribution.
KeywordsObesity Magnetic resonance imaging Liver steatosis Cingulate gyrus Hippocampus
Analyses of functional images
Body mass index
FMRIB’s automated segmentation tool
Fluid attenuation inversion recovery
FMRIB’s linear registration tool
Functional magnetic resonance imaging of the brain
FMRIB’s non-linear image registration tool
Cooperative Health Research in the Region of Augsburg
Nonalcoholic fatty liver disease
Proton density fat fraction
Total brain volume
Volume interpolated body examination
Visceral adipose tissue
This research was funded in-part by the German Research Foundation (DFG, Bonn, Germany; grant-number 245222810). The KORA study was initiated and financed by the Helmholtz Zentrum München—German Research Center for Environmental Health, which is funded by the German Federal Ministry of Education and Research (BMBF) and by the State of Bavaria. The KORA-MRI sub-study was supported by an unrestricted research grant from Siemens Healthcare.
Compliance with ethical standards
The scientific guarantor of this publication is Sophia Stoecklein.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• Diagnostic or prognostic study
• Performed at one institution
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