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Hruska P, Kucera J, Kuruczova D, Buzga M, Pekar M, Holeczy P, Potesil D, Zdrahal Z, Bienertova-Vasku J. Unraveling adipose tissue proteomic landscapes in severe obesity: insights into metabolic complications and potential biomarkers. Am J Physiol Endocrinol Metab 2023; 325:E562-E580. [PMID: 37792298 PMCID: PMC10864023 DOI: 10.1152/ajpendo.00153.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
In this study, we aimed to comprehensively characterize the proteomic landscapes of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in patients with severe obesity, to establish their associations with clinical characteristics, and to identify potential serum protein biomarkers indicative of tissue-specific alterations or metabolic states. We conducted a cross-sectional analysis of 32 patients with severe obesity (16 males and 16 females) of Central European descent who underwent bariatric surgery. Clinical parameters and body composition were assessed using dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance, with 15 patients diagnosed with type 2 diabetes (T2D) and 17 with hypertension. Paired SAT and VAT samples, along with serum samples, were subjected to state-of-the-art proteomics liquid chromatography-mass spectrometry (LC-MS). Our analysis identified 7,284 proteins across SAT and VAT, with 1,249 differentially expressed proteins between the tissues and 1,206 proteins identified in serum. Correlation analyses between differential protein expression and clinical traits suggest a significant role of SAT in the pathogenesis of obesity and related metabolic complications. Specifically, the SAT proteomic profile revealed marked alterations in metabolic pathways and processes contributing to tissue fibrosis and inflammation. Although we do not establish a definitive causal relationship, it appears that VAT might respond to SAT metabolic dysfunction by potentially enhancing mitochondrial activity and expanding its capacity. However, when this adaptive response is exceeded, it could possibly contribute to insulin resistance (IR) and in some cases, it may be associated with the progression to T2D. Our findings provide critical insights into the molecular foundations of SAT and VAT in obesity and may inform the development of targeted therapeutic strategies.NEW & NOTEWORTHY This study provides insights into distinct proteomic profiles of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and serum in patients with severe obesity and their associations with clinical traits and body composition. It underscores SAT's crucial role in obesity development and related complications, such as insulin resistance (IR) and type 2 diabetes (T2D). Our findings emphasize the importance of understanding the SAT and VAT balance in energy homeostasis, proteostasis, and the potential role of SAT capacity in the development of metabolic disorders.
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Affiliation(s)
- Pavel Hruska
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Jan Kucera
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Daniela Kuruczova
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Marek Buzga
- Department of Laboratory Medicine, University hospital Ostrava, Ostrava, Czech Republic
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Matej Pekar
- Vascular and Miniinvasive Surgery Center, Hospital AGEL Trinec-Podlesi, Trinec, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Pavol Holeczy
- Department of Surgery, Vitkovice Hospital, Ostrava, Czech Republic
- Department of Surgical Disciplines, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - David Potesil
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Zbynek Zdrahal
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Julie Bienertova-Vasku
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
- Department of Physical Activities and Health Sciences, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
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Poloczek J, Kazura W, Kwaśnicka E, Gumprecht J, Jochem J, Stygar D. Effects of Bariatric Surgeries on Fetuin-A, Selenoprotein P, Angiopoietin-Like Protein 6, and Fibroblast Growth Factor 21 Concentration. J Diabetes Res 2021; 2021:5527107. [PMID: 34414240 PMCID: PMC8369187 DOI: 10.1155/2021/5527107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/02/2021] [Indexed: 12/15/2022] Open
Abstract
Obesity is a civilization disease representing a global health problem. Excessive body weight significantly reduces the quality of life. It is also associated with the leading causes of death, including type 2 diabetes mellitus, cardiovascular diseases, and numerous types of cancer. The mainstay of therapy is a dietary treatment. However, in morbidly obese patients, dietary treatment is often insufficient. In these patients, the most effective procedure is bariatric surgery, but it is still difficult to predict its outcome and metabolic changes. Hepatokines are proteins secreted by hepatocytes. Many of them, including fetuin-A, selenoprotein P, angiopoietin-like protein 6, and fibroblast growth factor 21, have been linked to metabolic dysfunctions. In this context, hepatokines may prove helpful. This review investigates the possible changes in hepatokine profiles after selected bariatric surgery protocols. In this regard, Roux-en-Y gastric bypass is the most studied type of surgery. The overall analysis of published research identified fetuin-A as a potential marker of metabolic alternations in patients after bariatric surgery.
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Affiliation(s)
- Jakub Poloczek
- Department of Rehabilitation, 3rd Specialist Hospital in Rybnik, 44-200 Rybnik, Poland
- Department of Internal Medicine, Diabetology, and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Wojciech Kazura
- Doctoral School of Medical University of Silesia, Department of Physiology, Faculty of Medical Sciences in Zabrze, 41-808 Zabrze, Poland
| | - Ewa Kwaśnicka
- Pediatric Ward, Municipal Hospital in Żory, 44-240 Żory, Poland
| | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology, and Nephrology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jerzy Jochem
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Zabrze, Poland
| | - Dominika Stygar
- Department of Physiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-808 Zabrze, Poland
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Pekař M, Pekařová A, Bužga M, Holéczy P, Soltes M. The risk of sarcopenia 24 months after bariatric surgery - assessment by dual energy X-ray absorptiometry (DEXA): a prospective study. Wideochir Inne Tech Maloinwazyjne 2020; 15:583-587. [PMID: 33294073 PMCID: PMC7687671 DOI: 10.5114/wiitm.2020.93463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/10/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Bariatric procedures lead to changes in body composition. Desired fat loss may be accompanied by decrease of muscle mass, thus raising the risk of sarcopenia. AIM To detect the risk of sarcopenia in patients 24 months after different bariatric/metabolic (B/M) procedures by DEXA. MATERIAL AND METHODS Consecutive patients scheduled for a B/M procedure underwent DEXA scan and anthropometric assessment before and 24 months after surgery in a prospective manner. Obtained data were tested for significant differences (p < 0.05) to detect body composition changes and occurrence of sarcopenia. The International Physical Activity Questionnaire (IPAQ) was answered at 24 months to assess physical activity. RESULTS Nineteen patients were enrolled, with no drop-off at follow-up. Body mass index dropped from 42.4 ±6.3 to 30.3 ±4.9 kg/m2, with excess weight loss of 72 ±25% and substantial improvement of all relevant anthropometric measurements (p < 0.001). Significant changes in DEXA parameters were observed: fat mass index (19.5 ±4.7 vs. 12.1 ±3.7 kg/m2), estimated visceral adipose area (235.8 ±70.0 vs. 126.5 ±50.4 cm2), lean mass index (22.1 ±2.4 vs. 18.1 ±2.3 kg/m2), appendage lean mass index (9.7 ±1.3 vs. 7.7 ±1.1 kg/m2), bone mineral content (1.22 ±0.1 vs. 1.12 ±0.1 kg), Z score (2.32 vs. 0.96) and T score (0.58 vs. -0.58). A low level of physical activity was recorded at 24 months. CONCLUSIONS B/M procedures lead to significant changes in body composition at 24 months after surgery. DEXA detects these changes effectively. Desired fat loss is associated with significant reduction of skeletal muscle and bone mineral mass. As such, patients after B/M surgery are at risk of sarcopenia. A low level of physical activity may also play a negative role.
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Affiliation(s)
- Matej Pekař
- Department of Surgery, Vítkovice Hospital INC, Ostrava, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Anna Pekařová
- Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Bužga
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Ostrava, Czech Republic
| | - Pavol Holéczy
- Department of Surgery, Vítkovice Hospital INC, Ostrava, Czech Republic
- Department of Surgical Disciplines, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Marek Soltes
- 1 Department of Surgery, University of Pavol Jozef Safarik, Kosice, Slovak Republic
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El Soueidy T, Kassir R, Nakhoul M, Balian A, Nunziante M, Safieddine M, Perlemuter G, Lainas P, Dagher I. Laparoscopic Greater Curvature Plication for the Treatment of Obesity: a Systematic Review. Obes Surg 2020; 31:1168-1182. [PMID: 33215360 DOI: 10.1007/s11695-020-05112-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/29/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND During the last decade, laparoscopic greater curvature plication (LGCP) has been used as a bariatric procedure for the treatment of obesity, regarded as less invasive and less expensive than other surgical bariatric procedures. We aimed to systematically review the literature and highlight recent clinical data regarding outcomes of LGCP in the treatment of obesity. METHODS A comprehensive research of Pubmed database on LGCP was performed. The search was conducted on the first of May 2020 and was not limited to any date range. Outcomes of interest were surgical technique, postoperative complications, weight loss outcomes, comorbidities improvement or resolution, and revisional surgeries after technical failure or weight regain. RESULTS Fifty-three articles were eligible for inclusion, with 3103 patients undergoing LGCP (mean age: 13.8-55 years). Mean preoperative body mass index (BMI) ranged from 31.2 to 47.8 kg/m2. Mean operative time ranged from 48 to 193 min. Length of hospital stay ranged from 0.75 to 7.2 days. Most studies provided postoperative follow-up up to 12 months. Mean percentage of excess weight loss (%EWL) ranged from 30.2 to 71.1% and 35 to 77.1% at 6 and 12 months post-LGCP, respectively. Only one study followed patients for more than 10 years and mean %EWL at 1, 5, and 10 years was 67%, 55%, and 42%, respectively. CONCLUSION LGCP seems to be an acceptable surgical procedure for the treatment of obesity, especially in centers having a low medical budget. However, most existing comparative studies report superiority of LSG regarding weight loss.
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Affiliation(s)
- Toni El Soueidy
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, F-92140, Clamart, France
| | - Radwan Kassir
- Department of Bariatric Surgery, CHU de la Réunion, Saint Denis, de la Réunion, France.
| | - Mary Nakhoul
- Department of Gastroenterology, Saint-Joseph Hospital, Paris, France
| | - Axel Balian
- Department of Hepatogastroenterology, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, F-92140, Clamart, France
| | - Marco Nunziante
- Department of Bariatric Surgery, CHU de la Réunion, Saint Denis, de la Réunion, France
| | - Maissa Safieddine
- Methodological Support Unit, INSERM, CIC1410, CHU Felix-Guyon, St-Denis, La Réunion, France
| | - Gabriel Perlemuter
- Department of Hepatogastroenterology, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Panagiotis Lainas
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
| | - Ibrahim Dagher
- Department of Minimally Invasive Digestive Surgery, Antoine-Beclere Hospital, Assistance Publique - Hôpitaux de Paris, F-92140, Clamart, France.,Paris-Saclay University, F-91405, Orsay, France
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How Bad Is "Bad"? A Cost Consideration and Review of Laparoscopic Gastric Plication Versus Laparoscopic Sleeve Gastrectomy. Obes Surg 2020; 31:307-316. [PMID: 33098054 DOI: 10.1007/s11695-020-05018-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent large-scale studies have concluded that laparoscopic sleeve gastrectomy (LSG) is superior to laparoscopic gastric greater curve plication (LGP) in weight loss outcomes and post-operative complications, but LGP is still being performed due to its purported financial advantage. Our analysis provides an investigation of cost at the time of operation, and a consideration of the financial implications of the complications and percentage of reoperation associated with each procedure. METHODS A systematic literature search was performed on the electronic medical databases PubMed and Embase. Extraction of data was performed using a pre-made form which included number of subjects, minor complications and rates, major complications and rates, reoperation rate, percent end weight loss, length of operating time, and length of hospital stay. RESULTS Twenty-eight records were included after screening for inclusion criteria, representing data from 3242 patients (2668 with LGP and 574 with LSG). Minor and major complications of LGP were documented in 28.7% and 7.2% of cases, respectively, and the rate of reoperation was 10.2%. Minor and major complications of LSG were 19.4% and 4.1%, respectively, and the rate of reoperation was 3.3%. Based on analysis of operating time and length of hospital stay means, each LGP operation was calculated to cost $10,730 USD, and LSG cost $14,074. CONCLUSIONS LGP has higher rates of complications and reoperation, and less %EWL compared with LSG. Despite modest initial cost benefit of LGP, when considering costs associated with the complications and reoperations, we conclude that LSG is superior to LGP in outcome and cost-effectiveness.
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Alizadeh S. Letter to the editor on "Targeting bile acid metabolism in obesity reduction: A systematic review and meta-analysis". Obes Rev 2020; 21:e13071. [PMID: 32596963 DOI: 10.1111/obr.13071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/15/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Bužga M, Marešová P, Petřeková K, Holéczy P, Kuča K. The efficacy of selected bariatric surgery methods on lipid and glucose metabolism: a retrospective 12-month study. Cent Eur J Public Health 2018; 26:49-53. [PMID: 29684298 DOI: 10.21101/cejph.a4637] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 02/07/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Approximately 25% of the Czech population is currently obese. Obesity rates are expected to increase in the future. Obesity not only raises the risk of health complications for individuals, but increasing rates also represent a significant and steadily growing economic burden for healthcare systems and society as a whole. The aim of this study was to evaluate the therapeutic efficacy of three methods of bariatric surgery: laparoscopic greater curve plication (LGCP), laparoscopic sleeve gastrectomy (LSG), and Roux-en-Y gastric bypass (RYBG) in patients with type 2 diabetes mellitus (DM). This study examined the influence of bariatric surgery on body weight and BMI, changes in serum glucose and markers of lipid metabolism. METHODS This study evaluated outcomes in 74 patients with type 2 DM who underwent LGCP, LSG or RYGB. Patient selection followed guidelines of the International Federation for the Surgery of Obesity, i.e. BMI≥40 kg/m2 or BMI≥35 kg/m2 with associated comorbidities or BMI<35 kg/m2. For each of the procedures, the hypotheses were tested with the Bonferroni method. RESULTS Statistically significant weight loss, 20.2±9.3 kg on average, occurred by 12 months after surgery, with maximum weight reduction of 38 kg. Over the 12-month period, average fasting glycaemia decreased by 2.58 mmol/L after LGCP, by 2.01 mmol/L after LSG, and by 4.64 mmol/L after RYGB. Triacylglycerol (TGC) values decreased significantly with all procedures. The mean decrease was 1.35 mmol/L after LGCP and 1.06 mmol/L after LSG. The greatest TGC concentration decrease, 1.92 mmol/L, occurred after RYGB. Average concentrations decreased below 1.7 mmol/L. There was a statistically significant difference in body weight and BMI reduction between LGCP and LSG groups, as well as between LGCP and RYGB groups. A significant difference in the glucose decrease was observed between the LSG and RYGB groups, which can be explained by the fact that glycaemia and HbA1c levels were different between these groups prior to surgery. CONCLUSIONS The best results from the carbohydrate metabolism point reached the malabsorption method RYGB. However, the other two restrictive methods also achieved very good results. In particular, the LGCP method has not only the effect on weight reduction but also on metabolic functions and consequently points to potential healthcare expenditure savings.
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Affiliation(s)
- Marek Bužga
- Research Obesity Centre, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Petra Marešová
- Faculty of Informatics and Management, University of Hradec Králové, Hradec Králové, Czech Republic
| | - Karin Petřeková
- Research Obesity Centre, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Pavol Holéczy
- Research Obesity Centre, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Kamil Kuča
- Faculty of Informatics and Management, University of Hradec Králové, Hradec Králové, Czech Republic.,Biomedical Research Centre, University Hospital Hradec Králové, Hradec Králové, Czech Republic
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