Canan Altay1, Mustafa Seçil1, Süleyman Cem Adıyaman2, Başak Özgen Saydam2, Tevfik Demir2, Gülçin Akıncı3, Ilgın Yıldırım Simsir4, Erdal Eren5, Ela Temeloğlu Keskin6, Leyla Demir7, Hüseyin Onay8, Haluk Topaloğlu9, Banu Sarer Yürekli4, Nilüfer Özdemir Kutbay4, Ramazan Gen10, Barış Akıncı2. 1. Department of Radiology, Dokuz Eylül University School of Medicine, İzmir, Turkey. 2. Division of Endocrinology, Dokuz Eylül University School of Medicine, İzmir, Turkey. 3. Division of Pediatric Neurology, Dr. Behçet Uz Childrens' Hospital, İzmir, Turkey. 4. Division of Endocrinology, Ege University School of Medicine, İzmir, Turkey. 5. Division of Pediatric Endocrinology, Uludağ University School of Medicine, Bursa, Turkey. 6. Division of Endocrinology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey. 7. Department of Biochemistry, Atatürk Training Hospital, İzmir, Turkey. 8. Department of Medical Genetics, Ege University School of Medicine, İzmir, Turkey. 9. Division of Pediatric Neurology, Hacettepe University School of Medicine, Ankara, Turkey. 10. Division of Endocrinology, Mersin University School of Medicine, Mersin, Turkey.
Abstract
BACKGROUND/AIMS: Lipodystrophy is a rare metabolic disorder characterized by near total or partial lack of subcutaneous adipose tissue and associated with insulin resistance. We aimed to evaluate the efficacy of magnetic resonance spectroscopy imaging (MRS) to explore the fat content of the liver in patients with lipodystrophy and to determine the relationship between the liver fat accumulation and clinical presentations of lipodystrophy. MATERIALS AND METHODS: Between July 2014 and February 2016, 34 patients with lipodystrophy were assessed by MRS for quantification of hepatic steatosis. All patients had metabolic abnormalities associated with insulin resistance. Metabolic parameters and the MRS findings were analyzed to identify potential correlations between the liver fat content and disease severity. RESULTS: The MRS fat ratios (MRS-FR) were markedly higher, indicating severe hepatic steatosis in lipodystrophy. Patients with generalized and partial lipodystrophy had comparable levels of MRS-FRs, although patients with generalized lipodystrophy were significantly younger. Patients with genetically based lipodystrophy had elevated MRS-FR compared to those with acquired lipodystrophy (p=0.042). The MRS-FR was positively correlated with liver enzyme alanine aminotransferase (p=0.028) and serum adiponectin (p=0.043). CONCLUSION: Our data suggest that MRS might be an effective, noninvasive imaging method to quantify hepatic fat content in patients with lipodystrophy. Further studies are needed to validate the technique and threshold values which would allow accurate comparison of data acquired by different machines and centers.
BACKGROUND/AIMS: Lipodystrophy is a rare metabolic disorder characterized by near total or partial lack of subcutaneous adipose tissue and associated with insulin resistance. We aimed to evaluate the efficacy of magnetic resonance spectroscopy imaging (MRS) to explore the fat content of the liver in patients with lipodystrophy and to determine the relationship between the liver fat accumulation and clinical presentations of lipodystrophy. MATERIALS AND METHODS: Between July 2014 and February 2016, 34 patients with lipodystrophy were assessed by MRS for quantification of hepatic steatosis. All patients had metabolic abnormalities associated with insulin resistance. Metabolic parameters and the MRS findings were analyzed to identify potential correlations between the liver fat content and disease severity. RESULTS: The MRS fat ratios (MRS-FR) were markedly higher, indicating severe hepatic steatosis in lipodystrophy. Patients with generalized and partial lipodystrophy had comparable levels of MRS-FRs, although patients with generalized lipodystrophy were significantly younger. Patients with genetically based lipodystrophy had elevated MRS-FR compared to those with acquired lipodystrophy (p=0.042). The MRS-FR was positively correlated with liver enzyme alanine aminotransferase (p=0.028) and serum adiponectin (p=0.043). CONCLUSION: Our data suggest that MRS might be an effective, noninvasive imaging method to quantify hepatic fat content in patients with lipodystrophy. Further studies are needed to validate the technique and threshold values which would allow accurate comparison of data acquired by different machines and centers.
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