Radiologic evidence that hypothalamic gliosis is improved after bariatric surgery in obese women with type 2 diabetes.


Journal

International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108

Informations de publication

Date de publication:
01 2020
Historique:
received: 24 09 2018
accepted: 06 05 2019
revised: 10 04 2019
pubmed: 16 6 2019
medline: 1 12 2020
entrez: 16 6 2019
Statut: ppublish

Résumé

Hypothalamic neurons play a major role in the control of body mass. Obese subjects present radiologic signs of gliosis in the hypothalamus, which may reflect the damage or loss of neurons involved in whole-body energy homeostasis. It is currently unknown if hypothalamic gliosis (1) differs between obese nondiabetic (ND) and obese diabetic subjects (T2D) or (2) is modified by extensive body mass reduction via Roux-n-Y gastric bypass (RYGB). Fifty-five subjects (all female) including lean controls (CT; n = 13), ND (n = 28), and T2D (n = 14) completed at least one study visit. Subjects underwent anthropometrics and a multi-echo MRI sequence to measure mean bilateral T2 relaxation time in the mediobasal hypothalamus (MBH) and two reference regions (amygdala and putamen). The obese groups underwent RYGB and were re-evaluated 9 months later. Analyses were by linear mixed models. Analyses of T2 relaxation time at baseline showed a group by region interaction only in the MBH (P < 0.0001). T2D had longer T2 relaxation times compared to either CT or ND groups. To examine the effects of RYGB on hypothalamic gliosis a three-way (group by region by time) mixed effects model adjusted for age was executed. Group by region (P < 0.0001) and region by time (P = 0.0005) interactions were significant. There was a reduction in MBH relaxation time by RYGB, and, although the T2D group still had higher T2 relaxation time overall compared to the ND group, the T2D group had significantly lower T2 relaxation time after surgery and the ND group showed a trend. The degree of reduction in MBH T2 relaxation time by RYGB was unrelated to clinical outcomes. T2 relaxation times, a marker of hypothalamic gliosis, are higher in obese women with T2D and are reduced by RYGB-induced weight loss.

Sections du résumé

BACKGROUND/OBJECTIVES
Hypothalamic neurons play a major role in the control of body mass. Obese subjects present radiologic signs of gliosis in the hypothalamus, which may reflect the damage or loss of neurons involved in whole-body energy homeostasis. It is currently unknown if hypothalamic gliosis (1) differs between obese nondiabetic (ND) and obese diabetic subjects (T2D) or (2) is modified by extensive body mass reduction via Roux-n-Y gastric bypass (RYGB).
SUBJECTS/METHODS
Fifty-five subjects (all female) including lean controls (CT; n = 13), ND (n = 28), and T2D (n = 14) completed at least one study visit. Subjects underwent anthropometrics and a multi-echo MRI sequence to measure mean bilateral T2 relaxation time in the mediobasal hypothalamus (MBH) and two reference regions (amygdala and putamen). The obese groups underwent RYGB and were re-evaluated 9 months later. Analyses were by linear mixed models.
RESULTS
Analyses of T2 relaxation time at baseline showed a group by region interaction only in the MBH (P < 0.0001). T2D had longer T2 relaxation times compared to either CT or ND groups. To examine the effects of RYGB on hypothalamic gliosis a three-way (group by region by time) mixed effects model adjusted for age was executed. Group by region (P < 0.0001) and region by time (P = 0.0005) interactions were significant. There was a reduction in MBH relaxation time by RYGB, and, although the T2D group still had higher T2 relaxation time overall compared to the ND group, the T2D group had significantly lower T2 relaxation time after surgery and the ND group showed a trend. The degree of reduction in MBH T2 relaxation time by RYGB was unrelated to clinical outcomes.
CONCLUSION
T2 relaxation times, a marker of hypothalamic gliosis, are higher in obese women with T2D and are reduced by RYGB-induced weight loss.

Identifiants

pubmed: 31201362
doi: 10.1038/s41366-019-0399-8
pii: 10.1038/s41366-019-0399-8
pmc: PMC7366782
mid: NIHMS1594778
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

178-185

Subventions

Organisme : NIDDK NIH HHS
ID : P30 DK035816
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK089036
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01 DK098466
Pays : United States
Organisme : NIDDK NIH HHS
ID : R56 DK089036
Pays : United States

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Auteurs

Simone van de Sande-Lee (S)

Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas, Campinas, Brazil.

Susan J Melhorn (SJ)

Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA, USA.

Briana Rachid (B)

Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas, Campinas, Brazil.

Sylka Rodovalho (S)

Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas, Campinas, Brazil.

José C De-Lima-Junior (JC)

Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas, Campinas, Brazil.

Brunno M Campos (BM)

Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.

Tatiane Pedro (T)

Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.

Guilherme C Beltramini (GC)

Neurophysics Group, Institute of Physics Gleb Wataghin, University of Campinas, Campinas, Brazil.

Eliton A Chaim (EA)

Department of Surgery, University of Campinas, Campinas, Brazil.

Jose C Pareja (JC)

Department of Surgery, University of Campinas, Campinas, Brazil.

Fernando Cendes (F)

Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, Brazil.

Kenneth R Maravilla (KR)

Department of Radiology, University of Washington, Seattle, WA, USA.

Ellen A Schur (EA)

Department of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA, USA.

Licio A Velloso (LA)

Laboratory of Cell Signaling, Department of Internal Medicine, University of Campinas, Campinas, Brazil. lavelloso.unicamp@gmail.com.

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