title: Adipocyte fatty acid-binding protein as a determinant of insulin sensitivity in morbid-obese women.
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.
authors.affiliation: CIBERDEM, Endocrinology and Diabetes Research Department, University Hospital Joan XXIII from Tarragona, School of Medicine, Rovira i Virgili University, Pere Virgili Institute, Tarragona, Spain. ism@comt.org
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Simón
authors.forename: Xavier
authors.initials: X
authors.lastname: Escoté
authors.forename: Núria
authors.initials: N
authors.lastname: Vilarrasa
authors.forename: José
authors.initials: J
authors.lastname: Gómez
authors.forename: José M
authors.initials: JM
authors.lastname: Fernández-Real
authors.forename: Ana
authors.initials: A
authors.lastname: Megía
authors.forename: Cristina
authors.initials: C
authors.lastname: Gutiérrez
authors.forename: Lluis
authors.initials: L
authors.lastname: Gallart
authors.forename: Carles
authors.initials: C
authors.lastname: Masdevall
authors.forename: Joan
authors.initials: J
authors.lastname: Vendrell
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007333:Insulin Resistance; D020382:Interleukin-18 / Q000097:blood; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins; D020382:Interleukin-18; D047889:Receptors, Tumor Necrosis Factor, Type II; D002097:C-Reactive Protein