Chemerin correlates with markers for fatty liver in morbidly obese patients and strongly decreases after weight loss induced by bariatric surgery.
BACKGROUND
Chemerin is a new adipokine involved in in vitro adipogenesis and insulin resistance and associates with body mass index (BMI) in vivo.


OBJECTIVE
We investigated the role of chemerin in morbid obesity, associated metabolic diseases (insulin resistance, hepatic diseases), and postsurgery-induced weight loss.


METHODS
This was a prospective study performed at a university hospital.


METHODS
Subjects included 60 obese female patients (BMI 50.0 +/- 1.0 kg/m(-2)) being candidates for gastric bypass.


METHODS
Patients were examined before and 3, 6, and 12 months after surgery. In 27 patients, chemerin was measured after 2 yr.


RESULTS
Outcomes included chemerin, anthropometric parameters, homeostasis model assessment for insulin resistance index (HOMA-IR), cholesterol, high-density lipoprotein, triglycerides, C-reactive protein, adipokines at all time points; and liver histology and macrophage content in fat at baseline.


RESULTS
Chemerin was substantially elevated in obese patients compared with nonobese persons (353.8 +/- 18.0 vs. 191 +/- 14 ng/ml, P < 0.001). Preoperatively, chemerin concentrations correlated positively with BMI, C-reactive protein, IL-6, HOMA-IR, and the amount of omental macrophages and negatively with high-density lipoprotein levels. Baseline chemerin was elevated in patients with a significant activity score for nonalcoholic fatty liver disease, portal inflammation, fibrosis, and fibroinflammation. After surgery, chemerin decreased significantly to 253.0 +/- 14.9 ng/ml after 1 yr and pursued its decrease in patients studied for 2 yr. After surgery, chemerin concentrations positively correlated with triglycerides. The strong decrease of chemerin in the 3 months after surgery was associated with the decrease in HOMA-IR and blood glucose.


CONCLUSIONS
Chemerin concentrations are elevated in morbidly obese patients and correlated with insulin resistance and markers of liver pathology. Chemerin plasma concentrations decreased after bariatric surgery. This study suggests that chemerin might mediate metabolic alterations in obesity, drastically improving after gastric bypass.
Sell
Henrike
H
Institute of Clinical Biochemistry and Pathobiochemistry, German Diabetes Center, Auf'm Hennekamp 65, 40225 Düsseldorf, Germany. henrike.sell@ddz.uni-duesseldorf.de
Divoux
Adeline
A
Poitou
Christine
C
Basdevant
Arnaud
A
Bouillot
Jean-Luc
JL
Bedossa
Pierre
P
Tordjman
Joan
J
Eckel
Jürgen
J
Clément
Karine
K
D054392:Adipokines / Q000097:blood*; D000273:Adipose Tissue / Q000166:cytology; D000328:Adult; D000886:Anthropometry; D050110:Bariatric Surgery; D015415:Biomarkers; D018925:Chemokines / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D005234:Fatty Liver / Q000097:blood* / Q000209:etiology / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D036341:Intercellular Signaling Peptides and Proteins; D007958:Leukocyte Count; D008075:Lipoproteins, HDL / Q000097:blood; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000473:pathology; D008137:Longitudinal Studies; D008264:Macrophages / Q000502:physiology; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications / Q000601:surgery*; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss / Q000502:physiology*
D054392:Adipokines; D015415:Biomarkers; D018925:Chemokines; D036341:Intercellular Signaling Peptides and Proteins; D008075:Lipoproteins, HDL; C478630:RARRES2 protein, human; D014280:Triglycerides; D002784:Cholesterol