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Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis.

Publication ,  Journal Article
Shen, W; Middleton, MS; Cunha, GM; Delgado, TI; Wolfson, T; Gamst, A; Fowler, KJ; Alazraki, A; Trout, AT; Ohliger, MA; Shah, SN; Bashir, MR ...
Published in: J Hepatol
February 2023

BACKGROUND & AIMS: Non-alcoholic steatohepatitis (NASH) is prevalent in adults with obesity and can progress to cirrhosis. In a secondary analysis of prospectively acquired data from the multicenter, randomized, placebo-controlled FLINT trial, we investigated the relationship between reduction in adipose tissue compartment volumes and hepatic histologic improvement. METHODS: Adult participants in the FLINT trial with paired liver biopsies and abdominal MRI exams at baseline and end-of-treatment (72 weeks) were included (n = 76). Adipose tissue compartment volumes were obtained using MRI. RESULTS: Treatment and placebo groups did not differ in baseline adipose tissue volumes, or in change in adipose tissue volumes longitudinally (p = 0.107 to 0.745). Deep subcutaneous adipose tissue (dSAT) and visceral adipose tissue volume reductions were associated with histologic improvement in NASH (i.e., NAS [non-alcoholic fatty liver disease activity score] reductions of ≥2 points, at least 1 point from lobular inflammation and hepatocellular ballooning, and no worsening of fibrosis) (p = 0.031, and 0.030, respectively). In a stepwise logistic regression procedure, which included demographics, treatment group, baseline histology, baseline and changes in adipose tissue volumes, MRI hepatic proton density fat fraction (PDFF), and serum aminotransferases as potential predictors, reductions in dSAT and PDFF were associated with histologic improvement in NASH (regression coefficient = -2.001 and -0.083, p = 0.044 and 0.033, respectively). CONCLUSIONS: In adults with NASH in the FLINT trial, those with greater longitudinal reductions in dSAT and potentially visceral adipose tissue volumes showed greater hepatic histologic improvements, independent of reductions in hepatic PDFF. CLINICAL TRIAL NUMBER: NCT01265498. IMPACT AND IMPLICATIONS: Although central obesity has been identified as a risk factor for obesity-related disorders including insulin resistance and cardiovascular disease, the role of central obesity in non-alcoholic steatohepatitis (NASH) warrants further clarification. Our results highlight that a reduction in central obesity, specifically deep subcutaneous adipose tissue and visceral adipose tissue, may be related to histologic improvement in NASH. The findings from this analysis should increase awareness of the importance of lifestyle intervention in NASH for clinical researchers and clinicians. Future studies and clinical practice may design interventions that assess the reduction of deep subcutaneous adipose tissue and visceral adipose tissue as outcome measures, rather than simply weight reduction.

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Published In

J Hepatol

DOI

EISSN

1600-0641

Publication Date

February 2023

Volume

78

Issue

2

Start / End Page

238 / 246

Location

Netherlands

Related Subject Headings

  • Obesity, Abdominal
  • Obesity
  • Non-alcoholic Fatty Liver Disease
  • Magnetic Resonance Imaging
  • Liver
  • Humans
  • Gastroenterology & Hepatology
  • Fibrosis
  • Adult
  • Adipose Tissue
 

Citation

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Shen, W., Middleton, M. S., Cunha, G. M., Delgado, T. I., Wolfson, T., Gamst, A., … Lavine, J. E. (2023). Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis. J Hepatol, 78(2), 238–246. https://doi.org/10.1016/j.jhep.2022.10.027
Shen, Wei, Michael S. Middleton, Guilherme M. Cunha, Timoteo I. Delgado, Tanya Wolfson, Anthony Gamst, Kathryn J. Fowler, et al. “Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis.J Hepatol 78, no. 2 (February 2023): 238–46. https://doi.org/10.1016/j.jhep.2022.10.027.
Shen W, Middleton MS, Cunha GM, Delgado TI, Wolfson T, Gamst A, et al. Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis. J Hepatol. 2023 Feb;78(2):238–46.
Shen, Wei, et al. “Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis.J Hepatol, vol. 78, no. 2, Feb. 2023, pp. 238–46. Pubmed, doi:10.1016/j.jhep.2022.10.027.
Shen W, Middleton MS, Cunha GM, Delgado TI, Wolfson T, Gamst A, Fowler KJ, Alazraki A, Trout AT, Ohliger MA, Shah SN, Bashir MR, Kleiner DE, Loomba R, Neuschwander-Tetri BA, Sanyal AJ, Zhou J, Sirlin CB, Lavine JE. Changes in abdominal adipose tissue depots assessed by MRI correlate with hepatic histologic improvement in non-alcoholic steatohepatitis. J Hepatol. 2023 Feb;78(2):238–246.
Journal cover image

Published In

J Hepatol

DOI

EISSN

1600-0641

Publication Date

February 2023

Volume

78

Issue

2

Start / End Page

238 / 246

Location

Netherlands

Related Subject Headings

  • Obesity, Abdominal
  • Obesity
  • Non-alcoholic Fatty Liver Disease
  • Magnetic Resonance Imaging
  • Liver
  • Humans
  • Gastroenterology & Hepatology
  • Fibrosis
  • Adult
  • Adipose Tissue