title: Intramyocitic lipid accumulation and SREBP-1c expression are related to insulin resistance and cardiovascular risk in morbid obesity.
abstract: The aim of this study was to investigate the sterol regulatory element-binding protein 1c (SREBP1c) mRNA muscle expression in morbid obese subjects before and after massive lipid malabsorption due to bariatric surgery (bilio-pancreatic diversion, BPD). We studied 11 obese subjects (BMI 49+/-2 kg/m2) before and 24 months after BPD. Skeletal muscle SREBP1c mRNA expression was determined using RT-competitive PCR. Intramyocytic triglycerides were quantified by HPLC. Insulin sensitivity (M/I) was assessed by euglycemic-hyperinsulinemic clamp. Energy expenditure and respiratory quotient (RQ) were measured over 24 h in a calorimetric chamber. Total cardiovascular risk dropped from 2 before to -2.5 after BPD (P<0.0001). The M/I value was normalized after surgery (0.036+/-0.0148 to 0.095+/-0.0147 micromol kgFFM(-1) min(-1) pmoles(-1) P<0.001). SREBP-1c mRNA levels were decreased (from 4.12+/-2.43 to 2.69+/-1.83% of cyclophilin mRNA, P=0.02) after BPD. In a multiple regression analysis, M/I values (P<0.0001) as well as the intramyocytic triglyceride levels (P=0.039) were the most powerful independent variables for predicting cardiovascular risk. Our results show that the reduction of cardiovascular risk after bariatric massive weight loss is strongly related to the reversion of insulin resistance and to the lowering of intramyocytic triglyceride depots. These two parameters are associated with a significant reduction in SREBP-1c mRNA expression in skeletal muscle, suggesting that this transcription factor might be involved in the accumulation of triglycerides in muscle cells of morbidly obese subjects.
authors.affiliation: Istituto di Clinica Medica, Università Cattolica del Sacro Cuore, Rome, Italy. gmingrone@rm.unicatt.it
authors.forename: G
authors.initials: G
authors.lastname: Mingrone
authors.forename: G
authors.initials: G
authors.lastname: Rosa
authors.forename: A V
authors.initials: AV
authors.lastname: Greco
authors.forename: M
authors.initials: M
authors.lastname: Manco
authors.forename: N
authors.initials: N
authors.lastname: Vega
authors.forename: G
authors.initials: G
authors.lastname: Nanni
authors.forename: M
authors.initials: M
authors.lastname: Castagneto
authors.forename: H
authors.initials: H
authors.lastname: Vidal
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism / Q000601:surgery; D000328:Adult; D015904:Biliopancreatic Diversion; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D022762:CCAAT-Enhancer-Binding Proteins / Q000096:biosynthesis*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology*; D008076:Cholesterol, HDL / Q000097:blood; D021983:Cyclophilins / Q000378:metabolism; D004268:DNA-Binding Proteins / Q000096:biosynthesis*; D005215:Fasting / Q000378:metabolism; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D050356:Lipid Metabolism; D008297:Male; D032383:Myocytes, Cardiac / Q000378:metabolism*; D009767:Obesity, Morbid / Q000378:metabolism* / Q000503:physiopathology* / Q000601:surgery; D012333:RNA, Messenger / Q000378:metabolism; D012307:Risk Factors; D013223:Statistics as Topic; D051780:Sterol Regulatory Element Binding Protein 1; D014157:Transcription Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss / Q000502:physiology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D022762:CCAAT-Enhancer-Binding Proteins; D008076:Cholesterol, HDL; D004268:DNA-Binding Proteins; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D012333:RNA, Messenger; C497387:SREBF1 protein, human; D051780:Sterol Regulatory Element Binding Protein 1; D014157:Transcription Factors; D014280:Triglycerides; D021983:Cyclophilins