# High-throughput measurement of adipocyte size with open-source software using whole-slide adipose tissue images

## TL;DR

This study developed a fast, open-source automated method to measure fat cell sizes in tissue samples, which is useful for studying metabolic health.

## Contribution

A validated open-source automated method for high-throughput adipocyte diameter measurement using whole-slide images.

## Key findings

- Automated and manual methods showed strong correlation (r = 0.87) in measuring adipocyte diameters.
- Omental adipocyte sizes correlated with cardiometabolic risk markers using both methods.
- No significant differences were found between manual and automated methods for subcutaneous adipose correlations.

## Abstract

The aim of this study was to create and validate a high-throughput method based on open-source software for the measurement of adipocyte diameters in white adipose tissue histological sections. Human omental and subcutaneous adipose tissue samples collected during bariatric surgery were used to prepare haematoxylin and eosin-stained histological slides. Adipocyte diameters were measured both manually and with an automated procedure created using ImageJ. Comparative analysis of our automated method with the manual measurement and associations of the mean adipocyte diameters with cardiometabolic markers were used to validate our method. A total of 377 adipose samples (190 participants) were included in the analysis. Pearson correlation of mean adipocyte diameters showed a strong linear relationship between methods (r = 0.87, p < 0.0001). Omental adipocyte diameters of both methods were significantly associated with the same markers of cardiometabolic risk (fasting concentrations of TG, HDL-Chol, homoeostasis model assessment of insulin resistance, and visceral adiposity index values) with no significant differences between methods. There were also no significant differences between the manual and automated method regarding the correlations between mean subcutaneous adipocyte diameters and anthropometric or metabolic markers. In conclusion, we have created and validated a rapid automated method to measure adipocyte diameters from whole-slide adipose tissue images.