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J Clin Endocrinol Metab. 2017 Jul 1;102(7):2443-2453. doi: 10.1210/jc.2017-00138.

The FAT Score, a Fibrosis Score of Adipose Tissue: Predicting Weight-Loss Outcome After Gastric Bypass.

Bel Lassen P1,2,3,4, Charlotte F5, Liu Y1,2,3,4, Bedossa P6,7, Le Naour G5, Tordjman J1,2,3, Poitou C1,2,3,4, Bouillot JL8, Genser L1,2,3,9, Zucker JD1,2,3,10, Sokolovska N1,2,3, Aron-Wisnewsky J1,2,3,4, Clément K1,2,3,4.

Author information

1
Institute of Cardiometabolism and Nutrition (ICAN) F-75013 Paris France.
2
INSERM, UMRS 1166, Nutriomic Team 6, F-75013 Paris, France.
3
Sorbonne Universités, UPMC Université Paris 06, UMRS1166, F-75005 Paris France.
4
Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), F-75013 Paris, France.
5
Department of Pathology, Pitié-Salpêtrière Hospital, AP-HP, UIMAP, UPMC Université Paris 06, F-75013 Paris, France.
6
Beaujon Hospital, Pathology Department, AP-HP, F-92110 Clichy, France.
7
Centre de Recherche Bichat-Beaujon, INSERM U773, University Paris-Diderot, F-75018 Paris, France.
8
Department of General, Digestive, and Metabolic Surgery, Ambroise Paré University Hospital, AP-HP, Versailles Saint-Quentin University, F-92100 Boulogne, France.
9
Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Pitié-Salpêtrière Hospital, AP-HP, F-75013 Paris, France.
10
Sorbonne Universités, IRD, UMI 209, UMMISCO, IRD France Nord, F-93143 Bondy, France.

Abstract

Context:

Bariatric surgery (BS) induces major and sustainable weight loss in many patients. Factors predicting poor weight-loss response (PR) need to be identified to improve patient care. Quantification of subcutaneous adipose tissue (scAT) fibrosis is negatively associated with post-BS weight loss, but whether it could constitute a predictor applicable in clinical routine remains to be demonstrated.

Objective:

To create a semiquantitative score evaluating scAT fibrosis and test its predictive value on weight-loss response after Roux-en-Y gastric bypass (RYGB).

Methods:

We created a fibrosis score of adipose tissue (FAT score) integrating perilobular and pericellular fibrosis. Using this score, we characterized 183 perioperative scAT biopsy specimens from severely obese patients who underwent RYGB (n = 85 from a training cohort; n = 98 from a confirmation cohort). PR to RYGB was defined as <28% of total weight loss at 1 year (lowest tertile). The link between FAT score and PR was tested in univariate and multivariate models.

Results:

FAT score was directly associated with increasing scAT fibrosis measured by a standard quantification method (P for trend <0.001). FAT score interobserver agreement was good (κ = 0.76). FAT score ≥2 was significantly associated with PR. The association remained significant after adjustment for age, diabetes status, hypertension, percent fat mass, and interleukin-6 level (adjusted odds ratio, 3.6; 95% confidence interval, 1.8 to 7.2; P = 0.003).

Conclusion:

The FAT score is a new, simple, semiquantitative evaluation of human scAT fibrosis that may help identify patients with a potential limited weight-loss response to RYGB.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01655017.

PMID:
28419237
DOI:
10.1210/jc.2017-00138
[Indexed for MEDLINE]

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