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A pilot study of visceral fat and its association with adipokines, stool calprotectin and symptoms in patients with diverticulosis

Murray, Kathryn; Hoad, Caroline; Garratt, Jill; Kaviani, Mehri; Marciani, Luca; Smith, Jan; Siegmund, Britta; Gowland, Penny; Humes, David; Spiller, Robin


Kathryn Murray

Jill Garratt

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Professor of Gastrointestinal Imaging

Jan Smith

Britta Siegmund

Clinical Associate Professor

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Professor of Gastroenterology


Complications of diverticular disease are increasingly common, possibly linked to increasing obesity. Visceral fat could contribute to the development of symptomatic diverticular disease through its pro-inflammatory effects.

The study had 2 aims. A) to develop a semi-automated algorithm to measure abdominal adipose tissue from 2-echo magnetic resonance imaging (MRI) data B) to use this to determine if visceral fat was associated with bowel symptoms and inflammatory markers in patients with symptomatic and asymptomatic diverticular disease.

An observational study measuring visceral fat using MRI together with serum adiponectin, leptin, stool calprotectin and patient-reported somatisation and bowel habit.

Medical and imaging research centres of a university hospital.

MRI scans were performed on 55 patients after an overnight fast measuring abdominal subcutaneous and visceral adipose tissue volumes together with small bowel water content (SBWC). Blood and stool samples were collected and patients kept a 2 week stool diary and completed a somatisation questionnaire.

Main Outcome Measures
Difference in the volume of visceral fat between symptomatic and asymptomatic patients.

There were no significant differences in visceral (p = 0.98) or subcutaneous adipose (p = 0.60) tissue between symptomatic and asymptomatic patients. However measured fat volumes were associated with serum adipokines. Adiponectin showed an inverse correlation with visceral adipose tissue (VAT) (Spearman ? = -0.5, p = 0.0003), which correlated negatively with SBWC (? = -0.3, p=0.05). Leptin correlated positively with subcutaneous adipose tissue (? = 0.8, p < 0.0001). Overweight patients (BMI > 25 kgm-2) showed a moderate correlation between calprotectin and VAT (? = 0.3, p = 0.05). Somatization scores were significantly higher in symptomatic patients (p < 0.0003).

Increasing visceral fat is associated with lower serum adiponectin and increased faecal calprotectin suggesting a pro-inflammatory effect which may predispose to the development of complications of diverticulosis.


Murray, K., Hoad, C., Garratt, J., Kaviani, M., Marciani, L., Smith, J., …Spiller, R. (2019). A pilot study of visceral fat and its association with adipokines, stool calprotectin and symptoms in patients with diverticulosis. PLoS ONE, 14(5), Article e0216528.

Journal Article Type Article
Acceptance Date Apr 30, 2019
Online Publication Date May 8, 2019
Publication Date May 8, 2019
Deposit Date Apr 30, 2019
Publicly Available Date May 10, 2019
Journal PLoS ONE
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 14
Issue 5
Article Number e0216528
Keywords General Biochemistry, Genetics and Molecular Biology; General Agricultural and Biological Sciences; General Medicine
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