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Chang PC, Ya-Wei Huang I, Huang CK, Chang TW. Comment on: Histopathologic findings in laparoscopic sleeve gastrectomy: is routine full pathologic evaluation indicated? Surg Obes Relat Dis 2023; 19:1076-1077. [PMID: 37453839 DOI: 10.1016/j.soard.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/28/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Po-Chih Chang
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan; Weight Management Center, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ivy Ya-Wei Huang
- Weight Management Center, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Nursing, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chih-Kun Huang
- Body Science and Metabolic Disorders International Medical Center, China Medical University Hospital, Taichung City, Taiwan
| | - Ting-Wei Chang
- Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan; Weight Management Center, Kaohsiung Medical University Hospital/Kaohsiung Medical University, Kaohsiung City, Taiwan
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Alessandris R, Moroso F, Michelotto M, Fassan M, Angerilli V, Callegari L, Foletto M. Preoperative endoscopy and pathology report of the specimen to be recommended in sleeve gastrectomy? Pathologica 2023; 115:90-96. [PMID: 37017300 PMCID: PMC10463000 DOI: 10.32074/1591-951x-781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/12/2022] [Indexed: 04/06/2023] Open
Abstract
Objective Preoperative upper gastrointestinal endoscopy (UGIE) and postoperative histopathological examination (HPE) of resected specimens are still controversial issues in bariatric surgery. Methods A retrospective review of prospectively collected laparoscopic sleeve gastrectomies (SG) performed at our institution for morbid obesity was carried out. All patients underwent pre-operative UGIE with biopsy, post-operative HPE and conventional post-operative follow-up. Results From January 2019 through January 2021 we performed a total of 501 laparoscopic SG. A total of 12 (2.4%) neoplasms were found, 2 evident at preoperative UGIE, 4 detected during operation, and 6 at HPE. Eight of these 12 cases had some malignant potential and 5 would not have been detected without HPE of the specimen. The most significant unexpected case was a fundic gland type adenocarcinoma in a 64-year-old female with severe obesity. Conclusion On the basis of our clinical experience, we recommend both preoperative endoscopic assessment and postoperative HPE of the specimen to provide the best available treatment to these patients.
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Affiliation(s)
- Remo Alessandris
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Bariatric Unit, University of Padua, Padua, Italy
| | - Federico Moroso
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Bariatric Unit, University of Padua, Padua, Italy
| | - Mauro Michelotto
- Surgical Pathology Unit, University Hospital of Padua, Padua, Italy
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
- Veneto Institute of Oncology (IOV-IRCCS), Padua, Italy
| | - Valentina Angerilli
- Department of Medicine (DIMED), Surgical Pathology & Cytopathology Unit, University of Padua, Padua, Italy
| | - Linda Callegari
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Bariatric Unit, University of Padua, Padua, Italy
| | - Mirto Foletto
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Bariatric Unit, University of Padua, Padua, Italy
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Vreeken D, Seidel F, de La Roij G, Vening W, den Hengst WA, Verschuren L, Özsezen S, Kessels RPC, Duering M, Mutsaerts HJMM, Kleemann R, Wiesmann M, Hazebroek EJ, Kiliaan AJ. Impact of White Adipose Tissue on Brain Structure, Perfusion, and Cognitive Function in Patients With Severe Obesity: The BARICO Study. Neurology 2023; 100:e703-e718. [PMID: 36332987 PMCID: PMC9969926 DOI: 10.1212/wnl.0000000000201538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND OBJECTIVE While underlying pathophysiology linking obesity to brain health is not completely understood, white adipose tissue (WAT) is considered a key player. In obesity, WAT becomes dysregulated, showing hyperplasia, hypertrophy, and eventually inflammation. This disbalance leads to dysregulated secretion of adipokines influencing both (cardio)vascular and brain health. Within this study, we investigated the association between omental WAT (oWAT) and subcutaneous WAT (scWAT) with brain structure and perfusion and cognition in adults with severe obesity. METHODS Within the cross-sectional BARICO study, brain structure and perfusion and cognitive function were measured before bariatric surgery (BS) using MRI and cognitive assessments. During BS, oWAT and scWAT depots were collected and analyzed by histopathology. The number and diameter of adipocytes were quantified together with the amount of crown-like structures (CLS) as an indication of inflammation. Blood samples were collected to analyze adipokines and inflammatory markers. Neuroimaging outcomes included brain volumes, cortical thickness, white matter (WM) integrity, WM hyperintensities, cerebral blood flow using arterial spin labeling (ASL), and the ASL spatial coefficient of variation (sCoV), reflecting cerebrovascular health. RESULTS Seventy-one patients were included (mean age 45.1 ± 5.8 years; 83.1% women; mean body mass index 40.8 ± 3.8 kg/m2). scWAT showed more CLS (z = -2.72, p < 0.01, r = -0.24) and hypertrophy compared with oWAT (F(1,64) = 3.99, p < 0.05, η2 = 0.06). Adiponectin levels were inversely associated with the average diameter of scWAT (β = -0.31, 95% CI -0.54 to -0.08) and oWAT (β = -0.33, 95% CI -0.55 to -0.09). Furthermore, the adipocyte diameter in oWAT was positively associated with the sCoV in the parietal cortex (β = 0.33, 95% CI 0.10-0.60), and the number of adipocytes (per mm2) was positively associated with sCoV in the nucleus accumbens (NAcc) (β = 0.34, 95% CI 0.09-0.61). Cognitive function did not correlate with any WAT parameter or plasma marker. These associations were highly influenced by age and sex. sCoV in the NAcc was positively associated with fasting plasma glucose (β = 0.35, 95% CI 0.10-0.56). DISCUSSION scWAT and oWAT are different in morphology and in their relationship with plasma markers and cerebrovascular health. Although scWAT showed more CLS and hypertrophy, scWAT was not associated with brain readouts. This study showed, however, important relationships between oWAT morphology and cerebrovascular health in obesity. TRIAL REGISTRATION INFORMATION Trial Registration Number NTR7288 (trialregister.nl/trial/7090).
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Affiliation(s)
- Debby Vreeken
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Florine Seidel
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Guido de La Roij
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Wouter Vening
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Willem A den Hengst
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Lars Verschuren
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Serdar Özsezen
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Roy P C Kessels
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Marco Duering
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Henk J M M Mutsaerts
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Robert Kleemann
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Maximilian Wiesmann
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Eric J Hazebroek
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands
| | - Amanda J Kiliaan
- From the Department of Medical Imaging (D.V., F.S., G.L.R., M.W., A.J.K.), Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Bariatric Surgery (D.V., W.V., W.A.H., E.J.H.), Vitalys, Part of Rijnstate Hospital, Arnhem, The Netherlands; Donders Institute for Brain (D.V., F.S., R.P.C.K., M.W., A.J.K.), Cognition, and Behavior and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Metabolic Health Research (F.S., R.K.), Netherlands Organisation for Applied Scientific Research (TNO), Leiden; Department of Microbiology and Systems Biology (L.V., S.Ö.), Netherlands Organisation for Applied Scientific Research (TNO), Zeist; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, The Netherlands; Department of Medical Psychology and Radboudumc Alzheimer Center (R.P.C.K.), Radboud University Medical Center, Nijmegen, The Netherlands; Medical Image Analysis Center (MIAC) and Qbig (M.D.), and Department of Biomedical Engineering, University of Basel, Switzerland; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam UMC, Amsterdam Neuroscience, The Netherlands; and Division of Human Nutrition and Health (E.J.H.), Wageningen University, The Netherlands.
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Kim Y, Hwang J, Bae SH, Hong SS, Chang YW, Kim HJ, Kim SH, Jin SY. Clinical Feasibility of Shear Wave Dispersion Slope for Noninvasive Diagnosis of Nonalcoholic Steatohepatitis in Patients With Morbid Obesity: Preliminary Results Using US Shear Wave Elastography. Ultrasound Q 2022; 38:149-154. [PMID: 35250014 DOI: 10.1097/ruq.0000000000000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We aimed to investigate the clinical feasibility of shear wave dispersion slope for assessing nonalcoholic steatohepatitis (NASH) in patients with morbid obesity before bariatric surgery.This prospective study collected data from 25 participants who received liver biopsy during bariatric surgery between February 2019 and December 2020. All participants underwent ultrasonography shear wave elastography before surgery and shear wave speed and shear wave dispersion slope were measured. Liver specimens were evaluated by 1 pathologist scored histologically for nonalcoholic fatty liver disease (NAFLD). Ultrasonography measurements were compared according to histopathologic findings. Diagnostic performance in differentiating NASH from NAFLD was evaluated using the area under the receiver operating characteristic curve (AUC). Median shear wave speed (1.48 vs 1.62 m/s, P = 0.014) and dispersion slope (8.40 vs 11.80 [m/s]/kHz, P = 0.004) were higher in NASH group than in NAFLD group. Shear wave dispersion slope tended to increase step by step as the severity of activity grade (P = 0.032) and hepatic fibrosis (P = 0.015) increased. The AUC of shear wave dispersion slope for differentiating NASH from NAFLD (AUC, 0.83; 95% confidence intervals, 0.66-1.00) was higher than that of shear wave speed (AUC, 0.78; 95% CI, 0.60-0.97), although it did not reach statistical significance (P = 0.729). Shear wave dispersion slope could be a feasible tool for assessing NASH in patients with morbid obesity.
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Affiliation(s)
- Yeonsoo Kim
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Jiyoung Hwang
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Sung Hwan Bae
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Seong Sook Hong
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Yun-Woo Chang
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Hyun-Joo Kim
- Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Sang Hyun Kim
- Department of Surgery, Soonchunhyang University College of Medicine, Seoul Hospital
| | - So-Young Jin
- Department of Pathology, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea
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Giraudi PJ, Salvoza N, Bonazza D, Saitta C, Lombardo D, Casagranda B, de Manzini N, Pollicino T, Raimondo G, Tiribelli C, Palmisano S, Rosso N. Ficolin-2 Plasma Level Assesses Liver Fibrosis in Non-Alcoholic Fatty Liver Disease. Int J Mol Sci 2022; 23:2813. [PMID: 35269955 PMCID: PMC8911336 DOI: 10.3390/ijms23052813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023] Open
Abstract
Fibrosis is the strongest predictor for disease-specific mortality in non-alcoholic fatty liver diseases (NAFLD), but the need for liver biopsy limits its diagnosis. We assessed the performance of plasma ficolin-2 (FCN-2) as a biomarker of fibrosis identified by an in silico discovery strategy. Two hundred and thirty-five morbidly obese (MO) subjects with biopsy-proven NAFLD stratified by fibrosis stage (F0, n = 44; F1, n = 134; F2, n = 46; F3/F4, n = 11) and 40 cirrhotic patients were enrolled. The cohort was subdivided into discovery (n = 76) and validation groups (n = 159). The plasma level of FCN-2 and other candidate markers was determined. FCN-2 was inversely correlated with the stage of liver fibrosis (ρ = −0.49, p < 0.001) independently of steatosis (p = 0.90), inflammation (p = 0.57), and ballooning (p = 0.59). In the global cohort, FCN-2 level decreased significantly in a stepwise fashion from F0/F1 (median 4753 ng/mL) to F2−F3−F4 (2760 ng/mL) and in cirrhotic subjects (1418 ng/mL). The diagnostic performance of FCN-2 in detecting F ≥ 2 was higher than other indexes (APRI, FIB-4) (AUROC 0.82, 0.68, and 0.6, respectively). The accuracy improved when combined with APRI score and HDL values (FCNscore, AUROC 0.85). Overall, the FCN-2 plasma level can accurately discriminate liver fibrosis status (minimal vs. moderate/advanced) significantly improving the fibrosis diagnostic algorithms.
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Affiliation(s)
- Pablo J. Giraudi
- Fondazione Italiana Fegato, Centro Studi Fegato, Area Science Park Basovizza Bldg.Q SS14 Km, 163.5, 34149 Trieste, Italy; (N.S.); (C.T.); (S.P.); (N.R.)
| | - Noel Salvoza
- Fondazione Italiana Fegato, Centro Studi Fegato, Area Science Park Basovizza Bldg.Q SS14 Km, 163.5, 34149 Trieste, Italy; (N.S.); (C.T.); (S.P.); (N.R.)
- Philippine Council for Health Research and Development, DOST Compound, Bicutan Taguig City 1631, Philippines
| | - Deborah Bonazza
- Surgical Pathology Unit, Cattinara Hospital, ASUGI, 34149 Trieste, Italy;
| | - Carlo Saitta
- Department of Clinical and Experimental Medicine, Unit of Medicine and Hepatology, Laboratory of Molecular Hepatology, University Hospital of Messina, 98121 Messina, Italy; (C.S.); (D.L.); (G.R.)
| | - Daniele Lombardo
- Department of Clinical and Experimental Medicine, Unit of Medicine and Hepatology, Laboratory of Molecular Hepatology, University Hospital of Messina, 98121 Messina, Italy; (C.S.); (D.L.); (G.R.)
| | - Biagio Casagranda
- Surgical Clinic Division, Cattinara Hospital, ASUGI, 34149 Trieste, Italy; (B.C.); (N.d.M.)
| | - Nicolò de Manzini
- Surgical Clinic Division, Cattinara Hospital, ASUGI, 34149 Trieste, Italy; (B.C.); (N.d.M.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
| | - Teresa Pollicino
- Department of Human Pathology, Laboratory of Molecular Hepatology, University Hospital of Messina, 98121 Messina, Italy;
| | - Giovanni Raimondo
- Department of Clinical and Experimental Medicine, Unit of Medicine and Hepatology, Laboratory of Molecular Hepatology, University Hospital of Messina, 98121 Messina, Italy; (C.S.); (D.L.); (G.R.)
| | - Claudio Tiribelli
- Fondazione Italiana Fegato, Centro Studi Fegato, Area Science Park Basovizza Bldg.Q SS14 Km, 163.5, 34149 Trieste, Italy; (N.S.); (C.T.); (S.P.); (N.R.)
| | - Silvia Palmisano
- Fondazione Italiana Fegato, Centro Studi Fegato, Area Science Park Basovizza Bldg.Q SS14 Km, 163.5, 34149 Trieste, Italy; (N.S.); (C.T.); (S.P.); (N.R.)
- Surgical Clinic Division, Cattinara Hospital, ASUGI, 34149 Trieste, Italy; (B.C.); (N.d.M.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
| | - Natalia Rosso
- Fondazione Italiana Fegato, Centro Studi Fegato, Area Science Park Basovizza Bldg.Q SS14 Km, 163.5, 34149 Trieste, Italy; (N.S.); (C.T.); (S.P.); (N.R.)
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Osorio-Conles Ó, Vega-Beyhart A, Ibarzabal A, Balibrea JM, Vidal J, de Hollanda A. Biological Determinants of Metabolic Syndrome in Visceral and Subcutaneous Adipose Tissue from Severely Obese Women. Int J Mol Sci 2022; 23:ijms23042394. [PMID: 35216509 PMCID: PMC8878297 DOI: 10.3390/ijms23042394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022] Open
Abstract
The metabolic syndrome (MetS) is a cluster of the most dangerous heart attack risk factors: diabetes or raised fasting plasma glucose, abdominal obesity, high cholesterol and high blood pressure. The goal of this study is to compare the state of the main features of obesity-associated white adipose tissue (WAT) dysfunction in 66 women with severe obesity without (MetS-) or with MetS (MetS+). Fat cell area, adipocyte size distribution and histological fibrosis were analysed in visceral (VAT) and abdominal subcutaneous WAT (SAT) in 33 age- and BMI-matched pairs of MetS- and MetS+ subjects. The mRNA expression of 93 genes implicated in obesity-associated WAT dysfunction was analysed by RT-qPCR in both fat depots. MetS+ females showed higher adipocyte hypertrophy in both fat depots and increased fibrosis and expression of macrophage and hypoxia markers in SAT. Transcriptional data suggest increased fatty acid oxidation in SAT and impaired thermogenesis and extracellular matrix remodelling in VAT from MetS+ subjects. A sPLS-DA model, including SAT expression of PPARA and LEPR genes identified MetS with an AUC = 0.87. Despite equal age, BMI and body composition, MetS+ females display morphological and transcriptional differences in both WAT depots, especially in SAT. These factors may contribute to the transition to MetS.
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Affiliation(s)
- Óscar Osorio-Conles
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
- Correspondence: (Ó.O.-C.); (A.d.H.); Tel.: +34-932275707 (ext. 2910) (Ó.O.-C.); +34-932279846 (A.d.H.); Fax: +34932275589 (A.d.H.)
| | - Arturo Vega-Beyhart
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
| | - Ainitze Ibarzabal
- Gastrointestinal Surgery Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.I.); (J.M.B.)
| | - José María Balibrea
- Gastrointestinal Surgery Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.I.); (J.M.B.)
| | - Josep Vidal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Ana de Hollanda
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain;
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Correspondence: (Ó.O.-C.); (A.d.H.); Tel.: +34-932275707 (ext. 2910) (Ó.O.-C.); +34-932279846 (A.d.H.); Fax: +34932275589 (A.d.H.)
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Hruska P, Kucera J, Pekar M, Holéczy P, Mazur M, Buzga M, Kuruczova D, Lenart P, Fialova Kucerova J, Potesil D, Zdrahal Z, Bienertova-Vasku J. Proteomic Signatures of Human Visceral and Subcutaneous Adipocytes. J Clin Endocrinol Metab 2022; 107:755-775. [PMID: 34669916 PMCID: PMC8851937 DOI: 10.1210/clinem/dgab756] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Indexed: 11/21/2022]
Abstract
CONTEXT Adipose tissue distribution is a key factor influencing metabolic health and risk in obesity-associated comorbidities. OBJECTIVE Here we aim to compare the proteomic profiles of mature adipocytes from different depots. METHODS Abdominal subcutaneous (SA) and omental visceral adipocytes (VA) were isolated from paired adipose tissue biopsies obtained during bariatric surgery on 19 severely obese women (body mass index > 30 kg/m2) and analyzed using state-of-the-art mass spectrometry. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were performed to investigate proteome signature properties and to examine a possible association of the protein expression with the clinical data. RESULTS We identified 3686 protein groups and found 1140 differentially expressed proteins (adj. P value < 0.05), of which 576 proteins were upregulated in SA and 564 in VA samples. We provide a global protein profile of abdominal SA and omental VA, present the most differentially expressed pathways and processes distinguishing SA from VA, and correlate them with clinical and body composition data. We show that SA are significantly more active in processes linked to vesicular transport and secretion, and to increased lipid metabolism activity. Conversely, the expression of proteins involved in the mitochondrial energy metabolism and translational or biosynthetic activity is higher in VA. CONCLUSION Our analysis represents a valuable resource of protein expression profiles in abdominal SA and omental VA, highlighting key differences in their role in obesity.
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Affiliation(s)
- Pavel Hruska
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, 62500 Brno, Czech Republic
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
| | - Jan Kucera
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
| | - Matej Pekar
- Department of Surgery, Vitkovice Hospital, 70300 Ostrava, Czech Republic
- Department of Physiology, Faculty of Medicine, Masaryk University, 70300 Brno, Czech Republic
| | - Pavol Holéczy
- Department of Surgery, Vitkovice Hospital, 70300 Ostrava, Czech Republic
- Department of Surgical Disciplines, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
| | - Miloslav Mazur
- Department of Surgery, Vitkovice Hospital, 70300 Ostrava, Czech Republic
| | - Marek Buzga
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, 70900 Ostrava, Czech Republic
- Department of Physiology and Pathohysiology, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic
| | - Daniela Kuruczova
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
| | - Peter Lenart
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
| | - Jana Fialova Kucerova
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
| | - David Potesil
- Central European Institute of Technology, Masaryk University, 62500 Brno, Czech Republic
| | - Zbynek Zdrahal
- Central European Institute of Technology, Masaryk University, 62500 Brno, Czech Republic
| | - Julie Bienertova-Vasku
- Department of Pathological Physiology, Faculty of Medicine, Masaryk University, 62500 Brno, Czech Republic
- Research Centre for Toxic Compounds in the Environment, Faculty of Science, Masaryk University, 62500 Brno, Czech Republic
- Correspondence: Julie Dobrovolna (previously Bienertova-Vasku), Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, Building A18, Brno 625 00, Czech Republic.
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Herrero-Aguayo V, Sáez-Martínez P, López-Cánovas JL, Prados-Carmona JJ, Alcántara-Laguna MD, López FL, Molina-Puerta MJ, Calañas-Continente A, Membrives A, Castilla J, Ruiz-Ravelo J, Alonso-Echague R, Yubero-Serrano EM, Castaño JP, Gahete MD, Gálvez-Moreno MA, Luque RM, Herrera-Martínez AD. Dysregulation of Components of the Inflammasome Machinery After Bariatric Surgery: Novel Targets for a Chronic Disease. J Clin Endocrinol Metab 2021; 106:e4917-e4934. [PMID: 34363480 DOI: 10.1210/clinem/dgab586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Obesity is a metabolic chronic disease with important associated morbidities and mortality. Bariatric surgery is the most effective treatment for maintaining long-term weight loss in severe obesity and, consequently, for decreasing obesity-related complications, including chronic inflammation. AIM To explore changes in components of the inflammasome machinery after bariatric surgery and their relation with clinical/biochemical parameters at baseline and 6 months after bariatric surgery. PATIENTS AND METHODS Twenty-two patients with morbid-obesity that underwent bariatric surgery (sleeve gastrectomy and Roux-en-Y gastric bypass) were included. Epidemiological/clinical/anthropometric/biochemical evaluation was performed at baseline and 6 months after bariatric surgery. Inflammasome components and inflammatory-associated factors [nucleotide-binding oligomerization domain-like receptors (NLRs), inflammasome activation components, cytokines and inflammation/apoptosis-related components, and cell-cycle and DNA-damage regulators) were evaluated in peripheral blood mononuclear cells (PBMCs) at baseline and 6 months after bariatric surgery. Clinical molecular correlations/associations were analyzed. Functional parameters (lipid accumulation/viability/apoptosis) were analyzed in response to specific inflammasome components silencing in liver HepG2 cells). RESULTS A profound dysregulation of inflammasome components after bariatric surgery was found, especially in NLRs and cell-cycle and DNA damage regulators. Several components were associated with baseline metabolic comorbidities including type 2 diabetes (C-C motif chemokine ligand 2/C-X-C motif chemokine receptor 1/sirtuin 1), hypertension (absent in melanoma 2/ASC/purinergic receptor P2X 7), and dyslipidemia [C-X-C motif chemokine ligand 3 (CXCL3)/NLR family pyrin domain containing (NLRP) 7) and displayed changes in their molecular profile 6 months after bariatric surgery. The gene expression fingerprint of certain factors NLR family CARD domain containing 4 (NLRC4)/NLRP12/CXCL3)/C-C motif chemokine ligand 8/toll-like receptor 4) accurately differentiated pre- and postoperative PBMCs. Most changes were independent of the performed surgical technique. Silencing of NLRC4/NLRP12 resulted in altered lipid accumulation, apoptosis rate, and cell viability in HepG2 cells. CONCLUSION Bariatric surgery induces a profound alteration in the gene expression pattern of components of the inflammasome machinery in PBMCs. Expression and changes of certain inflammasome components are associated to baseline metabolic comorbidities, including type 2 diabetes, and may be related to the improvement and reversion of some obesity-related comorbidities after bariatric surgery.
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Affiliation(s)
- Vicente Herrero-Aguayo
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba; Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
| | - Prudencio Sáez-Martínez
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Juan L López-Cánovas
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba; Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
| | - Juan J Prados-Carmona
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
| | - María D Alcántara-Laguna
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Fernando L López
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba; Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
| | - María J Molina-Puerta
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Alfonso Calañas-Continente
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Antonio Membrives
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- General Surgery Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Juan Castilla
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- General Surgery Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Juan Ruiz-Ravelo
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- General Surgery Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Rosario Alonso-Echague
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- General Surgery Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Elena M Yubero-Serrano
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Reina Sofia University Hospital, Córdoba, Spain
| | - Justo P Castaño
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba; Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
| | - Manuel D Gahete
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba; Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
| | - María A Gálvez-Moreno
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
| | - Raúl M Luque
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba; Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn); Córdoba, Spain
| | - Aura D Herrera-Martínez
- Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Córdoba, Spain
- Reina Sofia University Hospital, Córdoba, Spain
- Endocrinology and Nutrition Service, Reina Sofia University Hospital; Córdoba, Spain
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Martinussen C, Svane MS, Bojsen-Møller KN, Jensen CZ, Kristiansen VB, Bookout AL, Jørgensen SB, Holst JJ, Wewer Albrechtsen NJ, Madsbad S, Kuhre RE. Plasma GDF15 levels are similar between subjects after bariatric surgery and matched controls and are unaffected by meals. Am J Physiol Endocrinol Metab 2021; 321:E443-E452. [PMID: 34370594 DOI: 10.1152/ajpendo.00190.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Growth differentiating factor 15 (GDF15) is expressed in the intestine and is one of the most recently identified satiety peptides. The mechanisms controlling its secretion are unclear. The present study investigated whether plasma GDF15 concentrations are meal-related and if potential responses depend on macronutrient type or are affected by previous bariatric surgery. The study included 1) volunteers ingesting rapidly vs. slowly digested carbohydrates (sucrose vs. isomaltose; n = 10), 2) volunteers who had undergone Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) surgery and unoperated matched controls ingesting a liquid mixed meal (n = 9-10 in each group), and 3) individuals with previous RYGB compared with unoperated controls ingesting isocaloric glucose, fat, or protein (n = 6 in each group). Plasma was collected after an overnight fast and up to 6 h after ingestion (≥12 time points). In cohort 1, fasting GDF15 concentrations were ∼480 pg/mL. Concentrations after sucrose or isomaltose intake did not differ from baseline (P = 0.26 to P > 0.99) and total area under the curves (tAUCs were similar between groups (P = 0.77). In cohort 2, fasting GDF15 concentrations were as follows (pg/mL): RYGB = 540 ± 41.4, SG = 477 ± 36.4, and controls = 590 ± 41.8, with no between-group differences (P = 0.73). Concentrations did not increase at any postprandial time point (over all time factor: P = 0.10) and tAUCs were similar between groups (P = 0.73). In cohort 3, fasting plasma GDF15 was similar among the groups (P > 0.99) and neither glucose, fat, nor protein intake consistently increased the concentrations. In conclusion, we find that plasma GDF15 was not stimulated by meal intake and that fasting concentrations did not differ between RYGB-, SG-, and body mass index (BMI)-matched controls when investigated during the weight stable phase after RYGB and SG.NEW & NOTEWORTHY Our combined data show that GDF15 does not increase in response to a liquid meal. Moreover, we show for the first time that ingestion of sucrose, isomaltose, glucose, fat, or protein also does not increase plasma GDF15 concentrations, questioning the role of GDF15 in regulation of food source preference. Finally, we find that neither fasting nor postprandial plasma GDF15 concentrations are increased in individuals with previous bariatric surgery compared with unoperated body mass index (BMI)-matched controls.
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Affiliation(s)
- Christoffer Martinussen
- Department of Endocrinology, Hvidovre Hospital, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria Saur Svane
- Department of Endocrinology, Hvidovre Hospital, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | | | | | - Jens Juul Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicolai J Wewer Albrechtsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department for Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre Hospital, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rune Ehrenreich Kuhre
- Obesity Pharmacology, Novo Nordisk, Måløv, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Osorio-Conles Ó, Vega-Beyhart A, Ibarzabal A, Balibrea JM, Graupera I, Rimola J, Vidal J, de Hollanda A. A Distinctive NAFLD Signature in Adipose Tissue from Women with Severe Obesity. Int J Mol Sci 2021; 22:ijms221910541. [PMID: 34638880 PMCID: PMC8509058 DOI: 10.3390/ijms221910541] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 02/06/2023] Open
Abstract
Development and severity of nonalcoholic fatty liver disease (NAFLD) have been linked to obesity and white adipose tissue (WAT) dysfunction plays a key role in this relation. We compared the main features of subcutaneous (SAT) and visceral WAT (VAT) tissue dysfunction in 48 obese women without (Ob) and with NAFLD (Ob-NAFLD) undergoing bariatric surgery and matched for age, BMI and T2D status. Fat cell area, adipocyte size distribution, the degree of histological fibrosis and the mRNA expression of adipokines and genes implicated in inflammation, adipogenesis, angiogenesis, metabolism and extracellular matrix remodeling were measured by RT-qPCR in both fat depots. Ob-NAFLD group showed higher TG and lower HDL circulating levels, increased VAT fat cell area and similar WAT fibrosis in comparison with Ob group. A sPLS-DA was performed in order to identify the set of genes that better characterize the presence of NAFLD. Finally, we build a multinomial logistic model including seven genes that explained 100% of the variance in NAFLD and correctly predicted 100% of cases. Our data support the existence of distinctive NAFLD signatures in WAT from women with severe obesity. A better understanding of these pathways may help in future strategies for the prevention and treatment of NAFLD.
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Affiliation(s)
- Óscar Osorio-Conles
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló Street 149, 08036 Barcelona, Spain;
- Correspondence: ; Tel.: +34-932-275-707 (ext. 2910)
| | - Arturo Vega-Beyhart
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (A.V.-B.); (J.R.); (A.d.H.)
| | - Ainitze Ibarzabal
- Gastrointestinal Surgery Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.I.); (J.M.B.)
| | - José María Balibrea
- Gastrointestinal Surgery Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain; (A.I.); (J.M.B.)
| | - Isabel Graupera
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain;
| | - Jordi Rimola
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (A.V.-B.); (J.R.); (A.d.H.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Hospital Clínic de Barcelona, 08036 Barcelona, Spain;
| | - Josep Vidal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Rosselló Street 149, 08036 Barcelona, Spain;
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
| | - Ana de Hollanda
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (A.V.-B.); (J.R.); (A.d.H.)
- Obesity Unit, Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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11
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Pellegrini M, Rahimi F, Boschetti S, Devecchi A, De Francesco A, Mancino MV, Toppino M, Morino M, Fanni G, Ponzo V, Marzola E, Abbate Daga G, Broglio F, Ghigo E, Bo S. Pre-operative micronutrient deficiencies in patients with severe obesity candidates for bariatric surgery. J Endocrinol Invest 2021; 44:1413-1423. [PMID: 33026590 PMCID: PMC8195915 DOI: 10.1007/s40618-020-01439-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE In patients with obesity, micronutrient deficiencies have been reported both before and after bariatric surgery (BS). Obesity is a chronic pro-inflammatory status, and inflammation increases the risk of micronutrient malnutrition. Our objective was to assess in pre-BS patients the prevalence of micronutrient deficiencies and their correlation with blood values of C-reactive protein (CRP). METHODS Anthropometric data, instrumental examinations, and blood variables were centrally measured in the first 200 patients undergoing a pre-BS evaluation at the "Città della Salute e della Scienza" Hospital of Torino, starting from January 2018. RESULTS At least one micronutrient deficiency was present in 85.5% of pre-BS patients. Vitamin D deficiency was the most prevalent (74.5%), followed by folate (33.5%), iron (32%), calcium (13%), vitamin B12 (10%), and albumin (5.5%) deficiency. CRP values were high (> 5 mg/L) in 65% of the patients. These individuals showed increased rate of iron, folate, vitamin B12 deficiency, and a higher number of micronutrient deficiencies. In a multiple logistic regression model, increased CRP levels were significantly associated with deficiencies of vitamin B12 (OR = 5.84; 95% CI 1.25-27.2; p = 0.024), folate (OR = 4.02; 1.87-8.66; p < 0.001), and with the presence of ≥ 2 micronutrient deficiencies (OR = 2.31; 1.21-4.42; p = 0.01). CONCLUSIONS Micronutrient deficiencies are common in patients with severe obesity undergoing BS, especially when inflammation is present. In the presence of increased CRP values before surgery, it might be advisable to search for possible multiple micronutrient deficiencies.
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Affiliation(s)
- M Pellegrini
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - F Rahimi
- Unit of Clinical Nutrition, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - S Boschetti
- Unit of Clinical Nutrition, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - A Devecchi
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - A De Francesco
- Unit of Clinical Nutrition, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - M V Mancino
- Unit of Clinical Nutrition, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - M Toppino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - M Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - G Fanni
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - V Ponzo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy
| | - E Marzola
- Department of Neuroscience, University of Turin, Turin, Italy
| | - G Abbate Daga
- Department of Neuroscience, University of Turin, Turin, Italy
| | - F Broglio
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy
- Diabetes and Metabolic Diseases Clinic, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - E Ghigo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy
- Diabetes and Metabolic Diseases Clinic, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - S Bo
- Department of Medical Sciences, University of Turin, c.so AM Dogliotti 14, 10126, Torino, Italy.
- Diabetes and Metabolic Diseases Clinic, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy.
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12
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Lytle KA, Bush NC, Triay JM, Kellogg TA, Kendrick ML, Swain JM, Gathaiya NW, Hames KC, Jensen MD. Adipocyte Proteins and Storage of Endogenous Fatty Acids in Visceral and Subcutaneous Adipose Tissue in Severe Obesity. Obesity (Silver Spring) 2021; 29:1014-1021. [PMID: 33893721 PMCID: PMC8154683 DOI: 10.1002/oby.23149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/25/2021] [Accepted: 02/11/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study tested whether substrate concentrations or fatty acid storage proteins predict storage of endogenous lipids in visceral adipose tissue (VAT) and upper body subcutaneous adipose tissue (UBSQ) fat. METHODS The day prior to surgery, 25 patients undergoing bariatric procedures received an infusion of autologous [1-14 C]triolein-labeled very low-density lipoprotein (VLDL) particles, and during surgery, they received a continuous [U-13 C]palmitate infusion/bolus [9,10-3 H]palmitate tracer. VAT and UBSQ fat were collected to measure VLDL-triglyceride (TG) storage, direct free fatty acid (FFA) storage rates, CD36 content, lipoprotein lipase (LPL), acyl-CoA synthetase, diacylglycerol acetyl-transferase, and glycerol-3-phosphate acyltransferase activities. RESULTS Storage of VLDL-TG and FFA-palmitate in UBSQ and VAT was not different. Plasma palmitate concentrations correlated with palmitate storage rates in UBSQ and VAT (r = 0.46, P = 0.02 and r = 0.46, P = 0.02, respectively). In VAT, VLDL-TG storage was correlated with VLDL concentrations (r = 0.53, P < 0.009) and LPL (r = 0.42, P < 0.05). In UBSQ, VLDL-TG storage was correlated with LPL (r = 0.42, P < 0.05). CD36, acyl-CoA synthetase, glycerol-3-phosphate acyltransferase, and diacylglycerol acetyl-transferase were not correlated with VLDL-TG or palmitate storage. CONCLUSIONS Adipose storage of VLDL-TG is predicted by VLDL-TG concentrations and LPL; FFA concentrations predict direct adipose tissue FFA storage rates.
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Affiliation(s)
- Kelli A. Lytle
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Nikki C. Bush
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Todd A. Kellogg
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | | | - James M. Swain
- Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
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13
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Soheilipour F, Ebrahimian M, Pishgahroudsari M, Hajian M, Amirkashani D, Ordooei M, Radgoodarzi M, Eskandari D. The prevalence of zinc deficiency in morbidly obese patients before and after different types of bariatric surgery. BMC Endocr Disord 2021; 21:107. [PMID: 34030687 PMCID: PMC8147400 DOI: 10.1186/s12902-021-00763-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/04/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The prevalence of obesity is considered to be increased worldwide. Lack of mineral elements is one of the essential side effects of bariatric surgery as a trending treatment for obesity. We aimed to assess zinc deficiency among morbidly obese patients before and following different types of bariatric surgical procedures. METHODS In the present retrospective cohort study, 413 morbidly obese patients (body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 with a complication or risk factor, e.g., diabetes mellitus) were enrolled who received bariatric surgery, aged between 18 and 65 years old, and had a negative history of active consumption of alcohol and illicit drugs. Patients were assigned into three groups of bariatric surgeries: mini-gastric bypass, Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG). We recorded baseline clinical and demographic characteristics and zinc serum levels during the preoperative and postoperative follow-up periods at three, six, and 12 months after the operation. RESULTS All patients with a mean age of 40.57 ± 10.63 years and a mean preoperative BMI of 45.78 ± 6.02 kg/m2 underwent bariatric surgery. 10.2% of the bariatric patients experienced zinc deficiency before the surgery, and 27.1% at 1 year after the surgery. The results showed that 27.7% of mini-gastric bypass patients, 29.8% of RYGB, and 13.3% of SG experienced zinc deficiency 12 months following surgery. We observed no statistical differences in the preoperative and postoperative zinc deficiency between different types of surgeries. CONCLUSION A high prevalence of preoperative zinc deficiency among morbidly obese patients who underwent bariatric surgery was observed, which increased during the postoperative periods. We recommend assessing zinc serum levels and prescribing zinc supplements before the bariatric operation to alleviate the prevalence of zinc deficiency after the operation.
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Affiliation(s)
- Fahimeh Soheilipour
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Maryam Hajian
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Davoud Amirkashani
- Pediatric Endocrinology Department, Ali Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mahtab Ordooei
- Children Growth Disorder Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Radgoodarzi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Delaram Eskandari
- Endocrinology Department, Rasool Akram Medical Complex, Iran University of Medical Sciences, Tehran, Iran
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14
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Barzin M, Aryannezhad S, Khalaj A, Mahdavi M, Valizadeh M, Ghareh S, Azizi F, Hosseinpanah F. Effects of bariatric surgery in different obesity phenotypes: Tehran Obesity Treatment Study (TOTS). Obes Surg 2021; 30:461-469. [PMID: 31650407 DOI: 10.1007/s11695-019-04182-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Not all morbid obese patients suffer from metabolic co-morbidities; thus, a sub-group of metabolically healthy morbid obese (MHMO) individuals are identified. However, the role of bariatric surgery is not well understood in this subgroup. METHODS A total of 2244 morbid obese individuals aged 18-65 years undergoing bariatric surgery were selected. Patients were considered MHMO according to the joint interim statement (JIS) definition, as having two or less abnormalities in these five parameters: waist circumference (WC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), systolic or diastolic blood pressure (SBP or DBP), and fasting plasma glucose (FPG). Otherwise, they were considered metabolically unhealthy morbid obese (MUMO). Follow-up data were collected at 6, 12, and 24 months post-surgery. RESULTS Prior to surgery, 36.2% of participants were MHMO and had significantly lower BMI, WC, TG, FPG, SBP, and DBP and higher HDL-C compared to MUMO. Both MHMO and MUMO participants showed a significant decrease in BMI, WC, TG, SBP, DBP, and FPG and increase in HDL-C and the percentage of excess weight loss (%EWL). Two-year post-operative changes (from baseline) of BMI, WC, and %EWL were greater in MHMO subjects and changes of TG, HDL-C, DBP, SBP, and FPG were greater in MUMO subjects. Further multivariate regression analysis for delta (∆) change in these characteristics revealed that only the delta (∆) changes of WC and %EWL were statistically different between the two phenotypes and were greater in MHMO subjects, 2 years after the surgery (- 3.077 cm decrease in WC and + 3.612% higher %EWL compared to MUMO subjects). CONCLUSION Bariatric surgery is an effective method for reduction of metabolic abnormalities and weight loss in both MUMO and MHMO phenotypes. Benefits of this intervention are comparable between patients with these two obesity phenotypes.
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Affiliation(s)
- Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayan Aryannezhad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sahar Ghareh
- Mashhad Medical Branch, Faculty of Medicine, Islamic Azad University, Mashhad, Islamic Republic of Iran
| | - Feridoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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15
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Kokkinos A, Liaskos C, Alexiadou K, Papassotiriou I, Margeli A, Argyrakopoulou G, Perrea D, Alexandrou A, Katsilambros N, Diamantis T, Tentolouris N. Plasma levels of soluble urokinase plasminogen activator receptor (suPAR) and high-sensitivity C-reactive protein after Roux-en-Y gastric bypass or sleeve gastrectomy: a 1-year prospective observational study. J Endocrinol Invest 2021; 44:599-608. [PMID: 32681464 DOI: 10.1007/s40618-020-01358-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Low-grade inflammation in obesity contributes to the development of cardiovascular disease, diabetes mellitus and cancer, and is associated with increased mortality. The purpose of this 1-year prospective observational study was to examine the weight loss effect of bariatric surgery on plasma concentrations of two inflammatory markers, namely high-sensitivity C-reactive protein (hsCRP) and soluble urokinase-type plasminogen activator receptor (suPAR), in patients with obesity. METHODS Sixteen subjects without obesity and 32 patients with obesity class III, who had already settled upon Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were included in the study. Subjects without obesity were examined once, at baseline; patients with obesity were examined preoperatively (baseline) and 3, 6 and 12 months postoperatively. RESULTS Plasma suPAR and hsCRP concentrations at baseline were higher in patients with obesity than in lean participants (2.68 ± 0.86 vs 1.86 ± 0.34 ng/mL, p < 0.001 and 9.83 ± 9.55 vs 1.36 ± 1.95 mg/dL, p < 0.001). Levels of suPAR following bariatric surgery increased significantly 3 months after either RYGB or SG (3.58 ± 1.58 vs 3.26 ± 0.7 ng/mL, respectively) and declined at 6 (3.19 ± 1.75 vs 2.8 ± 0.84 ng/mL, respectively) and 12 months (2.6 ± 1.5 vs 2.22 ± 0.49 ng/mL, respectively; p < 0.05 for the effect of time on suPAR levels during the study), whereas those of hsCRP declined consistently after bariatric surgery (3 months: 5.44 ± 3.99 vs 9.47 ± 11.98 mg/dL, respectively; 6 months; 5.39 ± 5.6 vs 10.25 ± 17.22 mg/dL, respectively; and 12 months: 2.23 ± 2.5 vs 3.07 ± 3.63 mg/dL, respectively; p < 0.001 for the effect of time on hsCRP levels during the study). 1-year change in BMI was negatively associated with suPAR levels at 12 months. CONCLUSION Our findings support an association between obesity and low-grade inflammation. Weight loss following bariatric surgery is associated with a consistent decline in plasma hsCRP, while plasma suPAR levels increase at 3 months and decline by 12 months.
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Affiliation(s)
- A Kokkinos
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - C Liaskos
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - K Alexiadou
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - I Papassotiriou
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou Street, 11527, Athens, Greece
| | - A Margeli
- Department of Clinical Biochemistry, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou Street, 11527, Athens, Greece
| | - G Argyrakopoulou
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - D Perrea
- Laboratory of Experimental Surgery and Surgical Research "NS Christeas", Medical School, National and Kapodistrian University of Athens, 15Β Agiou Thoma Street, 11527, Athens, Greece
| | - A Alexandrou
- First Department of Surgery, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - N Katsilambros
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - T Diamantis
- First Department of Surgery, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece
| | - N Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, 17 Agiou Thoma Street, 11527, Athens, Greece.
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Miskelly MG, Shcherbina L, Thorén Fischer AH, Abels M, Lindqvist A, Wierup N. GK-rats respond to gastric bypass surgery with improved glycemia despite unaffected insulin secretion and beta cell mass. Peptides 2021; 136:170445. [PMID: 33197511 DOI: 10.1016/j.peptides.2020.170445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
Roux-en-Y gastric bypass (RYGB) is the most effective treatment for morbid obesity and results in rapid remission of type 2 diabetes (T2D), before significant weight loss occurs. The underlying mechanisms for T2D remission are not fully understood. To gain insight into these mechanisms we used RYGB-operated diabetic GK-rats and Wistar control rats. Twelve adult male Wistar- and twelve adult male GK-rats were subjected to RYGB- or sham-operation. Oral glucose tolerance tests (OGTT) were performed six weeks after surgery. RYGB normalized fasting glucose levels in GK-rats, without affecting fasting insulin levels. In both rat strains, RYGB caused increased postprandial responses in glucose, GLP-1, and GIP. RYGB caused elevated postprandial insulin secretion in Wistar-rats, but had no effect on insulin secretion in GK-rats. In agreement with this, RYGB improved HOMA-IR in GK-rats, but had no effect on HOMA-β. RYGB-operated GK-rats had an increased number of GIP receptor and GLP-1 receptor immunoreactive islet cells, but RYGB had no major effect on beta or alpha cell mass. Furthermore, in RYGB-operated GK-rats, increased Slc5a1, Pck2 and Pfkfb1 and reduced Fasn hepatic mRNA expression was observed. In summary, our data shows that RYGB induces T2D remission and enhanced postprandial incretin hormone secretion in GK-rats, without affecting insulin secretion or beta cell mass. Thus our data question the dogmatic view of how T2D remission is achieved and instead point at improved insulin sensitivity as the main mechanism of remission.
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MESH Headings
- Animals
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/surgery
- Disease Models, Animal
- Gastric Bypass
- Gastric Inhibitory Polypeptide/genetics
- Glucagon-Like Peptide 1/genetics
- Glucose Tolerance Test
- Humans
- Insulin/genetics
- Insulin/metabolism
- Insulin Secretion/genetics
- Insulin-Secreting Cells/metabolism
- Insulin-Secreting Cells/pathology
- Islets of Langerhans/metabolism
- Islets of Langerhans/pathology
- Obesity, Morbid/genetics
- Obesity, Morbid/metabolism
- Obesity, Morbid/pathology
- Obesity, Morbid/surgery
- Rats
- Rats, Wistar
- Weight Loss/genetics
- Weight Loss/physiology
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Affiliation(s)
- Michael G Miskelly
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Liliya Shcherbina
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | | | - Mia Abels
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden.
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Zhang C, Biehl Rudkjær LC, Cachón MF, Falkenhahn M, Theis S, Schmidt T, Vrang N, Jelsing J, Rigbolt K. Transcriptomic changes in pancreatic islets, adipose and liver after Roux-en-Y gastric bypass in a diet-induced obese rat model. Peptides 2021; 136:170467. [PMID: 33253774 DOI: 10.1016/j.peptides.2020.170467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/28/2020] [Accepted: 11/21/2020] [Indexed: 12/28/2022]
Abstract
Roux-en-Y gastric bypass (RYGB) is the most efficient intervention in morbid obesity and promotes metabolic improvements in several peripheral tissues. However, the underlying molecular mechanisms are still poorly understood. To further understand the effects of RYGB on peripheral tissues transcriptomes, we determined transcriptome signatures in pancreatic islets, adipose and liver tissue from diet-induced obese (DIO) rats model following RYGB. Whereas RYGB led to discrete gene expression changes in pancreatic islets, substantial transcriptome changes were observed in metabolic and immune signaling pathways in adipose tissue and the liver, indicating major gene adaptive responses in fat-storing tissues. Compared to RYGB DIO rats, peripheral tissue transcriptome signatures were markedly different in caloric restricted weight matching DIO rats, implying that caloric restriction paradigms do not reflect transcriptomic regulations of RYGB induced weight loss. The present gene expression study may serve as a basis for further investigations into molecular regulatory effects in peripheral tissues following RYGB-induced weight loss.
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Affiliation(s)
| | | | | | | | - Stefan Theis
- Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany
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Borges-Canha M, Neves JS, Mendonça F, Silva MM, Costa C, M. Cabral P, Guerreiro V, Lourenço R, Meira P, Salazar D, Ferreira MJ, Pedro J, Barkoudah E, Sande A, Lau E, B. Souto S, Preto J, Freitas P, Carvalho D. Beta Cell Function as a Baseline Predictor of Weight Loss After Bariatric Surgery. Front Endocrinol (Lausanne) 2021; 12:714173. [PMID: 34456871 PMCID: PMC8387593 DOI: 10.3389/fendo.2021.714173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/22/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Obesity is a multifactorial disease, which is strongly associated to other metabolic disorders. Bariatric surgery is the most effective treatment of morbid obesity. The role of beta cell function in weight loss after bariatric surgery is uncertain. AIM To evaluate the association between beta cell function and percentage of total body weight loss (TBWL%) 1, 2, 3, and 4 years after bariatric surgery in patients with morbid obesity. METHODS Retrospective longitudinal study in patients with morbid obesity followed in our center between January 2010 and July 2018. Patients were excluded if they had diabetes at baseline or missing data on the needed parameters. We evaluated baseline Homeostatic Model Assessment of IR, Homeostatic Model Assessment of β-cell function (HOMA-beta), Quantitative Insulin Sensitivity Check Index, and Matsuda and DeFronzo index, and TBWL% at years 1 to 4. Linear regression models were used to evaluate the association of indexes of insulin resistance with TBWL% (unadjusted and adjusted for age, sex, BMI, and type of surgery). RESULTS There were 1,561 patients included in this analysis. HOMA-beta was negatively associated with TBWL% at second, third, and fourth years post-surgery (β = -1.04 [-1.82 to -0.26], p<0.01; β = -1.16 [-2.13 to -0.19], p=0.02; β = -1.29 [-2.64 to 0.06], p=0.061, respectively). This was not observed in the first year post-surgery nor for the other indexes. Glycemia at baseline was positively associated to EWL% at second and third years post-surgery. CONCLUSION β-cell function at baseline seems to be associated to long-term weight loss, explicitly after the first year post bariatric surgery. This might be a helpful predictor of weight loss in clinical practice.
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Affiliation(s)
- Marta Borges-Canha
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- *Correspondence: Marta Borges-Canha, ; orcid.org/0000-0003-2929-3751
| | - João Sérgio Neves
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Fernando Mendonça
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Maria Manuel Silva
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Cláudia Costa
- Serviço de Endocrinologia do Instituto Português de Oncologia do Porto, Francisco Gentil, EPE, Porto, Portugal
| | - Pedro M. Cabral
- Serviço de Patologia Clínica do Centro Hospitalar Universitário Cova da Beira, EPE, Covilhã, Portugal
| | - Vanessa Guerreiro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Rita Lourenço
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Patrícia Meira
- Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto, Porto, Portugal
| | - Daniela Salazar
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Maria João Ferreira
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Jorge Pedro
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ebrahim Barkoudah
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Ana Sande
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Eva Lau
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Selma B. Souto
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - John Preto
- Serviço de Cirurgia Geral do Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Paula Freitas
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Investigação e Inovação em Saúde (i3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Davide Carvalho
- Serviço de Endocrinologia, Diabetes e Metabolismo do Centro Hospitalar Universitário de São João, Porto, Portugal
- Investigação e Inovação em Saúde (i3s), Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Mullur J, Wang A, Feldweg A. A fatal case of coronavirus disease 2019 in a patient with common variable immunodeficiency. Ann Allergy Asthma Immunol 2021; 126:90-92. [PMID: 32818593 PMCID: PMC7431323 DOI: 10.1016/j.anai.2020.08.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/06/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Jyotsna Mullur
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
| | - Alberta Wang
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anna Feldweg
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Stafeev I, Sklyanik I, Mamontova E, Michurina S, Shestakova E, Yah’yaev K, Yurasov A, Masnikov D, Sineokaya M, Ratner E, Vorotnikov A, Menshikov M, Parfyonova Y, Shestakova M. NDRG1 Activity in Fat Depots Is Associated With Type 2 Diabetes and Impaired Incretin Profile in Patients With Morbid Obesity. Front Endocrinol (Lausanne) 2021; 12:777589. [PMID: 34956089 PMCID: PMC8695674 DOI: 10.3389/fendo.2021.777589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aimed to investigate insulin-, mTOR- and SGK1-dependent signaling basal states in morbidly obese patients' fat. We analyzed the correlation between the signaling activity, carbohydrate metabolism, and incretin profiles of patients. METHODS The omental and subcutaneous fat was obtained in patients with obesity. The omental study included 16 patients with normal glucose tolerance (NGT) and 17 patients with type 2 diabetes mellitus (T2DM); the subcutaneous study included 9 NGT patients and 12 T2DM patients. Insulin resistance was evaluated using the hyperinsulinemic euglycemic clamp test and HOMA-IR index. The oral glucose tolerance test (OGTT) for NGT patients and mixed meal tolerance test (MMTT) for T2DM patients were performed. The levels of incretins (GLP-1, GIP, oxyntomodulin) and glucagon were measured during the tests. Signaling was analyzed by Western blotting in adipose tissue biopsies. RESULTS We have shown equal levels of basal phosphorylation of insulin- and mTOR-dependent signaling in omental fat depot in NGT and T2DM obese patients. Nevertheless, pNDRG1-T346 was decreased in omental fat of T2DM patients. Correlation analysis has shown an inverse correlation of pNDRG1-T346 in omental fat and diabetic phenotype (HbA1c, impaired incretin profile (AUC GLP-1, glucagon)). Moreover, pNDRG1-T346 in subcutaneous fat correlated with impaired incretin levels among obese patients (inverse correlation with AUC glucagon and AUC GIP). CONCLUSIONS According to results of the present study, we hypothesize that phosphorylation of pNDRG1-T346 can be related to impairment in incretin hormone processing. pNDRG1-T346 in adipose tissue may serve as a marker of diabetes-associated impairments of the systemic incretin profile and insulin sensitivity.
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Affiliation(s)
- Iurii Stafeev
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
- *Correspondence: Iurii Stafeev,
| | - Igor Sklyanik
- Diabetes Institute, Endocrinology Research Centre, Moscow, Russia
| | - Elizaveta Mamontova
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
- Diabetes Institute, Endocrinology Research Centre, Moscow, Russia
- Faculty of Basic Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Svetlana Michurina
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
- Diabetes Institute, Endocrinology Research Centre, Moscow, Russia
- Faculty of Biology, Lomonosov Moscow State University, Moscow, Russia
| | | | - Kamil Yah’yaev
- Surgery Department, Central Clinical Hospital #1 of Open Join Stock Company (OJSC) Russian Railways, Moscow, Russia
| | - Anatoliy Yurasov
- Faculty of Basic Medicine, Lomonosov Moscow State University, Moscow, Russia
- Surgery Department, Central Clinical Hospital #1 of Open Join Stock Company (OJSC) Russian Railways, Moscow, Russia
| | - Denis Masnikov
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
- Center of Master’s Programs, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Maria Sineokaya
- Diabetes Institute, Endocrinology Research Centre, Moscow, Russia
| | - Elizaveta Ratner
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
- Diabetes Institute, Endocrinology Research Centre, Moscow, Russia
| | - Alexander Vorotnikov
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
| | - Mikhail Menshikov
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
| | - Yelena Parfyonova
- The Institute of Experimental Cardiology, National Medical Research Center for Cardiology, Moscow, Russia
- Faculty of Basic Medicine, Lomonosov Moscow State University, Moscow, Russia
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Istfan NW, Lipartia M, Anderson WA, Hess DT, Apovian CM. Approach to the Patient: Management of the Post-Bariatric Surgery Patient With Weight Regain. J Clin Endocrinol Metab 2021; 106:251-263. [PMID: 33119080 PMCID: PMC7765654 DOI: 10.1210/clinem/dgaa702] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
CONTEXT Weight regain (WR) after bariatric surgery is emerging as a common clinical problem due to the increase in the number of procedures performed. Early interventions are necessary to curtail the potential recurrence of comorbid conditions. However, it is often difficult to recognize WR early enough to introduce mitigating measures because there are no current guidelines for timely diagnosis and assessment of the severity of this condition. OBJECTIVE We present a practical approach for the early recognition of WR, based on 11-year follow-up data from our multiethnic bariatric surgery patient population. METHODS We classify WR according to the rate of increase in weight relative to nadir weight, normalized per 30-day interval. We also review pertinent literature about the etiologic factors contributing to WR after bariatric surgery. RESULTS According to our algorithm, mild, moderate, and rapid WR are defined as weight increases of 0.2% to <0.5%, 0.5% to 1.0%, and more than 1.0% of nadir weight per 30 days, respectively. Treatment options, including dietary counseling, use of antiobesity medication, and consideration of surgical revision, are described. A case is presented to illustrate the utility of timely identification of WR and the importance of collaboration between bariatric surgeons, obesity medicine specialists, and dietitians. CONCLUSION Our approach emphasizes the importance of regular long-term follow-up for all bariatric surgery patients.
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Affiliation(s)
- Nawfal W Istfan
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Marine Lipartia
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Wendy A Anderson
- Section of Minimally Invasive Surgery, Department of Surgery, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Donald T Hess
- Section of Minimally Invasive Surgery, Department of Surgery, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Caroline M Apovian
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
- Correspondence and Reprint Requests: Caroline M. Apovian, MD, Boston Medical Center, 720 Harrison Ave, Ste 8100, Boston, MA 02118, USA. E-mail:
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Chandru S, Pramodkumar TA, Pradeepa R, Muthukumar S, Balasubramanyam M, Bhuvaneshwari R, Anjana RM, Mohan V. Outcomes of metabolic surgery in obese patients with type 2 diabetes with respect to impact on beta cell function, insulin sensitivity and diabetes remission - A study from south India. Diabetes Metab Syndr 2020; 14:1829-1835. [PMID: 32961515 DOI: 10.1016/j.dsx.2020.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Metabolic surgery is gaining popularity as a procedure for the treatment of morbid obesity among patients with type 2 diabetes (T2DM). The aim of the study was to evaluate the effects of metabolic surgery on beta cell function, insulin sensitivity and glycemic status in obese Asian Indian patients. METHODS This is a prospective study of 26 patients with T2DM who underwent metabolic surgery. Complete diabetes remission was defined as FPG<100 mg/dl and HbA1c < 6%, without antidiabetic medications one-year post surgery. Anthropometry, HOMA-IR (insulin resistance), HOMA-insulin sensitivity, beta cell function and antidiabetic drug usage were measured at baseline, 6 months and 12 months post-surgery. RESULTS The overall duration of diabetes was 10.3 ± 5.4 years. At one year, 7 (27%) of 26 T2DM patients, achieved diabetes remission while the other 19 had improvement in diabetes status. ROC curves showed that those who had diabetes duration <8.5 years achieved remission. There was a significant decrease in HOMA-IR [3.7 ± 1.8 vs 1.4 ± 0.9 vs1.2 ± 0.6, p < 0.001] and improvement in HOMA-Insulin sensitivity [34 ± 17 vs 93 ± 50 vs 112 ± 62, p < 0.001] from baseline to 6 and 12 months post-surgery respectively. There was a significant (p < 0.001) reduction in the usage of anti-diabetes medications post-surgery. The limitations of this study are small sample size and limited follow up period of 1 year. CONCLUSIONS Among T2DM patients, metabolic surgery resulted in significant improvement in beta cell function and insulin sensitivity along with reduction in anti-diabetes medication. Diabetes remission was mainly seen in those who had duration of diabetes <8.5 years.
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Affiliation(s)
- Sundaramoorthy Chandru
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India; University of Madras, Chennai, India.
| | | | - Rajendra Pradeepa
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | | | - Raghavan Bhuvaneshwari
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialities Centre, Chennai, India
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23
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Perakakis N, Kokkinos A, Peradze N, Tentolouris N, Ghaly W, Tsilingiris D, Alexandrou A, Mantzoros CS. Metabolic regulation of activins in healthy individuals and in obese patients undergoing bariatric surgery. Diabetes Metab Res Rev 2020; 36:e3297. [PMID: 32026536 DOI: 10.1002/dmrr.3297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/12/2019] [Accepted: 02/02/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Follistatin binds and inactivates activins, which are potent inhibitors of muscle growth and metabolism and are currently being developed for the treatment of obesity and type 2 diabetes (T2D). We have recently reported that follistatin is regulated by glucose (and not lipids) and can prospectively predict the metabolic improvements observed after bariatric surgery. We utilized novel assays herein to investigate whether activins are regulated by glucose or lipids, whether their circulating levels change after bariatric surgery and whether these changes are predictors of metabolic outcomes up to 12 months later. DESIGN AND METHODS Activin A, B, AB and their ratios to follistatin were measured in (a) healthy humans (n = 32) undergoing oral or intravenous lipid or glucose intake over 6 h, (b) morbidly obese individuals with or without type 2 diabetes undergoing three different types of bariatric surgery (gastric banding, Roux-en-Y bypass or sleeve gastrectomy) in two clinical studies (n = 14 for the first and n = 27 for the second study). RESULTS Glucose intake downregulates circulating activin A, B and AB, indicating the presence of a feedback loop. Activin A decreases (~30%), activin AB increases (~25%) and activin B does not change after bariatric surgery. The changes in activin AB and its ratio to follistatin 3 months after bariatric surgery can predict the BMI reduction and the improvement in insulin and HOMA-IR observed 6 months postoperatively. CONCLUSION Activins are implicated in glucose regulation in humans as part of a feedback loop with glucose or insulin and predict metabolic outcomes prospectively after bariatric surgery.
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Affiliation(s)
- Nikolaos Perakakis
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Natia Peradze
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Wael Ghaly
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
| | - Dimitrios Tsilingiris
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Andreas Alexandrou
- First Department of Surgery, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA
- Department of Medicine, Boston VA Healthcare System, Boston, MA, USA
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Marciniak C, Duhem C, Boulinguiez A, Raverdy V, Baud G, Verkindt H, Caiazzo R, Staels B, Duez H, Pattou F, Lancel S. Differential unfolded protein response in skeletal muscle from non-diabetic glucose tolerant or intolerant patients with obesity before and after bariatric surgery. Acta Diabetol 2020; 57:819-826. [PMID: 32086613 DOI: 10.1007/s00592-020-01490-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/21/2020] [Indexed: 01/08/2023]
Abstract
AIMS Not all people with obesity become glucose intolerant, suggesting differential activation of cellular pathways. The unfolded protein response (UPR) may contribute to the development of insulin resistance in several organs, but its role in skeletal muscle remains debated. Therefore, we explored the UPR activation in muscle from non-diabetic glucose tolerant or intolerant patients with obesity and the impact of bariatric procedures. METHODS Muscle biopsies from 22 normoglycemic (NG, blood glucose measured 120 min after an oral glucose tolerance test, G120 < 7.8 mM) and 22 glucose intolerant (GI, G120 between 7.8 and 11.1 mM) patients with obesity were used to measure UPR activation by RTqPCR and western blot. Then, UPR was studied in biopsies from 7 NG and 7 GI patients before and 1 year after bariatric surgery. RESULTS Binding immunoglobulin protein (BIP) protein was ~ 40% higher in the GI compared to NG subjects. Contrastingly, expression of the UPR-related genes BIP, activating transcription factor 6 (ATF6) and unspliced X-box binding protein 1 (XBP1u) were significantly lower and C/EBP homologous protein (CHOP) tended to decrease (p = 0.08) in GI individuals. While BIP protein positively correlated with fasting blood glucose (r = 0.38, p = 0.01), ATF6 and CHOP were associated with G120 (r = - 0.38 and r = - 0.41, p < 0.05) and the Matsuda index (r = 0.37 and r = 0.38, p < 0.05). Bariatric surgery improved metabolic parameters, associated with higher CHOP expression in GI patients, while ATF6 tended to increase (p = 0.08). CONCLUSIONS CHOP and ATF6 expression decreased in non-diabetic GI patients with obesity and was modified by bariatric surgery. These genes may contribute to glucose homeostasis in human skeletal muscle.
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Affiliation(s)
- Camille Marciniak
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, F-59000, Lille, France
| | - Christian Duhem
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, F-59000, Lille, France
| | - Alexis Boulinguiez
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, F-59000, Lille, France
| | - Violeta Raverdy
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, F-59000, Lille, France
| | - Gregory Baud
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, F-59000, Lille, France
| | - Hélène Verkindt
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, F-59000, Lille, France
| | - Robert Caiazzo
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, F-59000, Lille, France
| | - Bart Staels
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, F-59000, Lille, France
| | - Hélène Duez
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, F-59000, Lille, France
| | - François Pattou
- Univ. Lille, Inserm, CHU Lille, U1190 - EGID, F-59000, Lille, France
| | - Steve Lancel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, F-59000, Lille, France.
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Pinhel MAS, Noronha NY, Nicoletti CF, Pereira VAB, de Oliveira BAP, Cortes-Oliveira C, Salgado W, Barbosa F, Marchini JS, Souza DRS, Nonino CB. Changes in DNA Methylation and Gene Expression of Insulin and Obesity-Related Gene PIK3R1 after Roux-en-Y Gastric Bypass. Int J Mol Sci 2020; 21:E4476. [PMID: 32599690 PMCID: PMC7352760 DOI: 10.3390/ijms21124476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 11/18/2022] Open
Abstract
Weight regulation and the magnitude of weight loss after a Roux-en-Y gastric bypass (RYGB) can be genetically determined. DNA methylation patterns and the expression of some genes can be altered after weight loss interventions, including RYGB. The present study aimed to evaluate how the gene expression and DNA methylation of PIK3R1, an obesity and insulin-related gene, change after RYGB. Blood samples were obtained from 13 women (35.9 ± 9.2 years) with severe obesity before and six months after surgical procedure. Whole blood transcriptome and epigenomic patterns were assessed by microarray-based, genome-wide technologies. A total of 1966 differentially expressed genes were identified in the pre- and postoperative periods of RYGB. From these, we observed that genes involved in obesity and insulin pathways were upregulated after surgery. Then, the PIK3R1 gene was selected for further RT-qPCR analysis and cytosine-guanine nucleotide (CpG) sites methylation evaluation. We observed that the PI3KR1 gene was upregulated, and six DNA methylation CpG sites were differently methylated after bariatric surgery. In conclusion, we found that RYGB upregulates genes involved in obesity and insulin pathways.
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Affiliation(s)
- Marcela A S Pinhel
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
- Department of Molecular Biology, São José do Rio Preto Medical School, São José do Rio Preto 15090-000, Brazil;
| | - Natália Y Noronha
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Carolina F Nicoletti
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Vanessa AB Pereira
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Bruno AP de Oliveira
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Cristiana Cortes-Oliveira
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Wilson Salgado
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Fernando Barbosa
- School of Pharmaceutical Sciences of Ribeirão Preto, Ribeirão Preto 14040-900, Brazil;
| | - Júlio S Marchini
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
| | - Doroteia RS Souza
- Department of Molecular Biology, São José do Rio Preto Medical School, São José do Rio Preto 15090-000, Brazil;
| | - Carla B Nonino
- Laboratory of Nutrigenomics Studies, Health Science Department, Ribeirão Preto Medical School, Ribeirão Preto 14049-900, Brazil; (M.A.S.P.); (N.Y.N.); (C.F.N.); (V.A.B.P.); (B.A.P.d.O.); (C.C.-O.); (W.S.J.); (J.S.M.)
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Di Furia M, Romano L, Salvatorelli A, Brandolin D, Lomanto D, Cianca G, Schietroma M, Carlei F, Giuliani A. Indocyanine Green Fluorescent Angiography During Laparoscopic Sleeve Gastrectomy: Preliminary Results. Obes Surg 2020; 29:3786-3790. [PMID: 31290111 DOI: 10.1007/s11695-019-04085-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Indocyanine green (ICG) fluorescent angiography has been routinely applied for various laparoscopic procedures to evaluate the tissue blood supply. A promising branch for this technology is represented by bariatric surgery, especially to estimate the risk of gastric leak after laparoscopic sleeve gastrectomy (LSG), which seems mainly related to ischemia of the stomach. MATERIALS AND METHODS 43 consecutive patients from January 2018 to March 2019 underwent in our institution LSG with intravenous injection of 5 ml ICG after the realization of gastric tube to evaluate the blood supply of the gastric tube. RESULTS In all 43 cases, there have been no adverse events related to ICG. The vascular supply to stomach was estimated "satisfactory" along the stapled line in all cases. However, one patient showed signs and symptoms indicative of gastric leak in the fifth post-op day and diagnosis was confirmed by CT scan with Gastrografin. CONCLUSIONS From our preliminary data, the intraoperative view of the blood supply of the stomach does not seem to represent a prognostic factor for the risk of gastric leak, suggesting a complex multifactorial etiology (intragastric hypertension? Abnormal inflammatory response?) which needs further data to be established.
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Affiliation(s)
- Marino Di Furia
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy.
| | - Lucia Romano
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Andrea Salvatorelli
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Denise Brandolin
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Davide Lomanto
- Department of Surgery, Division of Upper Gastrointestinal Surgery, National University Hospital, Singapore, Singapore
| | - Giovanni Cianca
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Mario Schietroma
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Francesco Carlei
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Antonio Giuliani
- Department of General Surgery, Hospital San Salvatore L'Aquila, University of L'Aquila, L'Aquila, Italy
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Shah K, Nergård BJ, Fagerland MW, Gislason H. Limb Length in Gastric Bypass in Super-Obese Patients-Importance of Length of Total Alimentary Small Bowel Tract. Obes Surg 2020; 29:2012-2021. [PMID: 30929197 DOI: 10.1007/s11695-019-03836-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND In super-obese patients, rates of weight loss failure and weight regain are high after RYGB. In order to improve weight loss, lengthening of the biliopancreatic limb is vital. In this study, efficacy and safety of two types of RYGB with 2-m BP-limb were assessed in improving weight loss and in the resolution of comorbidities compared with standard RYGB in a long-term follow-up. METHODS This is a retrospective cohort analysis on 671 super-obese patients operated in a 10-year period. Patients were classified into three groups: (1) 155 patients; roux limb 150 cm, BP-limb 60 cm; (2) 230 patients; roux limb 60 cm, BP-limb 200 cm; and (3) 286 patients; roux limb 150 cm, BP-limb 200 cm. EWL, TWL, BMI, failure, weight regain, comorbidity resolution, nutritional status, and complications were assessed. RESULTS Total alimentary limb length was shortened with 60 cm in group 1 and with 200 cm in groups 2 and 3. EWL, BMI change, and TWL were higher in the 2-m BP-limb groups vs group 1. No differences in complication rates were found, except higher frequency of marginal ulcers in patients with a shorter roux limb. EWL failure was higher in group 1 (10.3%) vs the other groups (4.3%; 5.2%). Group 3 had significantly less weight regain (26.6%). Remission of comorbidities was higher in the 2-m BP-limb groups at expense of nutritional and vitamin deficiencies (3.9%; 5.9%). No difference in hypoalbuminemia was noted. CONCLUSION Lengthening of the BP-limb gives significantly higher weight loss, lower rate of EWL failure, and lesser weight regain along with better resolution of obesity-associated comorbidities.
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Affiliation(s)
- Kamran Shah
- Aleris Obesity Clinic and Department of Surgery, Aleris Hospital, Fredrik-Stangsgate 11-13, 0264, Oslo, Norway.
| | - Bent Johnny Nergård
- Aleris Obesity Clinic and Department of Surgery, Aleris Hospital, Fredrik-Stangsgate 11-13, 0264, Oslo, Norway
| | - Morten Wang Fagerland
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Hjörtur Gislason
- Aleris Obesity Clinic and Department of Surgery, Aleris Hospital, Fredrik-Stangsgate 11-13, 0264, Oslo, Norway
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Suwannasrisuk P, Boonchaya-Anant P, Houngngam N, Udomsawaengsup S, Sunthornyothin S. Changes in plasma aldosterone level after weight loss by bariatric surgery in morbidly obese patients. BMC Endocr Disord 2020; 20:45. [PMID: 32252748 PMCID: PMC7132890 DOI: 10.1186/s12902-020-0527-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 03/24/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Overactivation of renin-aldosterone-angiotensin system (RAS) is part of the pathogenesis of obesity-associated hypertension. Evidences have shown that weight loss can result in reduction in blood pressure and RAS. This study was aim to investigate changes of plasma aldosterone concentration (PAC) after bariatric surgery. METHODS A prospective study was done in 14 morbidly obese patients undergoing bariatric surgery. Patients who were taking medications that can interfere with PAC and renin levels were excluded. Collection of blood samples were done at baseline and at 3 and 6-month post-bariatric surgery. RESULTS Four out of 14 patients had hypertension at baseline. Mean body mass index (BMI) was 56.7 ± 13.5 kg/m2. PAC were significantly decreased at 3-and 6-month post-bariatric surgery from 14.3 ± 8.0 to 7.5 ± 5.5 [reduction of 36% from baseline (P < 0.01)] and 8.0 ± 6.6 ng/dl [reduction of 32% from baseline (P < 0.05)] respectively. The reduction of PAC at 3-month post-surgery was correlated with the reduction of body weight (r = 0.46, P < 0.05), waist circumference (r = 0.73, P < 0.05) and percent of body fat (r = 0.58, P < 0.05). CONCLUSIONS Maximal reduction of PAC in obese patients underwent bariatric surgery occurred during the first 3 months after bariatric surgery. The reduction of PAC was associated with the reduction of body weight, waist circumference and percent of body fat suggesting the link between RAS and obesity-mediated hypertension.
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Affiliation(s)
- Preaw Suwannasrisuk
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.
| | - Patchaya Boonchaya-Anant
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center in Diabetes, Hormones and Metabolism, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Natnicha Houngngam
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center in Diabetes, Hormones and Metabolism, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Suthep Udomsawaengsup
- Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sarat Sunthornyothin
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Excellence Center in Diabetes, Hormones and Metabolism, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
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Coccia F, Testa M, Guarisco G, Bonci E, Di Cristofano C, Silecchia G, Leonetti F, Gastaldelli A, Capoccia D. Noninvasive assessment of hepatic steatosis and fibrosis in patients with severe obesity. Endocrine 2020; 67:569-578. [PMID: 31858390 DOI: 10.1007/s12020-019-02155-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE In morbid obesity nonalcoholic fatty liver disease (NAFLD) is endemic. Aim of this study is to evaluate the diagnostic accuracy of the most common noninvasive methods for identify NAFLD and fibrosis in a cohort of morbid obese population. METHODS Ninety morbid obese patients undergoing bariatric surgery (BS) and intraoperative liver biopsy were evaluated preoperatively with Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and serum biomarkers for steatosis and fibrosis and liver stiffness measurement (LSM) using acoustic radiation force impulse (ARFI) elastography. All nondiabetic patient (n = 77) underwent OGTT and calculation of Oral Glucose Insulin Sensitivity index (OGIS). RESULTS In the entire cohort prevalence of NAFLD was 77%, NASH 24%, moderate/severe steatosis 50%, and significant fibrosis 14%. New cut-offs were evaluated for all steatosis score assessed in this population. In all patients with moderate/severe steatosis HOMA IR was significantly greater than 3.5. ALT, GGT, Triglycerides, HOMA IR, and ARFI increased with fibrosis grade (p 0.03, p 0.008, p 0.04, p 0.05, respectively) and AST to Platelet ratio (APRI) was the only noninvasive fibrosis score significantly increased in significant fibrosis (p 0.04). A combination of 1/OGIS and VAI was able to discriminate NASH from simple steatosis (NAFL) (p 0.02). CONCLUSIONS In morbid obese subjects, we calculated new cut-offs of the most common steatosis indexes and found that a score based on insulin resistance (1/OGIS) and abdominal obesity (VAI) could represent a way to identify morbid obese subjects at risk of NASH.
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Affiliation(s)
- Federica Coccia
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy
| | - Moira Testa
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy
| | - Gloria Guarisco
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy
| | - Enea Bonci
- Department of Experimental Medicine, Sapienza University of Rome, Latina, Italy
| | - Claudio Di Cristofano
- Pathology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Gianfranco Silecchia
- General Surgery Unit and Bariatric Centre of Excellence, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Frida Leonetti
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy.
| | - Amalia Gastaldelli
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Danila Capoccia
- Diabetes Unit, Department of Medical-Surgical Sciences and Biotechnologies, Santa Maria Goretti Hospital, Sapienza University of Rome, Via Guido Reni 1, 04100, Latina, Italy
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Nogacka AM, Salazar N, Arboleya S, Ruas-Madiedo P, Mancabelli L, Suarez A, Martinez-Faedo C, Ventura M, Tochio T, Hirano K, Endo A, G. de los Reyes-Gavilán C, Gueimonde M. In Vitro Evaluation of Different Prebiotics on the Modulation of Gut Microbiota Composition and Function in Morbid Obese and Normal-Weight Subjects. Int J Mol Sci 2020; 21:E906. [PMID: 32019174 PMCID: PMC7038051 DOI: 10.3390/ijms21030906] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/13/2020] [Accepted: 01/28/2020] [Indexed: 02/07/2023] Open
Abstract
The gut microbiota remains relatively stable during adulthood; however, certain intrinsic and environmental factors can lead to microbiota dysbiosis. Its restoration towards a healthy condition using best-suited prebiotics requires previous development of in vitro models for evaluating their functionality. Herein, we carried out fecal cultures with microbiota from healthy normal-weight and morbid obese adults. Cultures were supplemented with different inulin-type fructans (1-kestose, Actilight, P95, Synergy1 and Inulin) and a galactooligosaccharide. Their impact on the gut microbiota was assessed by monitoring gas production and evaluating changes in the microbiota composition (qPCR and 16S rRNA gene profiling) and metabolic activity (gas chromatography). Additionally, the effect on the bifidobacterial species was assessed (ITS-sequencing). Moreover, the functionality of the microbiota before and after prebiotic-modulation was determined in an in vitro model of interaction with an intestinal cell line. In general, 1-kestose was the compound showing the largest effects. The modulation with prebiotics led to significant increases in the Bacteroides group and Faecalibacterium in obese subjects, whereas in normal-weight individuals, substantial rises in Bifidobacterium and Faecalibacterium were appreciated. Notably, the results obtained showed differences in the responses among the tested compounds but also among the studied human populations, indicating the need for developing population-specific products.
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Affiliation(s)
- Alicja M. Nogacka
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; (N.S.); (S.A.); (P.R.-M.); (C.G.d.l.R.-G.); (M.G.)
- Diet, Human Microbiota and Health Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain;
| | - Nuria Salazar
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; (N.S.); (S.A.); (P.R.-M.); (C.G.d.l.R.-G.); (M.G.)
- Diet, Human Microbiota and Health Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain;
| | - Silvia Arboleya
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; (N.S.); (S.A.); (P.R.-M.); (C.G.d.l.R.-G.); (M.G.)
- Diet, Human Microbiota and Health Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain;
| | - Patricia Ruas-Madiedo
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; (N.S.); (S.A.); (P.R.-M.); (C.G.d.l.R.-G.); (M.G.)
- Functionality and Ecology of Beneficial Microorganisms, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
| | - Leonardo Mancabelli
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, 43121 Parma, Italy; (L.M.); (M.V.)
| | - Adolfo Suarez
- Diet, Human Microbiota and Health Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain;
- Digestive Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Asturias, Spain
| | - Ceferino Martinez-Faedo
- Endocrinology and Nutrition Service, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Asturias, Spain;
- Endocrinology, Nutrition, Diabetes and Obesity Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain
| | - Marco Ventura
- Laboratory of Probiogenomics, Department of Life Sciences, University of Parma, 43121 Parma, Italy; (L.M.); (M.V.)
| | - Takumi Tochio
- β-Food Sciences Co., Chita 478-0046, Japan; (T.T.); (K.H.)
| | | | - Akihito Endo
- Department of Food and Cosmetic Science, Tokyo University of Agriculture, Abashiri 099-2493, Japan;
| | - Clara G. de los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; (N.S.); (S.A.); (P.R.-M.); (C.G.d.l.R.-G.); (M.G.)
- Diet, Human Microbiota and Health Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain;
| | - Miguel Gueimonde
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC), 33300 Villaviciosa, Asturias, Spain; (N.S.); (S.A.); (P.R.-M.); (C.G.d.l.R.-G.); (M.G.)
- Diet, Human Microbiota and Health Group, Institute of Health Research of the Principality of Asturias (ISPA), 33011 Oviedo, Spain;
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Sandvik J, Hole T, Klöckner C, Kulseng B, Wibe A. The Impact of Post-bariatric Abdominoplasty on Secondary Weight Regain After Roux-en-Y Gastric Bypass. Front Endocrinol (Lausanne) 2020; 11:459. [PMID: 32849265 PMCID: PMC7406571 DOI: 10.3389/fendo.2020.00459] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/11/2020] [Indexed: 11/25/2022] Open
Abstract
Roux-en-Y gastric bypass (RYGB), implies a considerable weight loss during the first two years after surgery. Excess skin due to rapid weight loss might affect self-esteem, decrease quality of life and be a hindrance to physical activity. Removing excess skin might reduce secondary weight regain. Among plastic surgeons, a BMI <30 kg/m2 is usually required to have abdominoplasty (AP). Many RYGB patients never reach this threshold even if they have a considerable weight loss and experience practical as well as emotional problems due to excess skin. The aim of this study was to investigate the role of abominoplasty on weight development until five years, among patients who did and did not achieve a nadir BMI <30 kg/m2 during the first two years after RYGB. Data on 645 patients from a single center RYGB-quality register from 2004 to 2013 with baseline and follow-up data were analyzed. Post-bariatric AP was publicly funded if medically needed. Weight regain (WR) from nadir weight to five years was analyzed as percentage WR of maximal weight loss. Nadir BMI was available in 633 (98.1%) patients, and BMI after five years in 553 (85.7%) patients. The 233 patients with nadir BMI <30 kg/m2 who underwent AP regained 17.8 (±16.1) % of their maximal weight loss at five years compared to 24.2 (±19.7) % in 185 patients not having AP (p < 0.001). The 27 patients with nadir BMI > 30 kg/m2 within two years after RYGB who underwent AP regained 12.9 (±19.3) % compared to 31.4 (±24.7) % in 188 patients without AP (p < 0.001). This procedure was more common among women than men, as 224 (46.4%) women, and 36 (22.2%) men underwent AP. Abdominoplasty was associated with reduced secondary weight regain after RYGB in this study. Whether this is caused by increased bodily satisfaction and better physical function, or a biological response to reduction of adipose tissue remains unclear. If removing abdominal subcutaneous adipose tissue prevent secondary weight regain and increase the robustness of bariatric surgery, this should be offered as part of the standard treatment after bariatric surgery.
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Affiliation(s)
- Jorunn Sandvik
- Clinic of Medicine and Rehabilitation, Møre and Romsdal Hospital Trust, Alesund, Norway
- Department of Surgery, Center for Obesity, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
- Obesity Research Group, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- *Correspondence: Jorunn Sandvik ;
| | - Torstein Hole
- Clinic of Medicine and Rehabilitation, Møre and Romsdal Hospital Trust, Alesund, Norway
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christian Klöckner
- Department of Surgery, Center for Obesity, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Psychology, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Bård Kulseng
- Department of Surgery, Center for Obesity, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
- Obesity Research Group, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arne Wibe
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
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Abstract
Sleeve gastrectomy (SG) is currently the most popular bariatric procedure. Portomesenteric venous thrombosis (PVT) is a feared and increasingly reported complication. Herein, we describe the history of a patient who developed a post-operative PVT after SG, aggravated with refractory ascites, and finally required orthotopic liver transplantation (LT). Acquired thrombophilia-anti-cardiolipin syndrome was present. As SG expands worldwide, this first case of LT for PVT following SG may warrant a systematic screening for prothrombotic condition and information on the possible consequences of PVT prior to bariatric surgery.
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Affiliation(s)
- J Danion
- Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Pitié-Salpêtrière University Hospital, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - L Genser
- Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Pitié-Salpêtrière University Hospital, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - O Scatton
- Assistance Publique-Hôpitaux de Paris, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Liver Transplantation, Pitié-Salpêtrière University Hospital, Sorbonne University, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
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Bastos ELDS, Liberatore AMA, Tedesco RC, Koh IHJ. Gut Microbiota Imbalance Can Be Associated with Non-malabsorptive Small Bowel Shortening Regardless of Blind Loop. Obes Surg 2019; 29:369-375. [PMID: 30293133 DOI: 10.1007/s11695-018-3540-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Some traditional bariatric surgery procedures may lead to functional gut shortening, which may unsettle the fine-tuned gastrointestinal physiology and affect gut microbiota balance. PURPOSE Evaluate the gut microbiota behavior in rat models facing gut shortening due to intestinal bypass. MATERIALS AND METHODS Wistar rats (n = 17) were randomly distributed in three groups: (1) sham group (n = 5); (2) blind loop group (n = 6); and (3) resection group (n = 6). Intestinal samples and feces were analyzed to measure bacterial concentrations (small intestinal bacterial overgrowth-SIBO) 12 weeks after the experimental procedures. Bacterial translocation (BT) was investigated in the mesenteric lymph node (MLN), liver, spleen, and lung of the animals. In addition, inflammatory aspects were investigated in their liver and small bowel through histological analysis. RESULTS Regardless of blind loop, gut shortening groups recorded similar high level of bacterial concentrations in intestine compartments, greater than that of the sham group (p ≤ 0.05). BT was only observed in the MLN of gut shortening models, with higher percentage in the blind loop group (p ≤ 0.05). The gut and liver histopathological analysis showed similar low-grade chronic inflammation in both gut shortening groups, likely associated with SIBO/BT events. CONCLUSION Sustained SIBO/BT was associated with proximal gut shortening in half regardless of blind loop, whereas the GI tract's ability to restore gut microbiota balance after a surgical challenge on the small bowel appears to be linked to the functional remaining gut.
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Affiliation(s)
- Eduardo Lemos de Souza Bastos
- Department of Gastrointestinal Surgery, Marilia Medicine School, 12 Santa Helena St., Marilia, Sao Paulo, 17515-410, Brazil.
| | | | - Roberto Carlos Tedesco
- Department of Morphology and Genetics, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Ivan Hong Jun Koh
- Department of Surgery and Experimental Research Laboratory, Federal University of Sao Paulo, Sao Paulo, Brazil
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Lytle KA, Bush NC, Triay JM, Kellogg TA, Kendrick ML, Swain JM, Gathaiya NW, Hames KC, Jensen MD. Hepatic Fatty Acid Balance and Hepatic Fat Content in Humans With Severe Obesity. J Clin Endocrinol Metab 2019; 104:6171-6181. [PMID: 31408176 PMCID: PMC6821207 DOI: 10.1210/jc.2019-00875] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 08/07/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Nonalcoholic fatty liver disease can lead to hepatic inflammation/damage. Understanding the physiological mechanisms that contribute to excess hepatic lipid accumulation may help identify effective treatments. DESIGN We recruited 25 nondiabetic patients with severe obesity scheduled for bariatric surgery. To evaluate liver export of triglyceride fatty acids, we measured very-low-density lipoprotein (VLDL)-triglyceride secretion rates the day prior to surgery using an infusion of autologous [1-14C]triolein-labeled VLDL particles. Ketone body response to fasting and intrahepatic long-chain acylcarnitine concentrations were used as indices of hepatic fatty acid oxidation. We measured intraoperative hepatic uptake rates of plasma free fatty acids using a continuous infusion of [U-13C]palmitate, combined with a bolus dose of [9,10-3H]palmitate and carefully timed liver biopsies. Total intrahepatic lipids were measured in liver biopsy samples to determine fatty liver status. The hepatic concentrations and enrichment from [U-13C]palmitate in diacylglycerols, sphingolipids, and acyl-carnitines were measured using liquid chromatography/tandem mass spectrometry. RESULTS Among study participants with fatty liver disease, intrahepatic lipid was negatively correlated with VLDL-triglyceride secretion rates (r = -0.92, P = 0.01) but unrelated to hepatic free fatty acid uptake or indices of hepatic fatty acid oxidation. VLDL-triglyceride secretion rates were positively correlated with hepatic concentrations of saturated diacylglycerol (r = 0.46, P = 0.02) and sphingosine-1-phosphate (r = 0.44, P = 0.03). CONCLUSION We conclude that in nondiabetic humans with severe obesity, excess intrahepatic lipid is associated with limited export of triglyceride in VLDL particles rather than increased uptake of systemic free fatty acids.
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Affiliation(s)
- Kelli A Lytle
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
| | - Nikki C Bush
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
| | | | - Todd A Kellogg
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - James M Swain
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
| | | | | | - Michael D Jensen
- Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
- Correspondence: Michael D. Jensen, MD, Endocrine Research Unit, 5-194 Joseph, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905. E-mail:
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Ozeki Y, Masaki T, Yoshida Y, Okamoto M, Anai M, Gotoh K, Endo Y, Ohta M, Inomata M, Shibata H. Relationships between computed tomography-assessed density, abdominal fat volume, and glucose metabolism after sleeve gastrectomy in Japanese patients with obesity. Endocr J 2019; 66:605-613. [PMID: 31019152 DOI: 10.1507/endocrj.ej18-0543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this study, we investigated the relationships between body weight (BW), computed tomography (CT)-assessed abdominal adipose tissue, and the glycemic metabolic profile in obese Japanese patients following laparoscopic sleeve gastrectomy (LSG). This study analyzed adipose tissue compartments using CT methods before and 1 year after LSG. Thirty obese patients were studied, and variables measured included visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), density of VAT (VAT-D), and density of SAT (SAT-D). We also examined the parameters in patients according to whether they had type-2 diabetes (T2DM). LSG induced significant losses in BW, SAT, and VAT after LSG. Additionally, SAT-D and VAT-D both increased and fasting plasma glucose (FPG) and HbA1c, but not C-peptide, decreased after surgery. ΔSAT and ΔVAT were positively related, and ΔSAT-D and ΔVAT-D were negatively related to ΔBW and/or FPG. Furthermore, a multivariate regression model showed that total BW loss (TBWL) was closely related to ΔSAT (β = 0.84; p < 0.001) and ΔVAT-D (β = -0.45; p < 0.05) and improvement of FPG was related to ΔVAT (β = 0.61; p < 0.05) after LSG. Finally, ΔFPG was correlated with ΔVAT in 16 T2DM patients (r = 0.58; p < 0.05) but not in non-T2DM patients. TBWL was related to ΔSAT and ΔVAT-D, and improvement of FPG was related to ΔVAT in obese Japanese patients after LSG.
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Affiliation(s)
- Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Manabu Anai
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
| | - Yuichi Endo
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Masayuki Ohta
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University, Yufu, Oita 879-5593, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Yufu, Oita 879-5593, Japan
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Abstract
There are numerous causes, such as environmental factors, medications, endocrine disorders, and genetic factors, that can lead to obesity. However, severe early-onset obesity with abnormal feeding behavior, mental retardation, dysmorphic features, organ-specific developmental abnormalities, and endocrine disorders suggest a genetic etiology. Mutations in genes related to the leptin-melanocortin pathway play a key role in genetic obesity. This pathway controls hypothalamic regulation of food intake. A few cases have been reported to have mutations in leptin (LEP) or leptin receptor (LEPR) genes. The cases had severe early-onset obesity, hyperphagia, and additional features, such as altered immune function, hypogonadism, and hypothyroidism. We present a 3-year-old male patient with severe early-onset obesity whose genetic analysis revealed a homozygous, novel, and pathogenic variant (c.1603+2T>C) in LEPR.
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Affiliation(s)
- Coşkun Armağan
- Department of Pediatrics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ceren Yılmaz
- Division of Pediatric Genetics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Altuğ Koç
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ayhan Abacı
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, 35340, Balçova, Izmir, Turkey
| | - Ayfer Ülgenalp
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Ece Böber
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, 35340, Balçova, Izmir, Turkey
| | - Derya Erçal
- Division of Pediatric Genetics, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Korcan Demir
- Division of Pediatric Endocrinology, Faculty of Medicine, Dokuz Eylül University, 35340, Balçova, Izmir, Turkey.
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Somda S, Lebrun A, Tranchart H, Lamouri K, Prevot S, Njike-Nakseu M, Gaillard M, Lainas P, Balian A, Dagher I, Perlemuter G, Naveau S, Voican CS. Adaptation of controlled attenuation parameter (CAP) measurement depth in morbidly obese patients addressed for bariatric surgery. PLoS One 2019; 14:e0217093. [PMID: 31125357 PMCID: PMC6534321 DOI: 10.1371/journal.pone.0217093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 05/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background and aim The controlled attenuation parameter (CAP) using FibroScan (Echosens, Paris, France) M or XL probe has been developed for liver steatosis assessment. However, CAP performs poorly in patients with high body mass index. The aim of our study was to assess whether CAP is overestimated using the standard XL probe in patients with morbid obesity, and in the case of an overestimation, to reprocess the data at a greater depth to obtain the appropriate CAP (CAPa). Patients and methods We conducted an observational prospective cohort study on a total of 249 severely obese patients admitted to our institution to undergo sleeve gastrectomy. Patients had a liver biopsy performed during the surgery and a CAP measurement during the 15 days preceding biopsy. Patient files were reprocessed retrospectively by an algorithm, blinded to the patients’ clinical data. The algorithm automatically assessed the probe-to-capsula distance (PCD) by analysing the echogenicity of ultrasound signals on the time-motion mode. In the case of a distance >35 mm, the algorithm automatically selected a deeper measurement for CAP (CAPa). When PCD was less than 35 mm, the measured CAP was considered as appropriated (CAPa) and no further reprocessing was performed. Results CAP recording was not performed at a sufficient depth in 130 patients. In these patients, the CAPa obtained at the adapted depth was significantly lower than CAP (298±3.9 versus 340±4.2 dB/m; p< 0.0001) measured at the standard depth (35 to 75 mm). Multiple linear regression analysis revealed that both body mass index and hepatic steatosis were independently correlated with CAP values. After reprocessing the CAP in patients with PCD > 35 mm, steatosis stage was the only parameter independently correlated with CAP values. For the diagnosis of steatosis (S≥1), moderate to severe steatosis (S≥2) and severe steatosis (S = 3), the AUROC curves of CAPa (measured CAP in patients with PCD<35 mm and reprocessed CAP in those with PCD>35 mm) were 0.86, 0.83 and 0.79, respectively. The Obuchowski measure for the diagnosis of steatosis was 0.90±0.013. Conclusion CAP was overestimated in a half of morbidly obese patients using an XL probe, but CAP can be performed correctly in these patients after adapting the measurement depth.
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Affiliation(s)
- Sosthene Somda
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Amandine Lebrun
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
- INSERM U996, DHU Hepatinov, Labex LERMIT, Clamart, France
| | - Hadrien Tranchart
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service de Chirurgie Digestive Minimale Invasive, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Karima Lamouri
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Sophie Prevot
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM U996, DHU Hepatinov, Labex LERMIT, Clamart, France
- Service d’Anatomie pathologique, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Micheline Njike-Nakseu
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Martin Gaillard
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service de Chirurgie Digestive Minimale Invasive, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Panagiotis Lainas
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service de Chirurgie Digestive Minimale Invasive, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Axel Balian
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Ibrahim Dagher
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service de Chirurgie Digestive Minimale Invasive, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
| | - Gabriel Perlemuter
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
- INSERM U996, DHU Hepatinov, Labex LERMIT, Clamart, France
| | - Sylvie Naveau
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
- INSERM U996, DHU Hepatinov, Labex LERMIT, Clamart, France
| | - Cosmin Sebastian Voican
- Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Service d’Hépato-Gastroentérologie et Nutrition, Hôpital Antoine-Béclère, Hôpitaux Universitaires Paris-Sud, Assistance Publique-Hôpitaux de Paris, Clamart, France
- INSERM U996, DHU Hepatinov, Labex LERMIT, Clamart, France
- * E-mail:
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Sridharan K, Kalayarasan R, Kamalanathan S, Sahoo J, Kar SS, Nandhini LP, Palui R, Durgia H. Change in insulin resistance, beta cell function, glucagon-like peptide-1 and calcitonin levels two weeks after bariatric surgery. Diabetes Metab Syndr 2019; 13:2142-2147. [PMID: 31235148 DOI: 10.1016/j.dsx.2019.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 05/06/2019] [Indexed: 12/17/2022]
Abstract
AIM OF THE STUDY Bariatric surgery causes profound improvement in metabolic parameters by increasing plasma glucagon like peptide - 1 (GLP-1) level even few weeks after surgery. GLP-1 analogues can cause calcitonin secreting medullary thyroid carcinoma in animals. The studies relating to the mechanisms that underlie these changes are few. The objectives of the study were to measure the change in insulin resistance, beta cell function, GLP-1 and calcitonin levels before and 2 weeks after bariatric surgery. METHODS Patients above 18 years of age who underwent either laparoscopic sleeve gastrectomy or Roux-en Y gastric bypass were recruited into the study. Measured indices were homeostatic model assessment 2 for insulin resistance (HOMA2-IR), an index for hepatic insulin resistance; Matsuda index, an index of whole body insulin sensitivity; and insulin secretion and sensitivity index (ISSI-2), a marker of beta cell secretion. RESULTS Twenty eight patients completed the study. HOMA2-IR was lower (2.72 ± 1.28 vs. 2.04 ± 0.9; P = 0.001) and ISSI-2 was higher (0.80 (0.51-1.26) vs. 1.04 (0.56-1.38); P = 0.019) at 2 weeks after surgery compared to baseline. Matsuda index also improved after surgery but was not statistically significant (2.02 (1.1-2.94) vs. 2.84 (1.56-4.12); P = 0.078). Fasting GLP-1 and calcitonin levels did not change while both peak GLP-1, and area under curve for GLP-1 were higher after surgery. CONCLUSIONS At 2 weeks following bariatric surgery, hepatic insulin resistance decreased while beta cell function improved due to increase in postprandial GLP-1 level without any change in fasting calcitonin levels.
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Affiliation(s)
- Kalyani Sridharan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Raja Kalayarasan
- Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Lakshmana Perumal Nandhini
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Rajan Palui
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Harsh Durgia
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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Calderón B, Huerta L, Casado ME, González-Casbas JM, Botella-Carretero JI, Martín-Hidalgo A. Morbid obesity-related changes in the expression of lipid receptors, transporters, and HSL in human sperm. J Assist Reprod Genet 2019; 36:777-786. [PMID: 30659447 PMCID: PMC6505031 DOI: 10.1007/s10815-019-01406-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/09/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To study the location and expression of receptors (SR-BI/CLA-1, SR-BII, and LDLr) and transporter (ABCA1) involved in uptake and efflux of cholesterol in human spermatozoa and assess whether obesity alters its location/expression and whether this could be related to infertility. DESIGN Observational study. SETTING None PATIENT(S): Ten controls and 20 obese patients. INTERVENTION(S) Anthropometric parameters. Serum and semen samples were collected. MAIN OUTCOME MEASURE(S) Spermatozoon concentration, immunolocalization, and protein expression in semen. RESULTS Spermatozoon concentration and motility was decreased in morbidly obese patients. SR-BI/CLA-1, SR-BII, LDLr, and ABCA1 are located in the spermatozoon cell membrane and the localization does not change between obese patients and controls. Control spermatozoa showed high SR-BI expression, and less expression for the rest of the receptors analyzed, indicating that SR-BI/CLA-1 is relevant in human spermatozoon cholesterol uptake/efflux. On the contrary, spermatozoa of obese patients showed less SR-BI/CLA-1 expression than controls, and more intense positive staining for SR-BII, LDLr, and ABCA1. Finally, human sperm expresses the 130- and 82-kDa hormone-sensitive lipase (HSL) isoforms. The 130-kDa isoform is expressed in the control sperm, and the expression disappears in the obese patients. CONCLUSION(S) The presence of lipid receptors/transporters and HSL in human spermatozoa suggests their role in the process of maturation/capacitation. The changes in the expression of lipid receptors/transporters and the lack of the 130-kDa HSL isoform in obese patients prevent the hydrolysis of cholesterol esters internalized by these receptors, and favor their accumulation in the cytoplasm of the spermatozoa that could contribute to lipotoxicity and infertility.
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Affiliation(s)
- Berniza Calderón
- Instituto Tecnológico Santo Domingo (INTEC), Santo Domingo, República Dominicana
- Departamento de Endocrinología y Metabolismo, Madrid, Spain
| | - Lydia Huerta
- Servicio de Bioquímica-Investigación, Madrid, Spain
| | - María Emilia Casado
- Servicio de Bioquímica-Investigación, Madrid, Spain
- CIBER de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), ISCIII, Madrid, Spain
| | - José Manuel González-Casbas
- Instituto Europeo de Fertilidad y Unidad de Reproducción Asistida, Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Hospital Universitario Ramón y Cajal, E-28034, Madrid, Spain
| | - José Ignacio Botella-Carretero
- Departamento de Endocrinología y Metabolismo, Madrid, Spain
- CIBER de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), ISCIII, Madrid, Spain
| | - Antonia Martín-Hidalgo
- Servicio de Bioquímica-Investigación, Madrid, Spain.
- CIBER de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), ISCIII, Madrid, Spain.
- Department of Biochemistry-Research, Hospital Universitario Ramón y Cajal, Ctra.ColmenarViejo, Km 9.100, E-28034, Madrid, Spain.
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Ezquerro S, Mocha F, Frühbeck G, Guzmán-Ruiz R, Valentí V, Mugueta C, Becerril S, Catalán V, Gómez-Ambrosi J, Silva C, Salvador J, Colina I, Malagón MM, Rodríguez A. Ghrelin Reduces TNF-α-Induced Human Hepatocyte Apoptosis, Autophagy, and Pyroptosis: Role in Obesity-Associated NAFLD. J Clin Endocrinol Metab 2019; 104:21-37. [PMID: 30137403 DOI: 10.1210/jc.2018-01171] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022]
Abstract
CONTEXT Human obesity is associated with increased circulating TNF-α, a proinflammatory cytokine that induces hepatocyte cell death. OBJECTIVE The potential beneficial effects of acylated and desacyl ghrelin in the progression of nonalcoholic fatty liver disease (NAFLD) to nonalcoholic steatohepatitis in obesity via the inhibition of TNF-α-induced hepatocyte apoptosis, autophagic cell death, and pyroptosis were investigated. DESIGN, SETTINGS, AND PARTICIPANTS Plasma ghrelin isoforms and TNF-α were measured in 158 participants, and hepatocyte cell death was evaluated in liver biopsies from 76 patients with morbid obesity undergoing bariatric surgery with available liver echography and pathology analysis. The effect of acylated and desacyl ghrelin on basal and TNF-α-induced cell death was determined in vitro in human HepG2 hepatocytes. RESULTS Circulating TNF-α and the acylated/desacyl ghrelin ratio were increased, whereas desacyl ghrelin levels were decreased in patients with obesity and NAFLD. Six months after bariatric surgery, decreased acylated/desacyl ghrelin levels, and improved hepatic function were found. Patients with obesity and type 2 diabetes showed increased hepatic ghrelin O-acyltransferase transcripts as well as an increased hepatic apoptosis, pyroptosis, and compromised autophagy. In HepG2 hepatocytes, acylated and desacyl ghrelin treatment reduced TNF-α-induced apoptosis, evidenced by lower caspase-8 and caspase-3 cleavage, as well as TUNEL-positive cells and pyroptosis, revealed by decreased caspase-1 activation and lower high-mobility group box 1 expression. Moreover, acylated ghrelin suppressed TNF-α-activated hepatocyte autophagy, as evidenced by a decreased LC3B-II/I ratio and increased p62 accumulation via AMPK/mTOR. CONCLUSIONS Ghrelin constitutes a protective factor against hepatocyte cell death. The increased acylated/desacyl ghrelin ratio in patients with obesity and NAFLD might constitute a compensatory mechanism to overcome TNF-α-induced hepatocyte apoptosis, autophagy, and pyroptosis.
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Affiliation(s)
- Silvia Ezquerro
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Fátima Mocha
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Rocío Guzmán-Ruiz
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cell Biology, Physiology, and Immunology, Instituto Maimónides de Investigación Biomédica, University of Córdoba, Reina Sofía University Hospital, Córdoba, Spain
| | - Víctor Valentí
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Surgery, Clínica Universidad de Navarra, Pamplona, Spain
| | - Carmen Mugueta
- Department of Biochemistry, Clínica Universidad de Navarra, Pamplona, Spain
| | - Sara Becerril
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Camilo Silva
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Javier Salvador
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Inmaculada Colina
- Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - María M Malagón
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
- Department of Cell Biology, Physiology, and Immunology, Instituto Maimónides de Investigación Biomédica, University of Córdoba, Reina Sofía University Hospital, Córdoba, Spain
| | - Amaia Rodríguez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Smith CR, Whipple OC. Incidental Gastric Fundus Diverticulum during Laparoscopic Sleeve Gastrectomy. Am Surg 2019; 85:e12-e13. [PMID: 30760360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Borel AL, Coumes S, Reche F, Ruckly S, Pépin JL, Tamisier R, Wion N, Arvieux C. Waist, neck circumferences, waist-to-hip ratio: Which is the best cardiometabolic risk marker in women with severe obesity? The SOON cohort. PLoS One 2018; 13:e0206617. [PMID: 30408116 PMCID: PMC6224066 DOI: 10.1371/journal.pone.0206617] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/16/2018] [Indexed: 12/11/2022] Open
Abstract
A centralized deposit of adiposity increases the risk of cardiometabolic diseases. Several anthropometric markers can be used to characterize fat distribution. In the case of severe obesity, several markers, such as hip and waist circumference, are prone to measurement error. Conversely, neck circumference is easy to obtain. The aim was to determine the best surrogate marker of obesity-related cardiometabolic diseases from: body mass index (BMI), waist, hip and neck circumferences and waist-to-hip ratio.
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Affiliation(s)
- Anne-Laure Borel
- Hypoxia PathoPhysiology laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- Grenoble Alpes University Hospital, Pole DIGIDUNE, nutrition department, Grenoble, France
- * E-mail:
| | - Sandrine Coumes
- Grenoble Alpes University Hospital, Pole DIGIDUNE, nutrition department, Grenoble, France
| | - Fabian Reche
- Grenoble Alpes University Hospital, Pole DIGIDUNE, digestive surgery department, Grenoble, France
| | | | - Jean-Louis Pépin
- Hypoxia PathoPhysiology laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- Grenoble University Hospital, Pole Thorax et Vaisseaux, physiology, sleep and exercise clinic, Grenoble, France
| | - Renaud Tamisier
- Hypoxia PathoPhysiology laboratory, INSERM U1042, University Grenoble Alpes, Grenoble, France
- Grenoble University Hospital, Pole Thorax et Vaisseaux, physiology, sleep and exercise clinic, Grenoble, France
| | - Nelly Wion
- Grenoble Alpes University Hospital, Pole DIGIDUNE, nutrition department, Grenoble, France
| | - Catherine Arvieux
- Grenoble Alpes University Hospital, Pole DIGIDUNE, digestive surgery department, Grenoble, France
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Schiavo L, Busetto L, Cesaretti M, Zelber-Sagi S, Deutsch L, Iannelli A. Nutritional issues in patients with obesity and cirrhosis. World J Gastroenterol 2018; 24:3330-3346. [PMID: 30122874 PMCID: PMC6092576 DOI: 10.3748/wjg.v24.i30.3330] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/15/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023] Open
Abstract
Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis. Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis. Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronic liver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation. Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble, water-soluble vitamins and trace elements and should be supplemented appropriately. Diet, physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations. Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation. The risk of sarcopenia, micronutrient status, and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review. Furthermore, the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed.
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Affiliation(s)
- Luigi Schiavo
- Department of Translational Medical Science, University of Campania “Luigi Vanvitelli”, Naples 80131, Italy
- IX Division of General Surgery, Vascular Surgery and Applied Biotechnology, Naples University Policlinic, Naples 80131, Italy
| | - Luca Busetto
- Department of Medicine, University of Padua, Padua 35128, Italy
- Center for the Study and the Integrated Management of Obesity, University Hospital of Padua, Padua 35128, Italy
| | - Manuela Cesaretti
- Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, AP-HP, Clichy 92110, France
- Department of Nanophysics, Italian Institute of Technology, Genova 16163, Italy
| | - Shira Zelber-Sagi
- School of Public Health, University of Haifa, Haifa 3498838, Israel
- Department of Gastroenterology and Liver disease, Tel Aviv Medical Center, 62431, Tel-Aviv 62431, Israel
| | - Liat Deutsch
- Department of Gastroenterology and Liver disease, Tel Aviv Medical Center, 62431, Tel-Aviv 62431, Israel
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 62431, Israel
| | - Antonio Iannelli
- Digestive Unit, Archet 2 Hospital, University Hospital of Nice, F-06202, Nice, France; Inserm, U1065, Team 8 “Hepatic complications of obesity”, Nice F-06204, France
- University of Nice Sophia-Antipolis, Nice F-06107, France
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Desmarais F, Bergeron KF, Lacaille M, Lemieux I, Bergeron J, Biron S, Rassart E, Joanisse DR, Mauriege P, Mounier C. High ApoD protein level in the round ligament fat depot of severely obese women is associated with an improved inflammatory profile. Endocrine 2018; 61:248-257. [PMID: 29869155 DOI: 10.1007/s12020-018-1621-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/30/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Apolipoprotein D (ApoD) is a lipocalin participating in lipid transport. It binds to a variety of ligands, with a higher affinity for arachidonic acid, and is thought to have a diverse array of functions. We investigated a potential role for ApoD in insulin sensitivity, inflammation, and thrombosis-processes related to lipid metabolism-in severely obese women. METHODS We measured ApoD expression in a cohort of 44 severely obese women including dysmetabolic and non-dysmetabolic patients. Physical and metabolic characteristics of these women were determined from anthropometric measurements and blood samples. ApoD was quantified at the mRNA and protein levels in samples from three intra-abdominal adipose tissues (AT): omental, mesenteric and round ligament (RL). RESULTS ApoD protein levels were highly variable between AT of the same individual. High ApoD protein levels, particularly in the RL depot, were linked to lower plasma insulin levels (-40%, p = 0.015) and insulin resistance (-47%, p = 0.022), and increased insulin sensitivity (+10%, p = 0.008). Lower circulating pro-inflammatory PAI-1 (-39%, p = 0.001), and TNF-α (-19%, p = 0.030) levels were also correlated to high ApoD protein in the RL AT. CONCLUSIONS ApoD variability between AT was consistent with different accumulation efficiencies and/or metabolic functions according to the anatomic location of fat depots. Most statistically significant correlations implicated ApoD protein levels, in agreement with protein accumulation in target tissues. These correlations associated higher ApoD levels in fat depots with improved metabolic health in severely obese women.
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Affiliation(s)
- Frederik Desmarais
- BioMed Research Center, Department of Biological Sciences, University of Quebec in Montreal, Montreal, QC, Canada
| | - Karl-F Bergeron
- BioMed Research Center, Department of Biological Sciences, University of Quebec in Montreal, Montreal, QC, Canada
| | - Michel Lacaille
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Isabelle Lemieux
- Research Center of the Quebec University Heart and Lung Institute, Quebec City, QC, Canada
| | - Jean Bergeron
- Endocrinology and Nephrology Axis, Research Center of the University Hospital, Quebec City, QC, Canada
| | - Simon Biron
- Research Center of the Quebec University Heart and Lung Institute, Quebec City, QC, Canada
- Department of Surgery, Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Eric Rassart
- BioMed Research Center, Department of Biological Sciences, University of Quebec in Montreal, Montreal, QC, Canada
| | - Denis R Joanisse
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC, Canada
- Research Center of the Quebec University Heart and Lung Institute, Quebec City, QC, Canada
| | - Pascale Mauriege
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec City, QC, Canada
- Research Center of the Quebec University Heart and Lung Institute, Quebec City, QC, Canada
| | - Catherine Mounier
- BioMed Research Center, Department of Biological Sciences, University of Quebec in Montreal, Montreal, QC, Canada.
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Wasmann RE, Ter Heine R, van Dongen EP, Burger DM, Lempers VJ, Knibbe CA, Brüggemann RJ. Pharmacokinetics of Anidulafungin in Obese and Normal-Weight Adults. Antimicrob Agents Chemother 2018; 62:e00063-18. [PMID: 29712664 PMCID: PMC6021625 DOI: 10.1128/aac.00063-18] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/20/2018] [Indexed: 12/20/2022] Open
Abstract
In 2025, approximately one out of five adults will be obese. Physiological changes associated with obesity have been shown to influence the pharmacokinetics of drugs. Anidulafungin is frequently used in critically ill patients, and to achieve optimal efficacy, it is essential that its dose is appropriate for each patient's characteristics. We combined data from obese subjects with data from normal-weight subjects and determined an optimal dosing regimen for obese patients by population pharmacokinetic modeling. Twenty adults, 12 of which were normal-weight healthy subjects (median weight, 67.7 kg; range, 61.5 to 93.6 kg) and 8 of which were morbidly obese subjects (median weight, 149.7 kg; range, 124.1 to 166.5 kg) were included in the analysis. Subjects received a single dose of 100 mg anidulafungin intravenously over 90 min, upon which blood samples were obtained. Monte Carlo simulations were performed to optimize dosing in obesity. A three-compartment model and equal volumes of distribution described the data best. Total body weight was identified as a descriptor for both clearance and the volume of distribution, but the effect of weight on these parameters was limited. Simulations showed that with the licensed 100-mg dose, more than 97% of subjects with a weight above 140 kg will have an area under the concentration-time curve from 0 to 24 h of less than 99 mg · h/liter (the reference value for normal-weight individuals). We found that in obese and normal-weight subjects, weight influenced both of the anidulafungin pharmacokinetic parameters clearance and volume of distribution, implying a lower exposure to anidulafungin in (morbidly) obese individuals. Consequently, a 25% increase in the loading and maintenance doses could be considered in patients weighing more than 140 kg.
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Affiliation(s)
- Roeland E Wasmann
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Center of Expertise in Mycology, Radboudumc/CWZ, Nijmegen, The Netherlands
| | - Rob Ter Heine
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eric P van Dongen
- Department of Anesthesiology, Intensive Care and Pain Management, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - David M Burger
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vincent J Lempers
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catherijne A Knibbe
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands
- Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Roger J Brüggemann
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Center of Expertise in Mycology, Radboudumc/CWZ, Nijmegen, The Netherlands
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Abu-Gazala S, Horwitz E, Ben-Haroush Schyr R, Bardugo A, Israeli H, Hija A, Schug J, Shin S, Dor Y, Kaestner KH, Ben-Zvi D. Sleeve Gastrectomy Improves Glycemia Independent of Weight Loss by Restoring Hepatic Insulin Sensitivity. Diabetes 2018; 67:1079-1085. [PMID: 29475831 PMCID: PMC5961409 DOI: 10.2337/db17-1028] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/12/2018] [Indexed: 12/21/2022]
Abstract
Bariatric surgery dramatically improves glycemic control, yet the underlying molecular mechanisms remain controversial because of confounding weight loss. We performed sleeve gastrectomy (SG) on obese and diabetic leptin receptor-deficient mice (db/db). One week postsurgery, mice weighed 5% less and displayed improved glycemia compared with sham-operated controls, and islets from SG mice displayed reduced expression of diabetes markers. One month postsurgery SG mice weighed more than preoperatively but remained near-euglycemic and displayed reduced hepatic lipid droplets. Pair feeding of SG and sham db/db mice showed that surgery rather than weight loss was responsible for reduced glycemia after SG. Although insulin secretion profiles from islets of sham and SG mice were indistinguishable, clamp studies revealed that SG causes a dramatic improvement in muscle and hepatic insulin sensitivity accompanied by hepatic regulation of hepatocyte nuclear factor-α and peroxisome proliferator-activated receptor-α targets. We conclude that long-term weight loss after SG requires leptin signaling. Nevertheless, SG elicits a remarkable improvement in glycemia through insulin sensitization independent of reduced feeding and weight loss.
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Affiliation(s)
- Samir Abu-Gazala
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
- Department of Surgery, The Hebrew University Hadassah Medical Center, Jerusalem, Israel
- Department of Genetics, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Elad Horwitz
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Rachel Ben-Haroush Schyr
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Aya Bardugo
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Hadar Israeli
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Ayat Hija
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Jonathan Schug
- Department of Genetics, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Soona Shin
- Department of Genetics, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Yuval Dor
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Klaus H Kaestner
- Department of Genetics, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Danny Ben-Zvi
- Department of Developmental Biology and Cancer Research, The Institute for Medical Research Israel-Canada, The Hebrew University Hadassah Medical School, Jerusalem, Israel
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Affiliation(s)
- Francesco Trimarchi
- Accademia Peloritana dei Pericolanti at the University of Messina, Messina, Italy.
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48
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Maier MT, Vilhelmsson A, Louie SM, Vagena E, Nomura DK, Koliwad SK, Xu AW. Regulation of Hepatic Lipid Accumulation and Distribution by Agouti-Related Protein in Male Mice. Endocrinology 2018; 159:2408-2420. [PMID: 29750244 PMCID: PMC6692877 DOI: 10.1210/en.2018-00040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/02/2018] [Indexed: 12/30/2022]
Abstract
Proper regulation of energy metabolism requires neurons in the central nervous system to respond dynamically to signals that reflect the body's energy reserve, and one such signal is leptin. Agouti-related protein (AgRP) is a hypothalamic neuropeptide that is markedly upregulated in leptin deficiency, a condition that is associated with severe obesity, diabetes, and hepatic steatosis. Because deleting AgRP in mice does not alter energy balance, we sought to determine whether AgRP plays an indispensable role in regulating energy and hepatic lipid metabolism in the sensitized background of leptin deficiency. We generated male mice that are deficient for both leptin and AgRP [double-knockout (DKO)]. DKO mice and ob/ob littermates had similar body weights, food intake, energy expenditure, and plasma insulin levels, although DKO mice surprisingly developed heightened hyperglycemia with advancing age. Overall hepatic lipid content was reduced in young prediabetic DKO mice, but not in the older diabetic counterparts. Intriguingly, however, both young and older DKO mice had an altered zonal distribution of hepatic lipids with reduced periportal lipid deposition. Moreover, leptin stimulated, whereas AgRP inhibited, hepatic sympathetic activity. Ablating sympathetic nerves to the liver, which primarily innervate the portal regions, produced periportal lipid accumulation in wild-type mice. Collectively, our results highlight AgRP as a regulator of hepatic sympathetic activity and metabolic zonation.
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Affiliation(s)
- Matthew T Maier
- Diabetes Center, University of California, San Francisco, San Francisco, California
| | - Anna Vilhelmsson
- Diabetes Center, University of California, San Francisco, San Francisco, California
| | - Sharon M Louie
- Department of Chemistry, University of California, Berkeley, Berkeley, California
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, California
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, California
| | - Eirini Vagena
- Diabetes Center, University of California, San Francisco, San Francisco, California
| | - Daniel K Nomura
- Department of Chemistry, University of California, Berkeley, Berkeley, California
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, California
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, Berkeley, California
| | - Suneil K Koliwad
- Diabetes Center, University of California, San Francisco, San Francisco, California
- Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Allison W Xu
- Diabetes Center, University of California, San Francisco, San Francisco, California
- Department of Anatomy, University of California, San Francisco, San Francisco, California
- Correspondence: Allison W. Xu, PhD, Diabetes Center, University of California, San Francisco, San Francisco, Box 0534 , S-1222, California 94143, E-mail:
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Rajamani U, Gross AR, Hjelm BE, Sequeira A, Vawter MP, Tang J, Gangalapudi V, Wang Y, Andres AM, Gottlieb RA, Sareen D. Super-Obese Patient-Derived iPSC Hypothalamic Neurons Exhibit Obesogenic Signatures and Hormone Responses. Cell Stem Cell 2018; 22:698-712.e9. [PMID: 29681516 PMCID: PMC6398951 DOI: 10.1016/j.stem.2018.03.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 02/06/2018] [Accepted: 03/12/2018] [Indexed: 12/21/2022]
Abstract
The hypothalamus contains neurons that integrate hunger and satiety endocrine signals from the periphery and are implicated in the pathophysiology of obesity. The limited availability of human hypothalamic neurons hampers our understanding of obesity disease mechanisms. To address this, we generated human induced pluripotent stem cells (hiPSCs) from multiple normal body mass index (BMI; BMI ≤ 25) subjects and super-obese (OBS) donors (BMI ≥ 50) with polygenic coding variants in obesity-associated genes. We developed a method to reliably differentiate hiPSCs into hypothalamic-like neurons (iHTNs) capable of secreting orexigenic and anorexigenic neuropeptides. Transcriptomic profiling revealed that, although iHTNs maintain a fetal identity, they respond appropriately to metabolic hormones ghrelin and leptin. Notably, OBS iHTNs retained disease signatures and phenotypes of high BMI, exhibiting dysregulated respiratory function, ghrelin-leptin signaling, axonal guidance, glutamate receptors, and endoplasmic reticulum (ER) stress pathways. Thus, human iHTNs provide a powerful platform to study obesity and gene-environment interactions.
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Affiliation(s)
- Uthra Rajamani
- Board of Governors, Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Andrew R Gross
- Board of Governors, Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Brooke E Hjelm
- Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA 92868, USA
| | - Adolfo Sequeira
- Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA 92868, USA
| | - Marquis P Vawter
- Functional Genomics Laboratory, Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA 92868, USA
| | - Jie Tang
- Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | | | - Yizhou Wang
- Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Allen M Andres
- Metabolism and Mitochondrial Research Core, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Roberta A Gottlieb
- Metabolism and Mitochondrial Research Core, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Dhruv Sareen
- Board of Governors, Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; Department of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA; iPSC Core, The David Janet Polak Foundation Stem Cell Core Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
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50
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Laura M, Mylene L, Christophe B, Boris H, Christophe M, Konstantinos A. Establishing a Reproducible Murine Animal Model of Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy (SADl-S). Obes Surg 2018; 28:2122-2125. [PMID: 29693220 PMCID: PMC6018587 DOI: 10.1007/s11695-018-3254-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Single-anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S) is a simplified biliopancreatic diversion. The objective of this study was to develop a reproducible animal model for SADI-S. We used three techniques for duodenal exclusion and duodenoileal anastomosis: (a) surgical clip and side-to-side anastomosis, (b) ligation and side-to-side anastomosis and (c) sectioning the duodenum, closing the duodenal stump and end-to-side anastomosis. We recorded the surgical technique and complications for each method. Twenty-five of 31 rats survived to the end of the study period. One death occurred from accidental anaesthesia overdose and the others from anastomosis leak. Four duodenal exclusions had repermeabilised at necropsy. Our murine model of SADI-S can be consistently reproduced. Sectioning the duodenum is preferable to avoid repermeabilisation of the duodenum.
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Affiliation(s)
- Montana Laura
- Department of Digestive and Metabolic Surgery, Centre Intégré Nord Francilien de l’Obésité, University Hospital Avicenne, 125 rue de Stalingrad, Bobigny, 93000 Paris, France
| | - Lamon Mylene
- Team of Regulation of Glucose Homeostasis by Nervous System (REGLYS), University of Paris (7) Diderot-CNRS UMR8251, Bâtiment Buffon, 3ème étage, pièce 340A, case courrier 7126, 4 rue Marie Andrée Lagroua Weill-Halle, 75205 Paris Cedex 13, France
| | - Barrat Christophe
- Department of Digestive and Metabolic Surgery, Centre Intégré Nord Francilien de l’Obésité, University Hospital Avicenne, 125 rue de Stalingrad, Bobigny, 93000 Paris, France
| | - Hansel Boris
- Department of Diabetes and Nutrition, Bichat-Claude Bernard University Hospital, 46, rue Henri Huchard, 75877 Cedex 18 Paris, France
| | - Magnan Christophe
- Team of Regulation of Glucose Homeostasis by Nervous System (REGLYS), University of Paris (7) Diderot-CNRS UMR8251, Bâtiment Buffon, 3ème étage, pièce 340A, case courrier 7126, 4 rue Marie Andrée Lagroua Weill-Halle, 75205 Paris Cedex 13, France
| | - Arapis Konstantinos
- Department of General and Digestive Surgery, University Hospital Bichat-Claude Bernard, 46, rue Henri Huchard, 75877 Cedex 18 Paris, France
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