The FAT score, a Fibrosis score of Adipose Tissue: predicting weight loss outcome after gastric bypass.

The FAT score, a Fibrosis score of Adipose Tissue: predicting weight loss outcome after gastric bypass.

J Clin Endocrinol Metab. 2017 Apr 17;:

Authors: Bel Lassen P, Charlotte F, Liu Y, Bedossa P, le Naour G, Tordjman J, Poitou C, Bouillot JL, Genser L, Zucker JD, Sokolovska N, Aron-Wisnewsky J, Clément K

Abstract
Context: Bariatric surgery (BS) induces major and sustainable weight loss in many but not all patients. Factors predicting poor responders (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 semi-quantitative score evaluating scAT fibrosis and test its predictive value on weight loss response after Roux-en-Y gastric bypass (RYGB).
Material and methods: We created a Fibrosis score of Adipose Tissue (FAT score) integrating peri-lobular and peri-cellular fibrosis. Using this score, we characterized 183 peroperative scAT biopsies (stained with picrosirius red) of severely obese patients who underwent RYGB (85 from a training cohort, 98 from a confirmation cohort). PR to RYGB was defined as < 28% of total weight-loss at one 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 inter-observer 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 IL-6 (adjusted OR =3.6, IC 95% [1.8, 7.2]; p =0.003).
Conclusion: The FAT score is a new simple semi-quantitative evaluation of human scAT fibrosis that may be used to help identifying patients with a potential limited weight loss response to RYGB.

PMID: 28419237 [PubMed - as supplied by publisher]

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