Overcoming metabolic syndrome in severe obesity: adiponectin as a marker of insulin sensitivity and HDL-cholesterol improvements after gastric bypass / Reversão da síndrome metabólica na obesidade mórbida: adiponectina como um marcador da sensibilização à insulina e do aumento do HDL-colesterol após o bypass gástrico
Arq. bras. endocrinol. metab
;
53(2): 293-300, Mar. 2009. graf, tab
Article
in English
| LILACS
| ID: lil-513785
ABSTRACT
OBJECTIVE:
To assess the relationship between adiponectin and metabolic parameters in severely obese women during surgical-induced weight loss.METHODS:
Nineteen lean (CT - BMI21.2 ± 0.3 kg.m²), 14 overweight/class II obese (OB/OW - BMI 29.7 ± 0.7 kg/m²) and 8 morbidly obese (OBIII - BMI 56.4 ± 3.6 kg/m²) 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/OW1.05 ± 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 (r² = 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.RESUMO
OBJETIVO:
Identificar a relação entre adiponectina e parâmetros metabólicos em mulheres obesas mórbidas durante o emagrecimento por bypass gástrico.MÉTODOS:
Dezenove magras (CT - IMC 21,2 ± 0,3 kg/m²), 14 com sobrepeso/obesidade classe II (OB/OW - IMC 29,7 ± 0,7 kg/m²) e oito obesas classe III (OBIII - IMC56,4 ± 3,6 kg/m²) foram avaliadas pelo clamp euglicêmico-hiperinsulinêmico, adiponectina e lípides. OBIII submeteram-se aos mesmos testes no quinto e décimo-sexto mês pós-operatório.RESULTADOS:
comparados a CT, os grupos obesos tiveram menor adiponectinemia (OB/OW 9,4 ± 0,9, OBIII 7,1 ± 1,3 versus 12,2 ± 0,9 ng/dL; p < 0,01), menor HDL-colesterol (OB/OW 1,05 ± 0,05, OBIII 0,88 ± 0,04 versus 1,22 ± 0,07 mmol/L; p < 0,01) e resistência insulínica - RI (captação de glicose, M - OB/OW43,6 ± 2,7, OBIII32,4 ± 3,2 versus 20,0 ± 1,8 umol/kgFFM.min; p < 0,001). Analisando todos os voluntários adiponectina correlacionou-se negativamente com IMC, circunferência da cintura e positivamente ao M-clamp e HDL-colesterol (p < 0,01). No emagrecimento, houve melhora da RI (Estudo III36,1 ± 3,9 umol/kgFFM.min, p < 0,0001), adiponectina (11,8 ± 1,4 ng/dL, p = 0,006) e HDL-colesterol (1,10 ± 0,04 mmol/L, p = 0,007). Aumentos do HDL-colesterol foram significativa e independentemente relacionados às variações da adiponectina e IMC (r² = 0,86; p < 0,0002).CONCLUSÕES:
A melhora da RI e adiponectina no emagrecimento induzido por bypass gástrico sugerem um importante papel da adiponectina na regulação do HDL-colesterol.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Obesity, Morbid
/
Insulin Resistance
/
Metabolic Syndrome
/
Adiponectin
/
Insulin
/
Cholesterol, HDL
Type of study:
Diagnostic study
/
Observational study
/
Prevalence study
/
Risk factors
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Arq. bras. endocrinol. metab
Journal subject:
Endocrinology
/
Metabolism
Year:
2009
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Instituto Nacional de Ciência e Tecnologia (INCT) de Obesidade e Diabetes/BR
/
Unicamp/BR
/
Universidade Estadual de Campinas/BR
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