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Intragastric balloon therapy leads to normalization of brain magnetic resonance spectroscopic markers of diabetes in morbidly obese patients
Author(s) -
Gazdzinski Stefan P.,
Gaździńska Agata P.,
Orzeł Jarosław,
RedliszRedlicki Grzegorz,
Pietruszka Maciej,
Mojkowska Aleksandra,
Pacho Ryszard A.,
Wylezol Mariusz
Publication year - 2018
Publication title -
nmr in biomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.278
H-Index - 114
eISSN - 1099-1492
pISSN - 0952-3480
DOI - 10.1002/nbm.3957
Subject(s) - medicine , endocrinology , weight loss , creatine , white matter , magnetic resonance imaging , obesity , radiology
Elevated brain myo‐inositol (m‐Ins) concentration (a putative marker of neuroinflammation) has been reported in patients suffering from type 2 diabetes mellitus (T2DM). Obesity alone and T2DM have been found to be associated with a lower concentration of N‐acetyloaspartate and N‐acetylaspartylglutamate (tNAA, a marker of neuronal integrity, reflecting neuronal loss or metabolic derangement). It is not clear if these changes reverse with weight loss. The intra‐gastric balloon (IGB) is an endoscopic bariatric therapy that leads to massive weight loss and improvement of glycemic control. In this study we evaluated if tNAA/tCr and m‐Ins/tCr metabolite ratios are affected by weight loss, where tCr is the signal of creatine containing compounds. Twenty‐three morbidly obese patients, 12 of them with T2DM (OD) and 11 without T2DM (OB), as well as 11 healthy controls of normal weight (CON), underwent single voxel spectroscopy at 3 T. Spectra were obtained within a region in the left parietal white matter one month before IGB insertion, three months after IGB insertion, and one month after IGB removal. Before IGB insertion, m‐Ins/tCr was 15% higher in OD than in OB ( p = 0.005) and 12% higher in OD than in CON ( p = 0.03). m‐Ins/tCr decreased significantly by 8% over the first three months after IGB insertion ( p = 0.01) and remained normal after IGB removal. tNAA/tCr was normal in all groups throughout the study, pointing to normal brain metabolism. Normalization of m‐Ins/tCr is consistent with remission of neuroinflammation in patients with T2DM. An evaluation of long‐term effects of IGB treatment is necessary.