Elevated Fetuin-A concentrations in morbid obesity decrease after dramatic weight loss.
BACKGROUND
Morbid obesity (MO) is a risk factor for cardiovascular morbidity, mortality, and diabetes, which can be effectively reduced by bariatric surgery. The liver-secreted protein Fetuin-A is elevated in insulin resistance, is an independent predictor of type 2 diabetes and is associated with atherosclerosis.


OBJECTIVE
We studied Fetuin-A concentrations in patients with MO before and after weight loss induced by gastric bypass.


METHODS
We conducted a cross-sectional study and a 16-month longitudinal study.


METHODS
This study was performed in secondary care. PATIENTS, SUBJECTS, AND INTERVENTION: We included 75 MO patients [65 women, body mass index (BMI) 45.6 ± 8.1 kg/m(2)] and 38 healthy controls (21 women, BMI 26.0 ± 5.5 kg/m(2)) in a cross-sectional study and investigated them before and about 16 months after gastric bypass surgery.


METHODS
Apart from measurements of blood pressure and routine laboratory parameters, a 75-g oral glucose tolerance test was performed. Insulin resistance was calculated by using homeostatic model assessment (HOMA).


RESULTS
Fetuin-A levels were significantly higher in MO (877 ± 318 μg/ml) than in controls (295 ± 61 μg/ml; P < 0.001). After surgery-induced weight loss (BMI 31.6 ± 6.8 vs. 45.6 ± 8.1 kg/m(2); P < 0.001), HOMA (2.0 ± 1.2 vs. 6.6 ± 6.3; P < 0.001) and Fetuin-A (710 ± 350 vs. 877 ± 318 μg/ml; P < 0.001) decreased. Delta (Δ) Fetuin-A concentrations correlated with Δfasting insulin (r = 0.710; P = 0.001), Δ2-h insulin (r = 0.693; P = 0.005), and HOMA-insulin resistance (r = 0.684; P = 0.001).


CONCLUSIONS
Fetuin-A is markedly increased in patients with MO. The reduction of Fetuin-A after weight loss could play an important role in the beneficial effects of gastric bypass surgery.
Brix
Johanna Maria
JM
Department of Medicine 1, Rudolfstiftung Hospital, Vienna, Juchgasse 25, Vienna, Austria.
Stingl
Harald
H
Höllerl
Florian
F
Schernthaner
Gerit Holger
GH
Kopp
Hans-Peter
HP
Schernthaner
Guntram
G
D001786:Blood Glucose; D001794:Blood Pressure; D001798:Blood Proteins / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D015390:Gastric Bypass; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D015431:Weight Loss / Q000502:physiology*; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001786:Blood Glucose; D001798:Blood Proteins; D008055:Lipids; D060749:alpha-2-HS-Glycoprotein