MR-Guided Focused Ultrasound Ablation of Visceral Fat: A new treatment for metabolic syndrome

Mapping Intimacies ◽

10.31225/osf.io/b376h ◽

2018 ◽

Author(s):

Charles Dumoulin

Keyword(s):

Metabolic Syndrome ◽

High Risk ◽

Visceral Fat ◽

Focused Ultrasound ◽

Subcutaneous Fat ◽

Metabolic Risk Factor ◽

Low Grade ◽

Causative Role ◽

Metabolic Risk ◽

The Metabolic Syndrome

The goal of this project is to develop a minimally invasive treatment for metabolic syndrome associated with obesity. Metabolic syndrome includes diabetogenic, atherogenic, pro-thrombotic and pro-inflammatory metabolic abnormalities; which often present during childhood. Patients with obesity-induced metabolic syndrome have a high risk of cardiovascular disease and type 2 diabetes. The most prevalent form of obesity-associated metabolic syndrome is related to the accumulation of visceral fat, rather than subcutaneous fat or total body fat. Visceral fat and its resident macrophages produce pro-inflammatory cytokines (e.g., necrosis factor-alpha, leptin, and interleukin-6) that are implicated in chronic low-grade inflammation which subsequently lead to metabolic syndrome in the obese. Recent animal studies show that loss of visceral fat may generate substantial improvements in the metabolic risk factor profile. This notion has important clinical implications as it recognize visceral adiposity as a therapeutic target for the management of metabolic syndrome in high-risk patients. While lifestyle modifications in the form of caloric restriction, pharmacotherapy and bariatric surgery have all been shown to provide improvement in metabolic risk factors associated with obesity, it is not known if these improvements are maintained over time. Improvement also takes time, (i.e., several months to years) to show beneficial effects. More importantly none of the existing interventions specifically target visceral fat which is thought to play a causative role in the metabolic syndrome. Thus, in this application we will investigate de-bulking of visceral fat by thermal ablation as a treatment option for obesity-induced metabolic syndrome. We hypothesize that HIFU treatment of visceral fat can improve insulin action in obese rats and provide a non-surgical alternative to visceral fat resection. To test this hypothesis, we will design, build, and validate an MR-guided focused ultrasound system for the ablation of visceral fat in a rodent model of metabolic syndrome.

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Reduced cardiovagal baroreflex gain in visceral obesity: implications for the metabolic syndrome

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00642.2001 ◽

2002 ◽

Vol 282 (2) ◽

pp. H630-H635 ◽

Cited By ~ 69

Author(s):

Stacy D. Beske ◽

Guy E. Alvarez ◽

Tasha P. Ballard ◽

Kevin P. Davy

Keyword(s):

Metabolic Syndrome ◽

Visceral Fat ◽

Subcutaneous Fat ◽

Visceral Obesity ◽

Abdominal Fat ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Wide Range ◽

Abdominal Visceral Fat ◽

Total Body

The influence of excess total and abdominal adiposity on cardiovagal baroreflex gain remains unclear. We tested the hypotheses that cardiovagal baroreflex gain would be reduced in men with 1) higher [higher fat (HF), mass >20 kg, n = 11] compared with lower [lower fat (LF), mass <20 kg, n = 10] levels of total body and abdominal fat and 2) higher abdominal visceral fat (HAVF; n = 10) compared with total body weight- and subcutaneous fat-matched peers with lower abdominal visceral fat (LAVF; n = 7) levels. To accomplish this, we measured cardiovagal baroreflex gain (modified Oxford technique), body composition (dual energy X-ray absorptiometry), and abdominal visceral and subcutaneous fat (computed tomography) in sedentary men (age, 18–40 yr; body mass index, <34.9 kg/m2) across a wide range of adiposity. Cardiovagal baroreflex gain was significantly lower in HF compared with LF (14.3 ± 2.8 vs. 21.4 ± 2.8 ms/mmHg, respectively). In addition, cardiovagal baroreflex gain was lower in HAVF compared with LAVF (13.0 ± 2.0 vs. 21.4 ± 3.6 ms/mmHg, P< 0.05). Therefore, the results of the present study indicate that cardiovagal baroreflex gain is reduced in men with elevated total body and abdominal fat mass. The reduced cardiovagal baroreflex gain in these individuals appears to be linked to their higher level of abdominal visceral fat. Importantly, reduced cardiovagal baroreflex gain may contribute to the increased risk of cardiovascular disease observed in men with the metabolic syndrome.

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Microvascular dysfunction: causative role in the association between hypertension, insulin resistance and the metabolic syndrome?

Essays in Biochemistry ◽

10.1042/bse0420163 ◽

2006 ◽

Vol 42 ◽

pp. 163-176 ◽

Cited By ~ 16

Author(s):

Erik H. Serné ◽

Renate T. de Jongh ◽

Etto C. Eringa ◽

Richard G. Ijzerman ◽

Michiel P. de Boer ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Microvascular Dysfunction ◽

Metabolic Risk Factors ◽

Causative Role ◽

Metabolic Risk ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Potential Factor

The metabolic syndrome defines a clustering of metabolic risk factors that confers an increased risk for type 2 diabetes and cardiovascular disease. The metabolic syndrome seems to have multiple etiological factors and microvascular dysfunction may be one potential factor explaining the clustering of multiple metabolic risk factors including hypertension, obesity, insulin resistance and glucose intolerance. Microvascular dysfunction may increase not only peripheral vascular resistance and blood pressure, but may also decrease insulin-mediated glucose uptake in muscle. The present article summarizes some of the data concerning the role of microvascular dysfunction in the metabolic syndrome.

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Macrophage gene expression is related to obesity and the metabolic syndrome in human subcutaneous fat as well as in visceral fat

Diabetologia ◽

10.1007/s00125-010-2014-3 ◽

2011 ◽

Vol 54 (4) ◽

pp. 876-887 ◽

Cited By ~ 46

Author(s):

E. Klimcakova ◽

B. Roussel ◽

Z. Kovacova ◽

M. Kovacikova ◽

M. Siklova-Vitkova ◽

...

Keyword(s):

Gene Expression ◽

Metabolic Syndrome ◽

Visceral Fat ◽

Subcutaneous Fat ◽

The Metabolic Syndrome

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Evaluation of adipose tissue mass with anthropometric and visualization methods; its relation to the components of the metabolic syndrome

Obesity and metabolism ◽

10.14341/2071-8713-4820 ◽

2013 ◽

Vol 10 (2) ◽

pp. 23-27

Author(s):

T N Markova ◽

V A Kichigin ◽

V N Diomidova ◽

D S Markov ◽

O V Petrova

Keyword(s):

Metabolic Syndrome ◽

Adipose Tissue ◽

Visceral Fat ◽

Subcutaneous Fat ◽

Tissue Mass ◽

The Metabolic Syndrome ◽

Adipose Tissue Mass ◽

Different Types ◽

Magnetic Resonance Imaging Mri ◽

Mri Measurements

We performed an estimation of body fat using ultrasound, magnetic resonance imaging (MRI) and anthropometry in 60 patients with different types of body weight (BW). Correlation of waist circumference (WC), thickness of subcutaneous fat and visceral fat with components of the metabolic syndrome was studied comparatively between ultrasound and MRI measurements. We noted a preferential increase in the thickness of visceral fat compared with subcutaneous with increasing degree of BW. Significant increase in adipose tissue and the development of metabolic disorders occurs in overweight, making it the state close to obesity. During a routine ultrasound of the abdomen it is advisable to determine the thickness of subcutaneous and visceral fat separately.

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Liver fat percent is associated with metabolic risk factors and the metabolic syndrome in a high-risk vascular cohort

Nutrition & Metabolism ◽

10.1186/1743-7075-7-50 ◽

2010 ◽

Vol 7 (1) ◽

pp. 50 ◽

Cited By ~ 5

Author(s):

Michel R Hoenig ◽

Gary Cowin ◽

Raymond Buckley ◽

Christine McHenery ◽

Alan Coulthard

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

High Risk ◽

Metabolic Risk Factors ◽

Liver Fat ◽

Metabolic Risk ◽

The Metabolic Syndrome

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Greater beneficial effects of visceral fat reduction compared with subcutaneous fat reduction on parameters of the metabolic syndrome: a study of weight reduction programmes in subjects with visceral and subcutaneous obesity

Diabetic Medicine ◽

10.1111/j.1464-5491.2004.01395.x ◽

2005 ◽

Vol 22 (3) ◽

pp. 266-272 ◽

Cited By ~ 54

Author(s):

H. S. Park ◽

K. Lee

Keyword(s):

Metabolic Syndrome ◽

Weight Reduction ◽

Visceral Fat ◽

Subcutaneous Fat ◽

Beneficial Effects ◽

The Metabolic Syndrome ◽

Fat Reduction

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Role of genetic factors in the development of hypertension in young patients with metabolic syndrome

Spravočnik vrača obŝej praktiki (Journal of Family Medicine) ◽

10.33920/med-10-2004-03 ◽

2020 ◽

pp. 23-32

Author(s):

Elena Korneeva ◽

Mikhail Voevoda ◽

Sergey Semaev ◽

Vladimir Maksimov

Keyword(s):

Metabolic Syndrome ◽

High Risk ◽

Arterial Hypertension ◽

Genetic Factors ◽

Young Patients ◽

Integrin Αiibβ3 ◽

Ace Gene ◽

The Metabolic Syndrome

Results of the study related to polymorphism of ACE gene (rs1799752)‎, integrin αIIbβ3, and CSK gene (rs1378942) influencing development of arterial hypertension in young patients with metabolic syndrome are presented. Hypertension as a component of the metabolic syndrome was detected in 15.0% of young patients. Prevalence of mutant alleles of the studied genes among the examined patients was quite high, so homozygous DD genotype was found in 21.6%, and mutant D allele of the ACE gene in 47.4%. A high risk of hypertension in patients with MS was detected in carriers of the T allele of the CSK (rs1378942) gene – 54.8%, which was most often observed in a combination of polymorphic ACE and CSK gene loci (p = 0.0053).

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