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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

Authors

Kathryn Murray

Jill Garratt

LUCA MARCIANI LUCA.MARCIANI@NOTTINGHAM.AC.UK
Professor of Gastrointestinal Imaging

Jan Smith

Britta Siegmund

DAVID HUMES david.humes@nottingham.ac.uk
Clinical Associate Professor

ROBIN SPILLER ROBIN.SPILLER@NOTTINGHAM.AC.UK
Professor of Gastroenterology



Abstract

Background
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.

Objective
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.

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

Setting
Medical and imaging research centres of a university hospital.

Participants
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.

Results
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 ρ = -0.5, p = 0.0003), which correlated negatively with SBWC (ρ = -0.3, p=0.05). Leptin correlated positively with subcutaneous adipose tissue (ρ = 0.8, p < 0.0001). Overweight patients (BMI > 25 kgm-2) showed a moderate correlation between calprotectin and VAT (ρ = 0.3, p = 0.05). Somatization scores were significantly higher in symptomatic patients (p < 0.0003).

Conclusions
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.

Journal Article Type Article
Publication Date May 8, 2019
Journal PLOS ONE
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 14
Issue 5
Article Number e0216528
APA6 Citation 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), https://doi.org/10.1371/journal.pone.0216528
DOI https://doi.org/10.1371/journal.pone.0216528
Keywords General Biochemistry, Genetics and Molecular Biology; General Agricultural and Biological Sciences; General Medicine
Publisher URL https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0216528

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