Overcoming metabolic syndrome in severe obesity: adiponectin as a marker of insulin sensitivity and HDL-cholesterol improvements after gastric bypass.
OBJECTIVE
To assess the relationship between adiponectin and metabolic parameters in severely obese women during surgical-induced weight loss.


METHODS
Nineteen lean (CT - BMI:21.2 +/- 0.3 kg.m(2)), 14 overweight/class II obese (OB/OW - BMI: 29.7 +/- 0.7 kg/m(2)) and 8 morbidly obese (OBIII - BMI: 56.4 +/- 3.6 kg/m(2)) were evaluated by hyperinsulinemic-euglycemic clamp, adiponectin, and lipids. OBIII were evaluated at 5th and 16th month post-operatively.


RESULTS
Compared to lean, obese groups had lower adiponectin (OB/OW: 9.4 +/- 0.9, OBIII: 7.1 +/- 1.3 versus 12.2 +/- 0.9 ng/dL; p < 0.01), lower HDL-cholesterol (OB/OW:1.05 +/- 0.05, OBIII: 0.88 +/- 0.04 versus 1.22 +/- 0.07 mmol/L; p < 0.01) and insulin resistance-IR (glucose uptake, M-value - OB/OW: 43.6 +/- 2.7, OBIII: 32.4 +/- 3.2 versus 20.0 +/- 1.8 umol/kgFFM.min; p < 0.001). Considering all subjects, adiponectin levels were inversely correlated to BMI and waist circumference, and directly to M-value and HDL-cholesterol (p < 0.01). During weight loss, improvements in IR (Study III: 36.1 +/- 3.9 umol/kg/FFM.min, p < 0.0001), adiponectin (11.8 +/- 1.4 ng/dL, p = 0.006) and HDL-cholesterol were observed (1.10 +/- 0.04 mmol/L, p = 0.007). Moreover, HDL-cholesterol improvement was significantly and independently related to variations of adiponectin and BMI (r(2) = 0.86; p < 0.0002).


CONCLUSIONS
The improvements of IR and adiponectin were related to surgical-induced weight loss, suggesting an important role of adiponectin in HDL-cholesterol regulation.
Geloneze
Bruno
B
Laboratório de Investigação em Metabolismo e Diabetes, Universidade Estadual de Campinas, Rua Carlos Chagas 420, Campinas, SP, Brazil. bgeloneze@terra.com.br
Pereira
Juliano Alves
JA
Pareja
José Carlos
JC
Lima
Marcelo Miranda de Oliveira
MM
Lazarin
Mary Aparecida Carvalho Tavares
MA
Souza
Iara Chaves Pereira de
IC
Tambascia
Marcos Antonio
MA
Chaim
Elinton
E
Muscelli
Elza
E
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D015390:Gastric Bypass; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D024821:Metabolic Syndrome / Q000378:metabolism* / Q000601:surgery; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D018709:Statistics, Nonparametric; D013851:Thinness / Q000097:blood; D015431:Weight Loss / Q000502:physiology
D052242:Adiponectin; D015415:Biomarkers; D008076:Cholesterol, HDL; D007328:Insulin