Faculty of Medicine, University in Novi Sad, 21000 Novi Sad, Serbia.
Institute for Diagnostic and Interventional Neuroradiology, University Hospital Bern and Inselspital, 3010 Bern, Switzerland.
Medicina (Kaunas). 2024 Nov 16;60(11):1880. doi: 10.3390/medicina60111880.
Obesity-related chronic inflammation may lead to neuroinflammation and neurodegeneration. This study aimed to evaluate the neurometabolic profile of obese patients using cerebral multivoxel magnetic resonance spectroscopy (mvMRS) and assess correlations between brain metabolites and obesity markers, including body mass index (BMI), waist circumference, waist-hip ratio, body fat percentage, and indicators of metabolic syndrome (e.g., triglycerides, HDL cholesterol, fasting blood glucose, insulin, and insulin resistance index (HOMA-IR)). This prospective study involved 100 participants, stratified into two groups: 50 obese individuals (BMI ≥ 30 kg/m) and 50 controls (18.5 ≤ BMI < 25 kg/m). Anthropometric measurements, body fat percentage, and biochemical markers were evaluated. All subjects underwent long- and short-echo mvMRS analysis of the frontal and parietal supracallosal subcortical and deep white matter, as well as the cingulate gyrus, analyzing NAA/Cr, Cho/Cr, and mI/Cr ratios, along with absolute concentrations of NAA and Cho. Obese participants exhibited significantly decreased NAA/Cr and Cho/Cr ratios in the deep white matter of the right cerebral hemisphere ( < 0.001), while absolute concentrations of NAA and Cho did not differ significantly between groups ( > 0.05). NAA levels showed negative correlations with more reliable obesity parameters (waist circumference and waist-to-hip ratio) but not with BMI, particularly in the deep frontal white matter and dorsal anterior cingulate gyrus of the left cerebral hemisphere. Notably, insulin demonstrated a significant negative impact on NAA (ρ = -0.409 and ρ = -0.410; < 0.01) and Cho levels (ρ = -0.403 and ρ = -0.392; < 0.01) at these locations in obese individuals. Central obesity and hyperinsulinemia negatively affect specific brain regions associated with cognitive and emotional processing, while BMI is not a reliable parameter for assessing brain metabolism.
肥胖相关的慢性炎症可能导致神经炎症和神经退行性变。本研究旨在使用脑多体素磁共振波谱（mvMRS）评估肥胖患者的神经代谢特征，并评估脑代谢物与肥胖标志物（包括体重指数（BMI）、腰围、腰臀比、体脂百分比和代谢综合征指标（如甘油三酯、高密度脂蛋白胆固醇、空腹血糖、胰岛素和胰岛素抵抗指数（HOMA-IR））之间的相关性。这项前瞻性研究纳入了 100 名参与者，分为两组：50 名肥胖患者（BMI≥30kg/m²）和 50 名对照组（18.5≤BMI<25kg/m²）。评估了人体测量学测量、体脂百分比和生化标志物。所有受试者均进行了额叶和顶叶额上回皮质下和深部白质以及扣带回的长回波和短回波 mvMRS 分析，分析了 NAA/Cr、Cho/Cr 和 mI/Cr 比值以及 NAA 和 Cho 的绝对浓度。肥胖参与者的右侧大脑半球深部白质的 NAA/Cr 和 Cho/Cr 比值显著降低（<0.001），而两组之间 NAA 和 Cho 的绝对浓度无显著差异（>0.05）。NAA 水平与更可靠的肥胖参数（腰围和腰臀比）呈负相关，但与 BMI 无显著相关性，特别是在左侧大脑半球的深部额白质和背侧前扣带回。值得注意的是，胰岛素对 NAA（ρ=-0.409 和 ρ=-0.410；<0.01）和 Cho 水平（ρ=-0.403 和 ρ=-0.392；<0.01）在肥胖个体的这些部位有显著的负向影响。中心性肥胖和高胰岛素血症会对与认知和情绪处理相关的特定脑区产生负面影响，而 BMI 不是评估脑代谢的可靠参数。
