title: Changes in metabolic profile and adipoinsular axis in morbidly obese premenopausal females treated with restrictive bariatric surgery.
abstract: BACKGROUND
  The aim of the present study was to evaluate the effects of surgically induced weight loss on the metabolic profile and adipocytokine levels in premenopausal morbidly obese females.
  
  
  METHODS
  Twenty premenopausal morbidly obese (MO) women with a median age of 34 years (range: 24-48 years) and a median body mass index (BMI) of 41.47 kg/m(2) (range: 38.0-56.73 kg/m(2)) were studied (13 women underwent gastric banding and 7 women underwent sleeve gastrectomy). In addition, 20 lean premenopausal women with a median age of 32 years (range: 22-44 years) and a median BMI of 20.0 kg/m(2) (range: 18.5-24.7 kg/m(2)) were also studied. Anthropometric measurements and metabolic parameters were analyzed in each patient, along with changes in leptin, adiponectin, resistin, and interleukin-6 (IL-6) before surgery, 6 months after surgery, and 12 months after surgery. Comparisons with the reference normal-weight subjects were also performed.
  
  
  RESULTS
  Both weight and BMI were found to be significantly decreased postoperatively. A 54.5% loss of excess BMI was observed 12 months after surgery, and was associated with significant improvement in all anthropometric and metabolic parameters. Twelve months after surgery we also observed decreased levels of serum leptin, resistin, and IL-6; increased levels of serum adiponectin; and a remarkable improvement in metabolic syndrome markers. Furthermore, postoperative serum resistin and IL-6 levels were found to reach those of normal-weight volunteers.
  
  
  CONCLUSIONS
  The results of this study suggest that weight loss through restrictive bariatric surgery results in a significant reduction in leptin, resistin, and IL-6 levels, and an increase in adiponectin levels, in addition to improving insulin sensitivity and glucose and lipid homeostasis in young morbidly obese female patients. These changes were significantly correlated with the magnitude of weight loss.
authors.affiliation: Bariatric Unit, Department of Surgical Oncology, P.O. Box 1352, Heraklion, 71110, Crete, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Marantos
authors.forename: Markos
authors.initials: M
authors.lastname: Daskalakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karkavitsas
authors.forename: Ioannis
authors.initials: I
authors.lastname: Matalliotakis
authors.forename: John A
authors.initials: JA
authors.lastname: Papadakis
authors.forename: John
authors.initials: J
authors.lastname: Melissas
mesh_terms: D054392:Adipokines / Q000378:metabolism*; D000328:Adult; D000886:Anthropometry; D050110:Bariatric Surgery / Q000379:methods*; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D020738:Leptin / Q000097:blood; D055442:Metabolome; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D017697:Premenopause / Q000502:physiology; D052243:Resistin / Q000097:blood; D016896:Treatment Outcome; D049629:Waist-Hip Ratio; D015431:Weight Loss; D055815:Young Adult
chemical_list: D054392:Adipokines; D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D015850:Interleukin-6; D020738:Leptin; D052243:Resistin