title: Angiopoietin-like protein 6 in patients with obesity, type 2 diabetes mellitus, and anorexia nervosa: The influence of very low-calorie diet, bariatric surgery, and partial realimentation.
abstract: OBJECTIVE
  Angiopoietin-like protein 6 (ANGPTL6) is a circulating protein with a potential role in energy homeostasis. The aim of the study was to explore the changes in ANGPTL6 levels in patients with obesity (Body mass index, BMI > 40 kg/m2) with and without type 2 diabetes mellitus (T2DM) undergoing dietary intervention (very low calorie diet - VLCD) and in a subgroup of T2DM patients after bariatric surgery. Additionally, we examined changes in ANGPTL6 in anorexia nervosa (AN) patients at baseline and after partial realimentation. We also explored the changes in ANGPTL6 mRNA expression in subcutaneous adipose tissue (SAT) of obese subjects.
  
  
  METHODS
  The study included 23 non-diabetic obese patients, 40 obese patients with T2DM (27 underwent VLCD and 13 underwent bariatric surgery), 22 patients with AN, and 37 healthy control subjects.
  
  
  RESULTS
  ANGPTL6 levels of AN patients were increased relative to the control group (68.6 ± 9.9 ng/ml) and decreased from 110.2 ± 13.3 to 73.6 ± 7.1 ng/ml (p = 0.004) after partial realimentation. Baseline ANGPTL6 levels in patients with obesity and T2DM did not differ from the control group. VLCD decreased ANGPTL6 levels only in obese patients with T2DM. Bariatric surgery induced a transient elevation of ANGPTL6 levels with a subsequent decrease to baseline levels. ANGPTL6 mRNA expression transiently increased after bariatric surgery and returned to baseline levels after 12 months.
  
  
  CONCLUSIONS
  Collectively, our data suggest that serum ANGPTL6 levels and ANGPTL6 mRNA expression in SAT are affected by metabolic disorders and their treatment but do not appear to directly reflect nutritional status.
authors.affiliation: a Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Cinkajzlova
authors.affiliation: a Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.|b Third Department of Medicine-Department of Endocrinology and Metabolism, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Zdenka
authors.initials: Z
authors.lastname: Lacinova
authors.affiliation: a Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Klouckova
authors.affiliation: a Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Petra
authors.initials: P
authors.lastname: Kavalkova
authors.affiliation: b Third Department of Medicine-Department of Endocrinology and Metabolism, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Trachta
authors.affiliation: b Third Department of Medicine-Department of Endocrinology and Metabolism, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Mikulas
authors.initials: M
authors.lastname: Kosak
authors.affiliation: c Department of Sports Medicine, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Denisa
authors.initials: D
authors.lastname: Haluzikova
authors.affiliation: d Department of Psychiatry, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Papezova
authors.affiliation: a Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.|b Third Department of Medicine-Department of Endocrinology and Metabolism, First Faculty of Medicine , Charles University in Prague and General University Hospital , Prague , Czech Republic.
authors.forename: Milos
authors.initials: M
authors.lastname: Mraz
authors.affiliation: e Department of Obesitology , Institute of Endocrinology , Prague , Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Haluzík
mesh_terms: D000091308:Angiopoietin-Like Protein 6; D000075802:Angiopoietin-like Proteins; D042682:Angiopoietins / Q000097:blood*; D000856:Anorexia Nervosa / Q000097:blood* / Q000178:diet therapy / Q000378:metabolism; D050110:Bariatric Surgery; D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000178:diet therapy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000178:diet therapy / Q000601:surgery; D016896:Treatment Outcome
chemical_list: C477601:ANGPTL6 protein, human; D000091308:Angiopoietin-Like Protein 6; D000075802:Angiopoietin-like Proteins; D042682:Angiopoietins
keywords: ANGPTL6; angiopoietin-related growth factor; bariatric surgery; partial realimentation; very low-calorie diet