Multimodal Anthropometric and Imaging Protocol

Clinical screening and anthropometric and biochemical measurements were performed as previously described [26 (link)]. Blood pressure was measured with OMRON 711 automatic blood pressure monitor (Omron Corporate, Kyoto, Japan). Before the measurements, subjects were sitting for >10 min in a quiet room. A study nurse then assessed each subject twice for blood pressure measurements within a five-minute interval, and the average value was considered for the analysis. Subjects then underwent whole-body magnetic resonance imaging (MRI) with either a Philips Gyroscan Intera 1.5 T CV Nova Dual scanner (Philips, Amsterdam, The Netherlands) or with a Siemens Magnetom Skyra fit 3T MRI scanner (Siemens Medical Solutions, Erlangen, Germany). MRI acquisition was performed with axial T1-weighted dual fast field echo images (echo time (TE) 2.3 and 4.6 ms, repetition time (TR) 120 ms, slice thickness 10 mm without gap, matrix 256 × 256) or with T1-weighted 3D VIBE two-point DIXON sequence in breath-hold mode (TE 1.2 and 2.5 ms, TR 4.0 ms, slice thickness 2 mm with 0.4 mm gap, matrix 182 × 224). Subjects were scanned from head to knee or to ankle in a supine position. Total scan duration was 20 min. In obese patients, the imaging studies were performed before the standard four-week very-low calorie diet that preceded surgery.