ABSTRACT: BackgroundThe mechanisms by which increased body weight influence bone mass density (BMD) are still unknown. The aim of our study was
to analyze the relationship between anthropometric and body composition variables, insulin growth factor-I (IGF-I), adiponectin
and soluble tumor necrosis factor-α receptors (sTNFR) 1 and 2 with BMD in two cohorts of morbid obese patients, before and
after bypass surgery.
MethodsThe first cohort included 25 women aged 48 ± 7.6years studied before bypass surgery. The second included 41 women aged 46 ± 9.2years,
12months after surgery. We studied anthropometric variables obtained from whole body DEXA composition analysis. Serum IGF-I,
intact serum parathyroid hormone, 25-hydroxivitamin D3, plasma adiponectin concentrations, sTNFR1, sTNFR2 concentrations were measured.
ResultsIn the first cohort, the BMI was 44.5 ± 3.6kg/m2, parathyroid hormone, IGF-I, and adiponectin concentrations were lower, and sTNFR1 concentrations were higher than in the
second cohort. In the multiple regression analysis, BMD remained significantly associated with body fat percentage (β −0.154,
p = 0.01), lean mass (β 0.057, p = 0.016) and phosphate concentration (β 0.225, p = 0.05). In the second cohort, BMI was 31 ± 5.1kg/m2. In the multiple regression analysis, BMD remained significantly associated with lean mass (β 0.006, p = 0.03).
ConclusionThe inverse correlation found between body fat and BMD in the first cohort indicates morbid obesity increases the risk of
osteoporosis and we found a positive correlation with lean and fat mass before bariatric surgery and with lean mass after
Obesity Surgery 04/2012; 19(3):345-350. · 3.29 Impact Factor
ABSTRACT: To analyse in a cohort of healthy subjects and in a group of morbidly obese patients, we studied the association amongst 25(OH) D and plasma concentrations of adipocytokines, inflammatory cytokines and insulin resistance. We also aimed to determine whether vitamin D-deficient patients showed a greater inflammatory profile. In the observational study that the authors conducted, plasma concentrations of 25(OH) D, leptin, resistin, adiponectin and interleukine-18 were determined in 134 healthy men and 127 women. In the population consisting of 44 patients with morbid obesity, plasma concentrations of 25(OH) D, leptin, resistin, adiponectin, interleukine-18, soluble tumor necrosis factor receptors 1 and 2 and C-reactive protein were analysed. In the healthy population, plasma 25(OH) D showed a negative correlation with body mass index, body fat, waist, hip circumference and with leptin. However, no significant associations were found amongst 25(OH) D and plasma concentrations of resistin, adiponectin or interleukine-18. Patients with vitamin D deficiency showed higher body mass index, fat mass percentage and higher leptin concentrations compared with subjects with normal 25(OH) D concentrations. In the morbidly obese subjects, 25(OH) D did not correlate with leptin, resistin, adiponectin, interleukine-18, soluble tumor necrosis factor receptors 1 and 2 or with C-reactive protein. In patients with morbid obesity, no differences were found in adipokines and inflammatory cytokines concentrations regarding 25(OH) D status. No associations were found either between 25(OH) D and plasma glucose and insulin resistance or with lipid profile. Plasma 25(OH) D concentrations are associated with adiposity markers but not with adipocytokines implicated in inflammation. This lack of association does not support a major role of 25(OH) D in the pro-inflammatory environment observed in morbidly obese subjects. In addition, subjects with vitamin D deficiency are not characterized by a greater inflammatory state.
Endocrine 10/2010; 38(2):235-42. · 1.42 Impact Factor
ABSTRACT: The aim of the study was to evaluate human plasma circulating levels of adipocyte fatty acid-binding protein (A-FABP) and its relationship with proinflammatory adipocytokines and insulin resistance in a severely obese cohort, before and 1 year after a surgical gastric bypass. Plasmatic levels of A-FABP were measured in 77 morbid-obese women before and 1 year after bariatric surgery. Anthropometrical parameters and body composition by bioelectrical impedance analysis were determined. Circulating levels of soluble tumor necrosis factor receptor 2 (sTNFR2), Interleukin 18 (IL-18), adiponectin, and high-sensitive C-reactive protein (hsCRP) were also analyzed. Insulin resistance by homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated. After massive weight loss, A-FABP plasmatic levels decreased significantly [7.6 (8.9) vs. 4.3 (5.1); P<0,001] but no association with circulating adipokines or proinflammatory cytokines, both at the beginning and at the end of follow-up, was observed. A decrease in sTNFR2, IL-18, hsCRP, and an increase in adiponectin levels (P<0.001 in all cases) were observed after the gastric bypass. HOMA-IR index improved 1 year after surgery and after multiple regression analysis remained associated with A-FABP after controlling for confounding variables (beta=0.322, P=0.014; R2 for the model 0.281). In morbid-obese women, plasma A-FABP concentrations were dramatically reduced after gastric bypass surgery. After weight loss this protein contributed to HOMA-IR index independently of proinflammatory/antinflammatory cytokine profile. Further studies are warranted to elucidate the role of A-FABP in the pathogenesis of insulin resistance in morbid obesity.
Obesity 02/2009; 17(6):1124-8. · 4.28 Impact Factor
ABSTRACT: Our goal was to test any association between human plasma circulating levels of monocyte chemoattractant protein-1 (cMCP-1) and insulin resistance and to compare monocyte chemoattractant protein-1 (MCP-1) adipose tissue gene expression and cMCP-1 in relation with inflammatory markers.
cMCP-1 was measured in n = 116 consecutive control male subjects to whom an insulin sensitivity (S(i)) test was performed. Circulating levels of soluble CD14, soluble tumor necrosis factor receptor type 2 (sTNFR2), soluble interleukin-6 (sIL-6), and adiponectin also were measured. Subcutaneous adipose tissue samples were obtained from n = 107 non-diabetic and type 2 diabetic subjects with different degrees of obesity. Real-time polymerase chain reaction was used to measure gene expression of MCP-1, CD68, tumor necrosis factor-alpha (TNF-alpha), and its receptor TNFR2.
In the S(i) study, no independent effect of cMCP-1 levels on insulin sensitivity was observed. In the expression study, in non-diabetic subjects, MCP-1 mRNA had a positive correlation with BMI (r = 0.407, p = 0.003), TNF-alpha mRNA (r = 0.419, p = 0.002), and TNFR2 mRNA (r = 0.410, p = 0.003). In these subjects, cMCP-1 was found to correlate with waist-to-hip ratio (r = 0.322, p = 0.048). In patients with type 2 diabetes, MCP-1 mRNA was up-regulated compared with non-diabetic subjects. TNF-alpha mRNA was found to independently contribute to MCP-1 mRNA expression. In this group, CD68 mRNA was found to correlate with BMI (r = 0.455, p = 0.001).
cMCP-1 is not associated with insulin sensitivity in apparently healthy men. TNF-alpha is the inflammatory cytokine associated with MCP-1 expression in subcutaneous adipose tissue.
Obesity 04/2007; 15(3):664-72. · 4.28 Impact Factor
ABSTRACT: Analysis of the relationship between adiponectin, interleukin-18 (IL-18) and ghrelin and bone mineral density (BMD), in a group of women that had undergone a gastric- bypass for morbid obesity a year before.
Forty-one morbidly obese patients aged 46 +/- 9 years and with an initial body mass index of 49.5 +/- 7.6 were included in the study and a gastric by-pass operation was performed in all of them. Anthropometric variables, body composition measured with dual energy X-ray absorptiometry (DEXA) and plasma concentrations of parathormone (PTH), 25(OH) vitamin D, insulin growth factor (IGF-I), adiponectin, IL-18 and ghrelin were determined before and a year after surgery. BMD was evaluated with DEXA 12 months after bariatric surgery.
A year after surgery 36.2% of inicial body weight was lost and this was associated with an improvement of the inflammatory profile reflected by a significant reduction of IL-18 and a increase of adiponectin plasma concentrations. In the univariate analysis BMD inversely correlated with age (r = -0.287, p = 0.008) and with lean mass (r = 0.318, p = 0.043) but not with adiponectin, IL-18 and ghrelin concentrations. PTH showed a positive correlation with weight (r = 0.362, p = 0.03), lean mass (r = 0.372, p = 0.039), and a negative association with plasma concentrations of calcium (r = -0.48, p = 0.003) and 25(OH) vitamin D (r = -0.44, p = 0.014). Plasma 25(OH) vitamin D correlated negatively with the sum of fat mass and lean mass measured with DEXA (r = -0.210, p = 0.043). In the multiple regression analysis BMD remained associated only with lean mass (beta = 0.193, p = 0.016).
Our study does not support the existance of a direct effect of adipose tissue on bone metabolism through the secretion of adiponectin. The absence of association between inflammatory cytokine IL-18 and ghrelin with BMD also argues against their implication in bone regulation.
Endocrinología y Nutrición 56(7):355-60.