Radiologic evidence that hypothalamic gliosis is improved after bariatric surgery in obese women with type 2 diabetes

Background/Objectives Hypothalamic neurons play a major role in the control of body mass. Obese subjects present radiologic signs of gliosis in the hypothalamus, which may reflect the damage or loss of neurons involved in whole-body energy homeostasis. It is currently unknown if hypothalamic gliosis (1) differs between obese nondiabetic (ND) and obese diabetic subjects (T2D) or (2) is modified by extensive body mass reduction via Roux-n-Y gastric bypass (RYGB). Subjects/Methods Fifty-five subjects (all female) including lean controls (CT; n = 13), ND ( n = 28), and T2D ( n = 14) completed at least one study visit. Subjects underwent anthropometrics and a multi-echo MRI sequence to measure mean bilateral T2 relaxation time in the mediobasal hypothalamus (MBH) and two reference regions (amygdala and putamen). The obese groups underwent RYGB and were re-evaluated 9 months later. Analyses were by linear mixed models. Results Analyses of T2 relaxation time at baseline showed a group by region interaction only in the MBH ( P