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Review
. 2023 Oct;47(10):948-955.
doi: 10.1038/s41366-023-01338-w. Epub 2023 Jul 21.

Pituitary T1 signal intensity at magnetic resonance imaging is reduced in patients with obesity: results from the CHIASM study

Giulia Puliani  1 , Emilia Sbardella  2 , Alessia Cozzolino  2 , Valentina Sada  2 , Rossella Tozzi  2 , Chiara Andreoli  3 , Marco Fiorelli  4 , Claudio Di Biasi  3 , Diletta Corallino  5 , Andrea Balla  5 , Alessandro M Paganini  5 , Mary Anna Venneri  2 , Andrea Lenzi  2 , Carla Lubrano  2 , Andrea M Isidori  6
Affiliations
Review

Pituitary T1 signal intensity at magnetic resonance imaging is reduced in patients with obesity: results from the CHIASM study

Giulia Puliani et al. Int J Obes (Lond). 2023 Oct.

Erratum in

Abstract

Background: Despite obesity being well known to be associated with several pituitary hormone imbalances, pituitary appearance in magnetic resonance imaging (MRI) in patients with obesity is understudied.

Objective: To evaluate the pituitary volume and signal intensity at MRI in patients with obesity.

Methods: This is a prospective study performed in an endocrine Italian referral center (ClinicalTrial.gov Identifier: NCT03458533). Sixty-nine patients with obesity (BMI > 30 kg/m2) and twenty-five subjects without obesity were enrolled. Thirty-three patients with obesity were re-evaluated after 3 years of diet and lifestyle changes, of whom 17 (51.5%) achieved a > 5% loss of their initial body weight, whereas the remaining 16 (48.5%) had maintained or gained weight. Evaluations included metabolic and hormone assessments, DEXA scan, and pituitary MRI. Pituitary signal intensity was quantified by measuring the pixel density using ImageJ software.

Results: At baseline, no difference in pituitary volume was observed between the obese and non-obese cohorts. At the 3-year follow-up, pituitary volume was significantly reduced (p = 0.011) only in participants with stable-increased body weight. Furthermore, a significant difference was noted in the mean pituitary intensity of T1-weighted plain and contrast-enhanced sequences between the obese and non-obese cohorts at baseline (p = 0.006; p = 0.002), and a significant decrease in signal intensity was observed in the subgroup of participants who had not lost weight (p = 0.012; p = 0.017). Insulin-like growth factor-1 levels, following correction for BMI, were correlated with pituitary volume (p = 0.001) and intensity (p = 0.049), whereas morning cortisol levels were correlated with pituitary intensity (p = 0.007). The T1-weighted pituitary intensity was negatively correlated with truncal fat (p = 0.006) and fibrinogen (p = 0.018).

Conclusions: The CHIASM study describes a quantitative reduction in pituitary intensity in T1-weighted sequences in patients with obesity. These alterations could be explained by changes in the pituitary stromal tissue, correlated with low-grade inflammation.

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Conflict of interest statement

GP, ES, AC, VS, CA, MF, GG, DC, AB, AMP, MAV, AL, and CL have nothing to disclose. AMI has served as a consultant for Novartis, Takeda, Recordati, and Sandoz companies, has received unconditional research grants from Shire, IPSEN, and Pfizer.

Figures

Fig. 1
Fig. 1. Study design.
The flowchart summarizes the number of patients enrolled and the subgroups division.
Fig. 2
Fig. 2. MRI image analysis.
Example of marking the region of interest in coronal (A) and sagittal (B) pituitary RM scans and results of the image analysis using ImageJ software.
Fig. 3
Fig. 3. Correlation analyses.
A Scatter plot showing the correlation between mean pituitary intensity in T1-weighted post-enhanced sagittal scan and body mass index (BMI) (R2 linear 0.231). B Scatter plot showing the correlation between mean pituitary intensity in T1-weighted post-enhanced coronal scan and BMI (R2 linear 0.231).
See this image and copyright information in PMC

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