Lipoprotein Lipase but Not Hormone-Sensitive Lipase Activities Achieve Normality After Surgically Induced Weight Loss in Morbidly Obese Patients
Biochemistry and Molecular Biology Department, Biology Faculty, Universitat de Barcelona, Diagonal 645, 08028, Barcelona, Spain. Obesity Surgery
(Impact Factor: 3.75).
06/2009; 19(8):1150-8. DOI: 10.1007/s11695-009-9853-3
Although bariatric surgery is currently the most common practice for inducing weight loss in morbidly obese patients (BMI>40 kg/m2), its effect on the lipid content of adipose tissue and its lipases (lipoprotein lipase [LPL] and hormone-sensitive lipase [HSL]) are controversial.
We analyzed LPL and HSL activities and lipid content from plasma as well as subcutaneous (SAT) and visceral (VAT) adipose tissue of 34 morbidly obese patients (MO) before and after (6 and 12 months) Roux-en-Y gastric bypass surgery and compare the values with those of normal weight (control) patients.
LPL activity was significantly higher in MO (SAT=32.9+/-1.0 vs VAT=36.4+/-3.3 mU/g tissue; p<0.001) than in control subjects (SAT=8.2+/-1.4 vs VAT=6.8+/-1.0 mU/g tissue) in both adipose depots. HSL activity had similar values in both types of tissue (SAT=32.8+/-1.6 and VAT=32.9+/-1.6 mU/g) of MO. In the control group, we found similar results but with lower values (SAT=11.9+/-1.4 vs VAT=12.1+/-1.4 mU/g tissue). Twelve months after surgery, SAT LPL activity diminished (9.8+/-1.4 mU/g tissue, p<0.001 vs morbidly obese), while HSL (46.6+/-3.7 mU/g tissue) remained high. All lipids in tissue and plasma diminished after bariatric surgery except plasma nonesterified fatty acids, which maintained higher levels than controls (16+/-3 vs 9+/-0 mg/dL; p<0.001, respectively).
When obese patients lose weight, they lose not only part of the lipid content of the cells but also the capacity to store triacylglycerides in SAT depots.
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ABSTRACT: The relationship between C-reactive protein (CRP), nitric oxide (NO), leptin, adiponectin, and insulin growth factor 1 (IGF-1) is poorly defined in morbidly obese patients before and after gastric bypass and, in some cases, is controversial.
We examined the plasma of 34 morbidly obese patients before and 1, 6, and 12 months after Roux-en-Y gastric bypass surgery.
Obese people had more CRP (21.3 +/- 1.8 microg/ml) and leptin (36.9 +/- 4.0 ng/ml) than those in the control group (nonobese people: CRP = 6.9 +/- 0.9 microg/ml, p < 0.0001; leptin = 7.5 +/- 0.4 ng/ml, p < 0.0001). However, they had less NO (30.4 +/- 2.7 nmol/ml), IGF-1 (77.5 +/- 6.6 ng/ml), and adiponectin (11.1 +/- 1.0 microg/ml) than those in the control group (NO = 45.8 +/- 3.9 nmol/ml, p = 0.0059; IGF-1 = 202.0 +/- 12.0 ng/ml, p < 0.0001; adiponectin = 18.0 +/- 2.0 microg/ml, p < 0.0001). During weight loss, the amount of CRP and leptin decreased until they reached the nonobese values, but the level of NO remained lower than in nonobese people, even 1 year after surgery. The linear regression slopes were negative and very significant for leptin (p = 0.0005) and CRP (p = 0.0018) but were less significant for NO (p = 0.0221). IGF-1 displayed a very good linear regression (both negative and significant) with some anthropometric parameters, including body mass index (p = 0.0025), total fat (p = 0.0177), and the percentage of fat (p < 0.0001).
For the first time, we report the relationship between IGF-1 and CRP, NO, leptin, and adiponectin. For all these parameters, the best and most widely demonstrated improvements in comorbidities before and during weight loss in morbid obesity were associated with CRP and leptin.
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