Skip to main content
Top
Published in: Techniques in Coloproctology 6/2020

01-06-2020 | Obesity | Original Article

Visceral and subcutaneous adipose tissue as markers of local and systemic inflammation: a comparison between celiac and obese patients using MRI

Authors: A. Picarelli, R. Borghini, M. Marino, R. Casale, M. Di Tola, C. Lubrano, A. Piermattei, G. Gualdi, A. Bella, G. Donato, G. Masselli

Published in: Techniques in Coloproctology | Issue 6/2020

Login to get access

Abstract

Background

Celiac disease (CD) is a systemic inflammatory disease, which primarily affects the gastrointestinal tract. It has been recently demonstrated that adipose-tissue infiltration by proinflammatory immune cells causes a chronic low-grade inflammation in obese patients. Magnetic resonance imaging (MRI) has already proved to be useful in evaluation of inflammatory states. The aim of the present study was to determine whether alterations of visceral and subcutaneous adipose tissue, identified with MRI, could serve as markers of local and systemic inflammation in patients with CD.

Methods

A pilot study was conducted comparing alterations in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in CD patients vs obese patients and healthy controls. Fifty patients were enrolled and assigned to one of the following groups: Group A: 11 active CD patients; Group B: 11 CD patients in remission; Group C: 16 obese patients; Group D: 12 healthy controls. A 3-T MRI unit was used and T2-weighted TSE images of VAT and SAT were obtained in specific regions of interest. Serum cytokine concentrations (TNF-α, IL-6, adiponectin, leptin, IL-2, IFN-γ) were determined.

Results

There was a significant difference in VAT T2 relaxation time between Group A and B (p < 0.001), A and D (p < 0.01), B and C (p < 0.001). There was a statistically significant difference in SAT T2 relaxation time between Group A and B (p < 0.001), A and C (p < 0.05), A and D (p < 0.001), B and C (p < 0.01). In addition, VAT/SAT T2 relaxation time ratio showed a statistically significant difference between Group A and C (p < 0.05) and between Group B and C (p < 0.01). Only TNF-α and IL-6 significantly correlated with both VAT and VAT/SAT ratio in active CD.

Conclusions

MRI showed similar increased visceral inflammatory signals in patients with active CD and obese patients. However, subcutaneous inflammatory signals were higher in active CD than in all the other groups. These data show that there is a systemic inflammatory state in active CD, whereas chronic inflammation appears confined to VAT in obesity. These data were only partially confirmed by serological cytokine profiles, which showed less specificity than MRI.
Literature
1.
go back to reference Picarelli A, Borghini R, Isonne C et al (2013) Reactivity to dietary gluten: new insights into differential diagnosis among gluten-related gastrointestinal disorders. Pol Arch Med Wewn 123:708–712PubMed Picarelli A, Borghini R, Isonne C et al (2013) Reactivity to dietary gluten: new insights into differential diagnosis among gluten-related gastrointestinal disorders. Pol Arch Med Wewn 123:708–712PubMed
4.
go back to reference Rashid M, Lee J (2016) Serologic testing in celiac disease: practical guide for clinicians. Can Fam Physician 62:38–43PubMedPubMedCentral Rashid M, Lee J (2016) Serologic testing in celiac disease: practical guide for clinicians. Can Fam Physician 62:38–43PubMedPubMedCentral
7.
go back to reference Tomei E, Semelka RC, Braga L et al (2006) Adult celiac disease: what is the role of MRI? J Magn Reson Imaging 24:625–629CrossRefPubMed Tomei E, Semelka RC, Braga L et al (2006) Adult celiac disease: what is the role of MRI? J Magn Reson Imaging 24:625–629CrossRefPubMed
8.
go back to reference Schreyer AG, Gölder S, Scheibl K et al (2005) Dark lumen magnetic resonance enteroclysis in combination with MRI colonography for whole bowel assessment in patients with Crohn's disease: first clinical experience. Inflamm Bowel Dis 11:388–394CrossRefPubMed Schreyer AG, Gölder S, Scheibl K et al (2005) Dark lumen magnetic resonance enteroclysis in combination with MRI colonography for whole bowel assessment in patients with Crohn's disease: first clinical experience. Inflamm Bowel Dis 11:388–394CrossRefPubMed
19.
Metadata
Title
Visceral and subcutaneous adipose tissue as markers of local and systemic inflammation: a comparison between celiac and obese patients using MRI
Authors
A. Picarelli
R. Borghini
M. Marino
R. Casale
M. Di Tola
C. Lubrano
A. Piermattei
G. Gualdi
A. Bella
G. Donato
G. Masselli
Publication date
01-06-2020
Publisher
Springer International Publishing
Published in
Techniques in Coloproctology / Issue 6/2020
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-020-02173-1

Other articles of this Issue 6/2020

Techniques in Coloproctology 6/2020 Go to the issue