Effect of weight loss on coronary circulation and adiponectin levels in obese women

Metabolic surgery-principles and current concepts

INTRODUCTION

In the almost six decades of bariatric surgery, a variety of surgical approaches to treating morbid obesity have been developed.

HISTORY AND EVOLUTION

Rather than prior techniques being continually superseded by new ones, a broad choice of surgical solutions based on restrictive, malabsorptive, humoral effects, or combinations thereof, is now available. In fact, in recent years, the advent of surgically modifying human metabolism promises new approaches to ameliorate traditionally medically treated metabolic entities, i.e., diabetes, even in the non-obese. The understanding of the various metabolic effects have led to a paradigm shift from bariatric surgery as a solely weight-reducing procedure to metabolic surgery affecting whole body metabolism.

CONCLUSION

The bariatric surgeon now faces the challenge and opportunity of selecting the most suitable technique for each individual case. To assist in such decision-making, this review, Metabolic surgery-principles and current concepts, is presented, tracing the historical development; describing the various surgical techniques; elucidating the mechanisms by which glycemic control can be achieved that involve favorable changes in insulin secretion and insulin sensitivity, gut hormones, adipokines, energy expenditure, appetite, and preference for low glycemic index foods; as well as exploring the fascinating future potential of this new interdisciplinary field.

The link between the metabolic syndrome and cancer

Since the incidence of the metabolic syndrome is on the rise in the western world, its coherence to cancer is becoming more apparent. In this review we discuss the different potential factors involved in the increase of cancer in the metabolic syndrome including obesity, dyslipidemia and Type 2 Diabetes Mellitus (T2DM) as well as inflammation and hypoxia. We especially focus on the insulin and IGF systems with their intracellular signaling cascades mediated by different receptor subtypes, and suggest that they may play major roles in this process. Understanding the mechanisms involved will be helpful in developing potential therapeutics.

The relationship among adiponectin, high sensitive C reactive protein and triacylglycerol level in healthy young persons

Background

The elevated postprandial triacylglycerol (TG) concentration is associated with elevated coronary artery disease. Oral fatty tolerant test (OFTT) is less performed in the health. This study was to evaluate the effect of sex and body mass index (BMI) on postprandial TG concentration of the low fat meal in healthy young persons. This study included 112 healthy college students (18.8+/-1.6y). Their body height and weight were measured for body mass index (BMI). According to BMI, 27 subjects were in the under-weight subgroup, 60 in the normal weight subgroup and 25 in the over-weight subgroup. After overnight fasting low fat OFTT (27 g fat, 600 kcal) was performed and the plasma TG and glucose concentrations were measured before and at 2, 4 and 6 hour after a fat meal. The area under the curve (AUC) of TG was calculated.

Results

The fasting TG levels were similar and the fasting TG levels gradually increased as BMI increased in both sexes. The postprandial TG levels at 2 and 4 h decreased in female, but did not significant change in male. In female, the TG curves of 3 BMI subgroups showed saddle type, but in male the TG curve of the over-weight subgroup had a peak at 2 h, on the other hand the TG curve of under- weight subgroup had a dip at 2 h.

Conclusions

Gender and BMI are important influencing factors for TG metabolism after fat meal in the youth. The young male persons with over-BMI have abnormal TG metabolism.

The beneficial effects of α-cyclodextrin on blood lipids and weight loss in healthy humans

α-Cyclodextrin (α-CD) is a soluble fiber derived from corn. It has previously been reported that early intervention with Mirafit fbcx, a trademarked name for α-CD, has beneficial effects on weight management in obese individuals with type 2 diabetes, and that it preferentially reduces blood levels of saturated and trans fats in the LDL receptor knockout mice. The current investigation involves overweight but not obese nondiabetic individuals and was intended to confirm the effects of α-CD on both weight management and improving blood lipid levels. Forty-one healthy adults (age: 41.4 ± 13.6 years) participated in this 2-month, double-blinded, crossover study. In 28 compliant participants (8 males and 20 females), when the active phase was compared to the control phase, there were significant decreases in body weight (-0.4 ± 0.2 kg, P < 0.05), serum total cholesterol (mean ± s.e.m., -0.295 ± 0.10 mmol/l, 5.3%, P < 0.02) and low-density lipoprotein (LDL) cholesterol (-0.23 ± 0.11 mmol/l, -6.7%, P < 0.05). Apolipoprotein B (Apo B) (-0.0404 ± 0.02 g/l, -5.6%, P = 0.06) and insulin levels also decreased by 9.5% (-0.16 ± 0.08 pmol/l, P = 0.06) while blood glucose and leptin levels did not change. These results suggest that α-CD exerts its beneficial health effects on body weight and blood lipid profile in healthy nonobese individuals, as previously reported in obese individuals with type 2 diabetes.

Energy-restricted high-fat diets only partially improve markers of systemic and adipose tissue inflammation

This study aimed at investigating whether the weight loss due to energy-restricted high-fat diets is accompanied with parallel improvements in metabolic markers and adipose tissue inflammation. Eight-week-old C57BL/6J mice were given free access to a low-fat (LF) or a high-fat (45% of energy from fat-HF) diet for 6 months. Restricting intake of the HF diet by 30% (HFR) during the last 2 months of the HF feeding trial decreased fasting plasma insulin, homeostasis model assessment of insulin resistance (HOMA(IR)), and plasma triglyceride levels and improved hepatic steatosis compared to ad libitum HF feeding, indicating an improved metabolic profile. Further, analysis of gonadal white adipose tissue (GWAT) gene expression by microarray and quantitative PCR analyses demonstrated that HFR downregulated expression of genes linked to cell and focal adhesion, cytokine-cytokine receptor interaction, and endoplasmic reticulum (ER)-associated degradation pathway. However, HFR had no effect on circulating plasminogen activator inhibitor-1 (PAI-1) and nonesterified fatty acid levels, which were persistently higher in both HF and HFR groups compared to the LF group. Furthermore, HFR had a negative effect on plasma total adiponectin level. Finally, while HFR decreased GWAT monocyte chemotactic protein-1 (MCP-1), interleukin-2 (IL-2), and PAI-1 levels, it did not affect several other cytokines including granulocyte-macrophage colony-stimulating factor, interferon-γ, IL-1β, IL-6, and IL-10. In summary, energy-restricted high-fat diets improve insulin sensitivity, while only partially improving markers of systemic and adipose tissue inflammation. In conclusion, our study supports the recommended low-fat intake for overall cardiovascular health.

Obesity and post-operative complications in patients undergoing non-bariatric surgery

As the prevalence of obesity continues to rise in society, an increasing number of patients undergoing non-bariatric surgery will be obese. Obesity is known to increase morbidity and mortality in the general population and thus is perceived as a risk factor for adverse post-surgical outcomes. This association is not clear-cut, however, and there is a lack of consensus in the literature on the risk between obesity and specific complications, in particular relating to infection, wound healing, respiratory and venous thromboembolism. The paucity of studies, as well as a lack of consistency of definition of obesity, with an over-reliance on body mass index rather than body composition analysis, may underlie this confusion. Emerging concepts position central/visceral adipose tissue as potentially key to the pathogenesis of the comorbidities associated with obesity, thus this article reviews emerging research investigating the association between visceral obesity, the metabolic syndrome and resulting post-operative complications. It is hypothesized that the state of chronic inflammation and dysmetabolism observed in visceral obese patients negatively influences post-operative outcomes and represents a potential target for pharmaconutrition. The need for further research investigating the influence of visceral adiposity on immune function post surgery and its impact on post-operative morbidity and mortality is highlighted.

The endocanabinnoid system and diabetes - critical analyses of studies conducted with rimonabant

Rimonabant is the first CB1 receptor inhibitor available in the Brazilian market. This new drug has been approved for the treatment of obese or overweight patients associated with cardiovascular risk factors. In this article it is compared the effects of rimonabant treatment in obese patients with cardiovascular risk factors to usual obesity pharmacological treatment.