TY - JOUR
T1 - Impact of White Adipose Tissue on Brain Structure, Perfusion, and Cognitive Function in Patients With Severe Obesity
T2 - The BARICO Study
AU - Vreeken, Debby
AU - Seidel, Florine
AU - de la Roij, Guido
AU - Vening, Wouter
AU - den Hengst, Willem A.
AU - Verschuren, Lars
AU - Özsezen, Serdar
AU - Kessels, Roy P. C.
AU - Duering, Marco
AU - Mutsaerts, Henk J. M. M.
AU - Kleemann, Robert
AU - Wiesmann, Maximilian
AU - Hazebroek, Eric J.
AU - Kiliaan, Amanda J.
N1 - Funding Information: This work is supported by a grant of the Rijnstate-Radboudumc promotion fund. The histopathologic and biochemical analyses were performed in collaboration with the Netherlands Organization for Applied Scientific Research (TNO) Metabolic Health Research (Leiden, the Netherlands) with support from TNO's Research programs Biomedical Health (PMC13), ERP Body Brain Interactions, and the Shared Research Program GLoBAL, an initiative of Radboudumc, Rijnstate, and TNO. H. Mutsaerts is supported by the Dutch Heart Foundation (03-004-2020-T049). Funding Information: Henk-Jan M.M. Mutsaerts is supported by the Dutch Heart Foundation (03-004-2020-T049); the other authors report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures. Publisher Copyright: Copyright © 2022 American Academy of Neurology.
PY - 2023/2/14
Y1 - 2023/2/14
N2 - Background and Objective While underlying pathophysiology linking obesity to brain health is not completely understood, white adipose tissue (WAT) is considered a key player. In obesity, WAT becomes dysregulated, showing hyperplasia, hypertrophy, and eventually inflammation. This disbalance leads to dysregulated secretion of adipokines influencing both (cardio)vascular and brain health. Within this study, we investigated the association between omental WAT (oWAT) and subcutaneous WAT (scWAT) with brain structure and perfusion and cognition in adults with severe obesity. Methods Within the cross-sectional BARICO study, brain structure and perfusion and cognitive function were measured before bariatric surgery (BS) using MRI and cognitive assessments. During BS, oWAT and scWAT depots were collected and analyzed by histopathology. The number and diameter of adipocytes were quantified together with the amount of crown-like structures (CLS) as an indication of inflammation. Blood samples were collected to analyze adipokines and inflammatory markers. Neuroimaging outcomes included brain volumes, cortical thickness, white matter (WM) integrity, WM hyperintensities, cerebral blood flow using arterial spin labeling (ASL), and the ASL spatial coefficient of variation (sCoV), reflecting cerebrovascular health. Results Seventy-one patients were included (mean age 45.1 ± 5.8 years; 83.1% women; mean body mass index 40.8 ± 3.8 kg/m 2). scWAT showed more CLS (z = −2.72, p < 0.01, r = −0.24) and hypertrophy compared with oWAT (F(1,64) = 3.99, p < 0.05, η 2 = 0.06). Adiponectin levels were inversely associated with the average diameter of scWAT (β = −0.31, 95% CI −0.54 to −0.08) and oWAT (β = −0.33, 95% CI −0.55 to −0.09). Furthermore, the adipocyte diameter in oWAT was positively associated with the sCoV in the parietal cortex (β = 0.33, 95% CI 0.10–0.60), and the number of adipocytes (per mm 2) was positively associated with sCoV in the nucleus accumbens (NAcc) (β = 0.34, 95% CI 0.09–0.61). Cognitive function did not correlate with any WAT parameter or plasma marker. These associations were highly influenced by age and sex. sCoV in the NAcc was positively associated with fasting plasma glucose (β = 0.35, 95% CI 0.10–0.56).
AB - Background and Objective While underlying pathophysiology linking obesity to brain health is not completely understood, white adipose tissue (WAT) is considered a key player. In obesity, WAT becomes dysregulated, showing hyperplasia, hypertrophy, and eventually inflammation. This disbalance leads to dysregulated secretion of adipokines influencing both (cardio)vascular and brain health. Within this study, we investigated the association between omental WAT (oWAT) and subcutaneous WAT (scWAT) with brain structure and perfusion and cognition in adults with severe obesity. Methods Within the cross-sectional BARICO study, brain structure and perfusion and cognitive function were measured before bariatric surgery (BS) using MRI and cognitive assessments. During BS, oWAT and scWAT depots were collected and analyzed by histopathology. The number and diameter of adipocytes were quantified together with the amount of crown-like structures (CLS) as an indication of inflammation. Blood samples were collected to analyze adipokines and inflammatory markers. Neuroimaging outcomes included brain volumes, cortical thickness, white matter (WM) integrity, WM hyperintensities, cerebral blood flow using arterial spin labeling (ASL), and the ASL spatial coefficient of variation (sCoV), reflecting cerebrovascular health. Results Seventy-one patients were included (mean age 45.1 ± 5.8 years; 83.1% women; mean body mass index 40.8 ± 3.8 kg/m 2). scWAT showed more CLS (z = −2.72, p < 0.01, r = −0.24) and hypertrophy compared with oWAT (F(1,64) = 3.99, p < 0.05, η 2 = 0.06). Adiponectin levels were inversely associated with the average diameter of scWAT (β = −0.31, 95% CI −0.54 to −0.08) and oWAT (β = −0.33, 95% CI −0.55 to −0.09). Furthermore, the adipocyte diameter in oWAT was positively associated with the sCoV in the parietal cortex (β = 0.33, 95% CI 0.10–0.60), and the number of adipocytes (per mm 2) was positively associated with sCoV in the nucleus accumbens (NAcc) (β = 0.34, 95% CI 0.09–0.61). Cognitive function did not correlate with any WAT parameter or plasma marker. These associations were highly influenced by age and sex. sCoV in the NAcc was positively associated with fasting plasma glucose (β = 0.35, 95% CI 0.10–0.56).
UR - http://www.scopus.com/inward/record.url?scp=85148113050&partnerID=8YFLogxK
U2 - https://doi.org/10.1212/WNL.0000000000201538
DO - https://doi.org/10.1212/WNL.0000000000201538
M3 - Article
C2 - 36332987
SN - 0028-3878
VL - 100
SP - e703-e718
JO - Neurology
JF - Neurology
IS - 7
ER -