MRI-assessed visceral adipose tissue (VAT) in different lipodystrophic (LD) syndromes
Dieudonne Lucile1, Migaud Maria Claire1, Boury Samuel4, Lascols Olivier3, Lacroix Dominique2, Mathurin Philippe5, Wemeau Jean-Louis1 & Vantyghem Marie-Christine1
Lipodystrophy (LD) and obesity are opposites in terms of a deficiency versus excess of adipose tissue mass, yet these conditions are accompanied by similar metabolic consequences. VAT has not been well quantified in LD. The aim of this study was to compare the metabolic profile and VAT in different kinds of LD. Six-eight adult patients (45 females) referred for LD were classified in four groups: 23 LMNA-mutated patients (LMNA), 14 non-mutated related to the LMNA-mutated (control group C), 15 lipomatosis (LPS) and 16 patients with other types of anomalies of fat mass repartition (A group).
Methods: Gender, age, BMI, diabetes, glycemia, insulin, HbA1c, and leptin levels, percentage of fat mass (%FM) (dual-X absorptiometry), VAT and liver steatosis (MRI) were determined.
Results: The frequency of diabetes (P<0.001), mean weight and BMI (P<0.001), HbA1c (P<0.05), insulin and leptin (P<0.01) differed significantly across the four groups. Mean weight and BMI in LMNA were 66/24 kgs per m2, significantly lower than in LPS (98/35) and A (82/29), but not different from C (76/26) groups. HbA1c was significantly lower in C (5.4%) vs A (7.4%) not different from LMNA (6.6%) and LPS (6.4%). Mean insulinemia was significantly higher in LMNA (25 mUI/ml) compared to the three other groups (9 to 10). The mean of leptin (8 ng/ml) was significantly lower in LMNA versus LPS (27 ng/ml). The %FM and VAT and frequency of steatosis were respectively 24±13%/112±62 cm2/75% in LMNA, 43±9/ 117±51/48% in LPS and 33±9/143±79/38% in A groups.
Conclusion: A BMI <25, diabetes and steatosis in more than ¾ of cases, an insulinemia >20 mUI/l and leptinemia <10 ng/ml were the most common findings in LMNA. Referred to BMI and despite LD, the LMNA patients had a high volume of VAT (4.6), similar to A patients (4.9) who were also more often diabetic and higher than LPS (3.3).