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Roux-en-Y gastric bypass surgery progressively alters radiologic measures of hypothalamic inflammation in obese patients

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Rullmann,  Michael
Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Germany;
Department of Nuclear Medicine, University of Leipzig, Germany;
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Collaborative Research Center Obesity Mechanisms, Institute of Biochemistry, University of Leipzig, Germany;

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Preusser,  Sven
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

Poppitz,  Sindy
Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Germany;
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Mueller,  Karsten
Methods and Development Unit Nuclear Magnetic Resonance, MPI for Human Cognitive and Brain Sciences, Max Planck Society;

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Pleger,  Burkhard
Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Germany;
Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society;
Collaborative Research Center Obesity Mechanisms, Institute of Biochemistry, University of Leipzig, Germany;
Department of Neurology, University Hospital Bergmannsheil, Bochum, Germany;

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Citation

Hankir, M. K., Rullmann, M., Seyfried, F., Preusser, S., Poppitz, S., Heba, S., et al. (2019). Roux-en-Y gastric bypass surgery progressively alters radiologic measures of hypothalamic inflammation in obese patients. JCI Insight, 4: 19. doi:10.1172/jci.insight.131329.


Cite as: http://hdl.handle.net/21.11116/0000-0004-DD37-6
Abstract
There is increased interest in whether bariatric surgeries such as Roux-en-Y gastric bypass (RYGB) achieve their profound weight-lowering effects in morbidly obese individuals through the brain. Hypothalamic inflammation is a well-recognized etiologic factor in obesity pathogenesis and so represents a potential target of RYGB, but clinical evidence in support of this is limited. We therefore assessed hypothalamic T2-weighted signal intensities (T2W SI) and fractional anisotropy (FA) values, 2 validated radiologic measures of brain inflammation, in relation to BMI and fat mass, as well as circulating inflammatory (C-reactive protein; CrP) and metabolic markers in a cohort of 27 RYGB patients at baseline and 6 and 12 months after surgery. We found that RYGB progressively increased hypothalamic T2W SI values, while it progressively decreased hypothalamic FA values. Regression analyses further revealed that this could be most strongly linked to plasma CrP levels, which independently predicted hypothalamic FA values when adjusting for age, sex, fat mass, and diabetes diagnosis. These findings suggest that RYGB has a major time-dependent impact on hypothalamic inflammation status, possibly by attenuating peripheral inflammation. They also suggest that hypothalamic FA values may provide a more specific radiologic measure of hypothalamic inflammation than more commonly used T2W SI values.