Role of Full-spectrum Endoscopy in Colorectal Cancer Screening: Randomized Trial.

GOALS: The aim of this study was to compare a new, full-spectrum endoscope (Fuse; EndoChoice, Alpharetta, GA) to standard forward-viewing colonoscopy in the detection of colorectal neoplasms. BACKGROUND: Colonoscopy, the gold standard for the detection of colorectal cancer, fails to detect 22% to 28% of polyps, increasing the risk of interval cancer. Endoscopic improvement of the adenoma detection rate decrease interval carcinomas. Full-spectrum endoscopy (FUSE) (330-degree field of view), in a tandem study, has been shown to reduce the adenoma miss rate. STUDY: Prospective, randomized study of 249 patients in patients referred from the colorectal screening program with a positive fecal occult blood test (FOBT). Patients were randomized to standard forward-viewing colonoscopy (170 degrees) or to full-spectrum colonoscopy with the Fuse system (330 degrees). Study variables were the adenoma detection rate, the polyp detection rate, the mean number of adenomas per procedure, the lesions detected according to the location, morphology and size, cecal intubation rate, total procedure time, insertion time to the cecum, therapeutic success, and adverse events. RESULTS: The Fuse system did not produce a significantly higher adenoma detection rate than standard forward-viewing colonoscopy (FUSE 73.1% vs. standard colonoscopy 68.1%; P=0.47) but did have a significantly longer insertion time (FUSE 6.2 min vs. standard colonoscopy 4.2 min; P< 0.001). Further analysis failed to reveal any significant difference in polyp/adenoma detection rates by lesion size or colonic section. CONCLUSIONS: FUSE did not detect significantly more colorectal neoplasia than forward viewing colonoscopy in a medium-risk CRC screening population with positive FOBT.

Cocaine Allergy in Drug-Dependent Patients and Allergic People.

BACKGROUND: Adverse reactions to local anesthetics (LAs), especially esters, are not uncommon, but true allergy is rarely diagnosed. To our knowledge, currently there is no reliable method of determining IgE-mediated hypersensitivity to LAs and cocaine. OBJECTIVE: To assess the clinical value of allergy tests (prick, IgE, challenges, and arrays) in people suffering hypersensitivity reactions (asthma and anaphylaxis) during local anesthesia with cocaine derivatives and drug abusers with allergic symptoms after cocaine inhalation. METHODS: We selected cocaine-dependent patients and allergic patients who suffered severe reactions during local anesthesia from a database of 23,873 patients. The diagnostic yield (sensitivity, specificity, and predictive value) of allergy tests using cocaine and coca leaf extracts in determining cocaine allergy was assessed, taking a positive challenge as the criterion standard. RESULTS: After prick tests, specific IgE, and challenge with cocaine extract, 41 of 211 patients (19.4%) were diagnosed as sensitized to cocaine. Prick tests and IgE to coca leaves (coca tea) had a good sensitivity (95.1% and 92.7%, respectively) and specificity (92.3 and 98.8%, respectively) for the diagnosis of cocaine allergy and LA-derived allergy. CONCLUSIONS: Cocaine may be an important allergen. Drug abusers and patients sensitized to local anesthesia and tobacco are at risk. Both prick tests and specific IgE against coca leaf extract detected sensitization to cocaine. The highest levels were related to severe clinical profiles.

Relation of the rs6923761 gene variant in glucagon-like peptide 1 receptor with weight, cardiovascular risk factor, and serum adipokine levels in obese female subjects.

BACKGROUND: Studies of the glucagon-like peptide 1 (GLP-1) receptor have been directed at identifying polymorphisms in the GLP-1 receptor gene that may be a contributing factor in the pathogenesis of diabetes mellitus and cardiovascular risk factors. Nevertheless, the role of GLP-1 variants on body weight, cardiovascular risk factors, and adipokines remains unclear in obese patients. OBJECTIVE: Our aim was to analyze the effects of rs6923761 GLP-1 receptor polymorphism on body weight, cardiovascular risk factors, and serum adipokine levels in nondiabetic obese females. DESIGN: A sample of 645 obese nondiabetic Caucasian females was enrolled in a prospective way. Basal fasting glucose, c-reactive protein (CRP), insulin, insulin resistance (homeostasis model assessment (HOMA)), total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides concentration, and adipokines were measured. Weights, body mass index (BMI), waist circumference, fat mass by bioimpedance, and blood pressure measures were measured. RESULTS: Three hundred and twenty-seven participants (50.7%) had the genotype GG and 318 (49.3%) study subjects had the next genotypes; GA (270 study subjects, 41.9%) or AA (48 study subjects, 7.4%) (second group). In wild group (GG genotype), BMI (1.8 ± 2.3 kg/m(2) ; P < 0.05), weight (3.1 ± 1.3 kg; P < 0.05), fat mass (2.4 ± 1.1 kg; P < 0.05), waist circumference (2.7 ± 1.9 cm; P < 0.05), triglyceride levels (10.4 ± 5.3 mg/dl; P < 0.05), interleukin 6 (IL-6) (1.5 ± 0.9 ng/dl; P < 0.05), resistin (1.1 ± 0.3 ng/dl; P < 0.05), and leptin (30.1 ± 10.3 ng/dl; P < 0.05) levels were higher than mutant group (GA + AA). CONCLUSION: Data from our study revealed an association with decreased metabolic and cardiovascular markers in obese females. BMI weight, fat mass, waist circumference, triglycerides, leptin, resistin, and IL-6 serum levels were lower in subjects with A allele than non-A allele subjects.

Effect of two types of bariatric surgery (gastrojejunal bypass and sleeve gastroplasty) on gene expression of bone remodeling markers in Goto-Kakizaki rats.

BACKGROUND: The aim of this study was to evaluate gene expression of bone remodeling markers in type 2 diabetic Goto-Kakizaki (GK) nonobese rats after gastrojejunal bypass and sleeve gastroplasty and their relationship with hormonal parameters. METHODS: We designed an experimental study in three groups of GK rats (nonoperated gastrojejunal bypass and sleeve gastroplasty). Gene expression of markers of bone remodeling and levels of insulin, leptin, and glucagon-like peptide-1 (GLP-1) were determined. RESULTS: GK rats had decreased levels of osteocalcin expression compared with Wistar rats. Gene expression of markers of bone remodeling in GK rats was similar in the three groups studied, although there was a trend to decreased receptor activator for nuclear factor κ B ligand (RANKL) in gastroplasty rats. Significant differences in the osteocalcin/RANKL ratio were observed between controls and gastrojejunal bypass rats compared with gastroplasty rats. The behavior of gastrointestinal hormones was antagonistic (GLP-1 gastrojejunal bypass 1.54 ± 0.24 ng/ml vs. GLP-1 gastroplasty 0.673 ± 0.09, p = 0.0001; leptin gastrojejunal bypass 1,178 ± 0.474 pg/ml vs. leptin gastroplasty 7,391 ± 4,054 pg/ml, p = 0.002). There was a reduction in leptin in the bypass group associated with an increase in gastrectomized rats. In gastrectomized rats, there was a trend toward an inverse relationship between leptin and RANKL (r = -0.771, p = 0.072). This relationship was more marked in the totality of operated rats, n = 12 (r = -0.608, p = 0.036). CONCLUSION: Our results show a more favorable profile of sleeve gastroplasty on bone remodeling. There was a trend to an increase in the expression of the osteocalcin gene, which is probably mediated by increased expression of leptin that inhibits the expression of RANKL.

Evaluation of weight loss and adipocytokine levels after two hypocaloric diets with different macronutrient distribution in obese subjects with the rs6923761 gene variant of glucagon-like peptide 1 receptor.

BACKGROUND: The role of glucagon-like peptide-1 receptor (GLP-1R) variants on body weight response after dietary intervention has not been evaluated so far. OBJECTIVE: Our aim was to evaluate weight loss and adipocytokine levels after two hypocaloric diets with different macronutrient distribution in obese subjects with rs6923761. DESIGN: A sample of 280 obese subjects was randomized to two hypocaloric diets. RESULTS: 124 patients (44.3%) had the genotype GG (wild-type) and 156 (55.7%) had another genotype (mutant), i.e. GA (n = 132, 47.1%) or AA (n = 24, 8.6%). With the type I diet (low in carbohydrates) in the wild-type and mutant groups, BMI, weight, fat mass, waist circumference, insulin levels, insulin resistance and triglycerides decreased. Anthropometric parameters were higher in non-A-allele carriers than A-allele carriers. With the type II diet (low in fats) in all genotypes, BMI, weight, fat mass, waist circumference, insulin levels, total cholesterol and LDL cholesterol decreased. CONCLUSION: Our data showed better anthropometric parameters in obese subjects with the mutant allele (A) of the rs6923761 GLP-1R polymorphism. A lack of association of this polymorphism with weight loss or biochemical parameters after two different hypocaloric diets was observed.

Papel de la variante del promotor G308 del factor de necrosis tumoral α sobre el peso y parámetros metabólicos tras una dieta rica en grasas monoinsaturadas frente a una dieta rica en grasas poliinsaturadas / Role of G308 promoter variant of tumor necrosis factor alpha gene on weight loss and metabolic parameters after a high monounsaturated versus a high polyunsaturated fat hypocaloric diets

Background and objective: The aim of our study was to investigate the influence of G-308 promoter variant of the tumor necrosis factor (TNF) alpha gene on metabolic changes and weight loss secondary to a high monounsaturated fat vs a high polyunsaturated fat hypocaloric diet in obese subjects. Patients and method: A sample of 261 obese subjects were enrolled in a consecutive prospective way, from May 2011 to July 2012 in a tertiary hospital. In the basal visit, patients were randomly allocated during 3 months to Diet M (high monounsaturated fat hypocaloric diet) and Diet P (high polyunsaturated fat hypocaloric diet). Results: One hundred and ninety seven patients (73.2%) had the genotype G-308G and 64 (26.8%) patients had the genotype G-308A. There were no significant differences between the effects (on weight, body mass index (BMI), waist circumference, fat mass) in either genotype group with both diets. With the diet type P and in genotype G-308G, glucose levels (−6.7(22.1) mg/dl vs −3.7(2.2) mg/dl: p = 0.02), HOMA-R (−0.6(2.1) units vs −0.26(3.1) units: p = 0.01), insulin levels (−1.7(6.6) UI/L vs −0.6(7.1) UI/L: p = 0.009), total cholesterol levels (−15.3(31.1) mg/dl vs −8.4(22.1) mg/dl: p = 0.01), LDL cholesterol levels (−10.7(28.1) mg/dl vs −3.8(21.1) mg/dl: p = 0.008) and triglycerides (−12.1(52.1) mg/dl vs −6.6(43.1) mg/dl: p = 0.02) decreased. Conclusion: Carriers of the G-308G promoter variant of TNF alpha gene have a better metabolic response than A-308 obese with a high polyunsaturated fat hypocaloric diet (AU)

Fundamento y objetivo: El objetivo de este estudio es investigar la influencia de la variante G-308 del promotor del gen TNF-αsobre los cambios metabólicos y pérdida de peso secundaria a una dieta hipocalórica rica en grasas monoinsaturadas frente a una dieta rica en grasas poliinsaturadas. Pacientes y método: Una muestra de 261 obesos fue reclutada de una manera prospectiva consecutiva, desde mayo de 2011 a julio de 2012 en un hospital terciario. En la visita basal fueron aleatorizados a recibir las siguientes dietas durante al menos 3 meses: dieta M (rica en grasa monoinsaturada) y dieta P (rica en grasa poliinsaturada). Resultados: Ciento noventa y siete (73,2%) obesos presentaron el genotipo G-308G, y 64 (26,8%), el genotipo G-308A. No hubo diferencias significativas en la mejoría de peso, IMC, circunferencia de la cintura y masa grasa con ambas dietas y en ambos genotipos. Tras la dieta P y con el genotipo G-308G, los niveles de glucosa (−6,7 [22,1] vs. −3,7 [2,2] mg/dl; p = 0,02), HOMA-R (−0,6 [2,1] vs. −0,26 [3,1] unidades; p = 0,01), insulina (−1,7 [6,6] vs. −0,6 [7,1] UI/l; p = 0,009), colesterol total (−15,3 [31,1] vs. −8,4 [22,1] mg/dl; p = 0,01), colesterol LDL (−10,7 [28,1] vs. −3,8 [21,1] mg/dl; p = 0,008) y triglicéridos (−12,1 [52,1] mg/dl vs. −6,6 [43,1] mg/dl; p = 0,02) disminuyeron. Conclusión: Los portadores del genotipo G-308G presentan mayores beneficios metabólicos tras la pérdida de peso generada por la dieta rica en grasas poliinsaturadas (AU)

Role of G308 promoter variant of tumor necrosis factor alpha gene on weight loss and metabolic parameters after a high monounsaturated versus a high polyunsaturated fat hypocaloric diets.

BACKGROUND AND OBJECTIVE: The aim of our study was to investigate the influence of G-308 promoter variant of the tumor necrosis factor (TNF) alpha gene on metabolic changes and weight loss secondary to a high monounsaturated fat vs a high polyunsaturated fat hypocaloric diet in obese subjects. PATIENTS AND METHOD: A sample of 261 obese subjects were enrolled in a consecutive prospective way, from May 2011 to July 2012 in a tertiary hospital. In the basal visit, patients were randomly allocated during 3 months to Diet M (high monounsaturated fat hypocaloric diet) and Diet P (high polyunsaturated fat hypocaloric diet). RESULTS: One hundred and ninety seven patients (73.2%) had the genotype G-308G and 64 (26.8%) patients had the genotype G-308A. There were no significant differences between the effects (on weight, body mass index (BMI), waist circumference, fat mass) in either genotype group with both diets. With the diet type P and in genotype G-308G, glucose levels (-6.7(22.1)mg/dl vs -3.7(2.2)mg/dl: p = 0.02), HOMA-R (-0.6(2.1)units vs -0.26(3.1)units: p = 0.01), insulin levels (-1.7(6.6)UI/L vs -0.6(7.1)UI/L: p = 0.009), total cholesterol levels (-15.3(31.1)mg/dl vs -8.4(22.1)mg/dl: p = 0.01), LDL cholesterol levels (-10.7(28.1)mg/dl vs -3.8(21.1)mg/dl: p = 0.008) and triglycerides (-12.1(52.1)mg/dl vs -6.6(43.1)mg/dl: p = 0.02) decreased. CONCLUSION: Carriers of the G-308G promoter variant of TNF alpha gene have a better metabolic response than A-308 obese with a high polyunsaturated fat hypocaloric diet.

Relation of the rs9939609 gene variant in FTO with metabolic syndrome in obese female patients.

OBJECTIVES: Common polymorphisms of the fat mass and obesity associated gene (FTO) have been linked to obesity and diabetes mellitus type 2 in some populations. The aim of our study was to analyze the relationship of the rs9939609 FTO gene polymorphism with metabolic syndrome and its components. MATERIAL AND METHODS: A population of 457 obese Caucasian females was analyzed in a cross-sectional survey. To estimate the prevalence of Metabolic Syndrome, the definitions of the ATPIII were considered. Genotype of FTO gene polymorphism (rs9939609) was studied. RESULTS: One hundred and thirty patients (28.4%) had the genotype TT (wild group), whereas 227 patients (49.7%) had the genotype TA and 100 patients (21.9%) had the genotype AA. Prevalence of metabolic syndrome (MS) with ATP III definition was 40.7% (186 patients) and 59.3% patients had no MS (n = 271). Prevalence of mutant FTO genotypes was similar in patients with metabolic syndrome (27.4% wild genotype and 72.6% mutant genotype) and without metabolic syndrome (29.2% wild genotype and 70.8% mutant genotype).Odds ratio of metabolic syndrome in wild vs mutant genotype was 1.04 (95% CI: 0.87-1.22). Insulin levels (13.9±6.3 mUI/L vs. 12.6 ± 3.4 mUI/L; p<0.05), HOMA-R (3.3 ± 1.6 vs. 2.8 ± 1.4; p < 0.05) and triglycerides concentrations (110.8 ± 27.3 mg/dl vs. 103.1 ± 47.3 mg/dl; p < 0.05) were lower in the mutant type group than the wild type group in patients without metabolic syndrome. CONCLUSION: The FTO gene polymorphism (rs9939609) was found to be associated with increased insulin resistance, insulin and triglyceride levels in obese females with TT variant and without metabolic syndrome. MS or its components were not associated with this polymorphism in obese females.

Genetic variation in the endocannabinoid degrading enzyme fatty acid amide hydrolase (FAAH) and their influence on weight loss and insulin resistance under a high monounsaturated fat hypocaloric diet.

BACKGROUND AND AIMS: The C385A polymorphism of FAAH gene (rs324420C>A) has been associated with obesity. We investigate the role of this polymorphism on anthropometric and metabolic responses after an enriched monounsaturated fat hypocaloric diet. METHODS: A sample of 95 obese individuals was analyzed at baseline and after 3 months of an enriched monounsaturated fat hypocaloric diet. RESULTS: Sixty two patients (65.3%) had the genotype C385C and 33 (34.7%) patients had C385A genotype (30 patients, 31.6%) or A358A (3 patients, 3.2%) (A carriers group). In subjects with C385C genotype, insulin (-1.9±5.3 mUI/l) and HOMA-R (-0.48±0.75 U) decreased. In A carriers subjects, the decreases in weight were 3.7±3.4 kg (decrease in C385C genotype group 4.4±3.6 kg), fat mass 2.7±3.2 kg (decrease in C385C genotype group 3.4±3.2 kg) and waist circumference 3.1±3.4cm (decrease in C385 genotype group 4.4±4.6 cm). These changes were significantly higher in the C385C genotype group than the A carriers subjects. CONCLUSION: After weight loss, noncarriers of the allele A385 of FAAH had an improvement on insulin and HOMA-R levels with an enriched monounsaturated fat hypocaloric diet. A better response of weight, fat mass and waist circumference was observed in C385 genotype subjects than A carriers participants.

Genetic variation in the cannabinoid receptor gene (CNR1) (G1359A polymorphism) and their influence on anthropometric parameters and metabolic parameters under a high monounsaturated vs. high polyunsaturated fat hypocaloric diets.

An intragenic polymorphism (1359 G/A) of the cannabinoid receptor 1 (CNR1) gene was reported as a common polymorphism in Caucasian populations (rs1049353). Intervention studies with this polymorphism have yield contradictories results. We decide to investigate the role of polymorphism (G1359A) of (CNR1) gene on metabolic parameters and weight loss secondary to a high monounsaturated fat and high polyunsaturated fat hypocaloric diets in obese subjects. A population of 258 obese subjects was analyzed in a randomized trial. A nutritional evaluation was performed at the beginning and at the end of a 3-month period in which subjects received 1 of 2 diets (diet M: high monounsaturated fat diet vs diet P: high polyunsaturated fat diet). One hundred and sixty five patients (63.9%) had the genotype G1359G and 93 (36.1%) patients (A allele carriers) had G1359A (78 patients,30.3%) or A1359A (15 patients,5.8%) genotypes. In subjects with both genotypes, body mass index, weight, fat mass, waist circumference and systolic blood pressures decreased with both diets. With the diet-type M and in both genotype groups, biochemical parameters remained unchanged. After the diet type P and in subjects with both genotypes, glucose, total cholesterol, low-density lipoprotein (LDL) cholesterol, insulin and homeostasis model assessment for insulin resistance (HOMA-IR) levels decreased. In G1359G genotype subjects after both diets, leptin levels decreased. The finding of this study is the association of the A allele with a lack of improvement on leptin levels. Subjects with both genotypes and after a high polyunsaturated fat hypocaloric diet showed a significant improvement of LDL cholesterol, total cholesterol, HOMA-IR and insulin levels.

Lys656Asn polymorphism of leptin receptor gene is related with leptin changes after a high monounsaturated fat diet in obese patients.

BACKGROUND: Human obesity is characterized by high levels of leptin, and it has been suggested that obese patients may be leptin resistant. The aim of our study was to investigate the influence of Lys656Asn polymorphism in the leptin receptor gene on metabolic response, weight loss, and serum leptin levels to a high monounsaturated fat hypocaloric diet in obese patients. DESIGN: A sample of 126 obese patients was analyzed in a prospective way. The hypocaloric diet had 1342 kcal, 46.6% of carbohydrates, 34.1% of lipids, and 19.2% of proteins, with a 67.5% of monounsaturated fats, during 3 months. RESULTS: In Lys656Lys genotype, body mass index (-1.8 ± 1.4 kg/m), weight (-4.3 ± 3.7 kg), fat mass (-3.5 ± 3.5 kg), waist circumference (-5.0 ± 2.9 cm), systolic blood pressure (-3.8 ± 10.5 mm Hg), insulin (-1.5 ± 4.6 mUI/L), and homeostasis model assessment of insulin resistance (-0.4 ± 1.9 Units) decreased. In Asn allele carriers, body mass index (1.5 ± 2.1 kg/m), weight (-3.7 ± 3.1 kg), waist circumference (-4.4 ± 3.1 cm) decreased. Only leptin levels have a significant decrease in the Lys656Lys group (-6.9 ± 10.1 ng/mL) (24.2%). CONCLUSIONS: Patients with Asn656 allele have a different response than Lys656Lys genotype subjects, with a lack of decrease in insulin levels, leptin levels, and homeostasis model assessment of insulin resistance after weight loss.

The rs9939609 gene variant in FTO modified the metabolic response of weight loss after a 3-month intervention with a hypocaloric diet.

BACKGROUND: Common polymorphisms in the fat mass and obesity associated gene (FTO) have been linked to obesity in some populations. Nevertheless, the role of FTO variants on body weight response after dietary intervention remains equivocal. OBJECTIVE: We decided to analyze the effects of the rs9939609 FTO gene polymorphism on body weight changes and metabolic parameters after 3 months of a hypocaloric diet. DESIGN: Before and after 3 months on a low-fat hypocaloric diet, a white population of 106 subjects with obesity was analyzed. RESULTS: Of the study subjects, 35 (33%) had the genotype TT and 71 (67%) had the next genotypes; TA (46 study subjects, 43.4%) or AA (25 study subjects, 23.6%). After dietary treatment and in TT group, weight, waist circumference, total cholesterol, LDL-cholesterol, insulin, and homeostasis model assessment decreases were less than subjects carrying the A allele [-3.1 (3.6) vs -2.4 (4.1) kg: P < 0.05], waist circumference [-5.4 (6.4) vs -2.6 (4.8) cm; P < 0.05], total cholesterol [-12.3 (35.3) vs -6.4 (4.7) mg/dL; P < 0.05], LDL-cholesterol [-22.3 (30.5) vs -10.7 (30.5) mg/dL; P < 0.05], insulin [-1.89 (5.5) vs +0.94 (8.2) mUI/L; P < 0.05], and homeostasis model assessment [-0.46 (1.11) vs -0.01 (2.4); P < 0.05]. CONCLUSIONS: Our study confirmed a higher weight loss in A carriers of FTO rs9939609 polymorphism than in TT genotype study subjects.

Relation of visfatin to cardiovascular risk factors and adipocytokines in patients with impaired fasting glucose.

OBJECTIVE: The discovery of visfatin has great potential to significantly enhance our understanding of impaired fasting glucose and diabetes mellitus. The aim of the present study was to explore the relation of visfatin concentrations to cardiovascular risk factors and serum adipocytokine concentrations in patients with impaired fasting glucose. METHODS: A sample of 55 patients with impaired fasting glucose was analyzed in a prospective way. All patients with a 2-wk weight-stabilization period before recruitment were enrolled. Weight, blood pressure, basal glucose, lipoprotein(a), C-reactive protein, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols, blood, and adipocytokines (visfatin, leptin, adiponectin, resistin, tumor necrosis factor-α [TNF-α], and interleukin-6) levels were measured. Tetrapolar impedancometry, indirect calorimetry, and prospective serial assessment of nutritional intake with 3-d written food records were performed. RESULTS: Fourteen men (25.5%) and 41 women (74.5%), with a mean age of 57.3 ± 11.7 y and mean body mass index of 35.8 ± 3.6 kg/m(2), were included. Patients were divided in two groups by median visfatin value (18.2 ng/mL): group I had low values and group II had high values. Patients in group I had greater weight, body mass index, fat mass, fat-free mass, and adiponectin than patients in group II. Patients in group II had higher total cholesterol, low-density lipoprotein cholesterol, resistin, and TNF-α levels than patients in group I. In the multivariate analysis with age- and sex-adjusted basal visfatin concentration as a dependent variable, only TNF-α remained an independent predictor in the model (F = 8.4, P < 0.05), with an inverse correlation. Visfatin concentration decreased 7.33 ng/mL (95% confidence interval 2.10-12.58) for each nanogram per milligram of TNF-α increase. CONCLUSION: Only TNF-α is related in an independent way to serum visfatin levels.

Effect of fatty acid-binding protein 2 Ala54Thr genotype on weight loss and cardiovascular risk factors after a high-polyunsaturated fat diet in obese patients.

BACKGROUND: It has been found that the expression of fatty acid-binding protein 2 messenger RNA is under dietary control. The aim of our study was to investigate the influence of Thr54 polymorphism in the FABP2 gene on weight loss and secondarily in cardiovascular risk factors and serum adipokine after an enriched polyunsaturated fat hypocaloric diet in obese patients. DESIGN: A sample of 111 obese patients was analyzed. The enriched polyunsaturated fat hypocaloric diet during 3 months' intervention consisted of 1459 kcal, 45.7% carbohydrates, 34.4% lipids, and 19.9% proteins. The distribution of fats was as follows: 21.8% saturated fats, 55.5% monounsaturated fats, and 22.7% polyunsaturated fats. Level of significance was P < 0.05. RESULTS: In Ala54Ala genotype, body mass index (-1.6 ± 1.5 kg/m(2)), weight (-3.2 ± 3.3 kg), fat mass (-3.1 ± 3.5 kg), and waist circumference (-3.3 ± 2.1 cm) decreased. In carriers of the Thr54 allele, body mass index (-1.9 ± 1.6 kg/m(2)), weight (- 4.7 ± 1.4 kg), and waist circumference (-3.9 ± 3.7 cm) decreased. These changes were significantly higher in the carriers of the Thr54 allele than noncarriers. Only in the carriers of Thr54 allele, total cholesterol levels (-11.4 ± 20.6 mg/dl), low-density lipoprotein cholesterol levels (-5.4 ± 10.6 mg/dL), insulin (-2.6 ± 3.4 MUI/L), and the level of homeostasis model assessment for insulin sensitivity (-0.9 ± 1.7 U) decreased. CONCLUSION: Carriers of Thr54 allele have a better metabolic response than obese carriers with Ala54Ala genotype, with a decrease of total cholesterol, low-density lipoprotein cholesterol, insulin levels, leptin levels, and homeostasis model assessment for insulin sensitivity.

Relationship of fat distribution with adipokines in patients with acquired immunodeficiency virus infection.

BACKGROUND: The aim was to examine the relationship of fat distributions with adipokines concentrations in HIV-infected patients. METHODS: This was a cross-sectional analysis of 36 HIV (free of lipodystrophy) infected patients. Dual-energy X-ray absorptiometry was used. RESULTS: In the multivariate analysis, basal adiponectin concentration was a dependent variable, whereas waist to hip ratio and abdominal fat mass were independent predictors in the model (F = 5.1; P < 0.05). Adiponectin concentration decreases by 5.541.2 µg/ml (CI 95%: 8,071.9-3,029.1) for each unit of waist to hip ratio and 561.9 ng/ml (CI 95%: 918.2-213.4) for each kilogram of fat mass of abdominal area. In the multivariate analysis, basal leptin concentration was a dependent variable, whereas waist circumference remained an independent predictor in the model (F = 6.3; P < 0.05), with a direct correlation. Leptin concentration increases by 0.067 ng/ml (CI 95%: 0.001-0.12) for each centimeter of waist circumference. CONCLUSIONS: Leptin and adiponectin are related with adiposity in HIV-infected patients.

Relation of leptin and adiponectin with cardiovascular risk factors, intact parathormone, and vitamin D levels in patients with primary hyperparathyroidism.

BACKGROUND: Primary hyperparathyroidism (PHPT) is associated with high cardiovascular morbidity. The aim of the present study was to explore the relationship of leptin and adiponectin levels with cardiovascular risk factors and anthropometric parameters in patients with PHTP with and without metabolic syndrome (MS). METHODS: A total of 62 patients with PHPT were enrolled. Weight, blood pressure, basal glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, HOMA-R, intact parathormone, vitamin D, calcium, leptin, and adiponectin levels were measured in fasting condition. RESULTS: Prevalence of MS with ATP III definition was 32.3% (20 patients; 15 females (75%) and 5 males (25%)) and 67.7% patients without MS (n = 42 patients; 35 females (83.3%) and 7 males (16.7%)). In the analysis with leptin as dependent variable, the weight and HOMA-R levels remained in the model (F = 9.2; P < 0.05), with an increase of 1.31 (CI 95%: 0.24-2.31) ng/ml with each one unit of HOMA-R and an increase of 0.4 (CI 95%: 0.01-0.84) ng/ml with each 1 kg of weight. In a second model with adiponectin as dependent variable, the HOMA-R and HDL-cholesterol levels remained in the model (F = 7.37; P < 0.05), with a decrease of -0.62 (CI 95%: 0.01-1.1) ng/ml with each one point of HOMA-R and an increase of 0.18 (CI 95%: 0.04-0.38) ng/ml with each 1 mg/dl of HDL-cholesterol. In the multivariate, PTH I was not associated with other variables. CONCLUSION: There was a high prevalence of MS-32.3% of patients with PHPT presented an MS. Serum levels of leptin and adiponectin are not related with PTH I, vitamin D, and calcium levels in patients with PHPT.

Evaluation of weight loss and adipocytokines levels after two hypocaloric diets with different macronutrient distribution in obese subjects with rs9939609 gene variant.

BACKGROUND: Common polymorphisms of the fat mass and obesity associated gene (FTO) have been linked to obesity in some populations. One of these genetic variants (rs9939609) has been related to an increased risk of obesity. OBJECTIVE: Our aim was to evaluate weight loss and adipocytokine levels after two hypocaloric diets with different macronutrient distribution in obese subjects with RS9939609 gene variant. DESIGN: 305 obese patients were enrolled in a prospective way. In the basal visit, patients were randomly allocated during 3 months to low carbohydrates and low fat. RESULTS: After treatment with both diets and in both genotypes, weight, fat mass, waist circumference and systolic blood pressures decreased. With the diet type I and in TT genotype, insulin (-6.6 ± 9.8 IU/L) and homeostasis model assessment (-2.9 ± 6.1 units) decreased. With the diet type II and in both genotypes (wild and mutant type), insulin (-5.2 ± 6.1 vs. -3.8 ± 6.1 IU/L; p < 0.05) and homeostasis model assessment (-2.4 ± 4.8 vs. -1.1 ± 3.8 kg; p < 0.05) decreased. In the A allele group, a significant decrease was detected in total cholesterol levels (-11.5 ± 20.1 mg/dL), low density lipoprotein cholesterol levels (-13.2 ± 20.9 mg/dL) and c-reactive protein levels (-1.3 ± 3.8 mg/dL) secondary to weight loss after treatment with diet II. The decrease of leptin levels was higher in mutant type group than wild type group with low fat diet (-10.3 ± 36.1 vs. -28.6 ± 53.7 ng/mL; p < 0.05). CONCLUSION: Metabolic improvement secondary to weight loss was better in A carriers with a low fat hypocaloric diet.

Basal GLP-1 levels in morbidly obese patients following biliopancreatic diversion surgery.

BACKGROUND: Previous studies addressing the changes of glucagon-like peptide-1 (GLP-1) concentrations in morbidly obese patients after bariatric surgery have demonstrated conflicting results. The aim of the present study was to investigate the changes in serum GLP-1 levels 9 months after biliopancreatic diversion in morbidly obese patients without diabetes mellitus. METHODS: A sample of 40 morbidly obese patients without diabetes mellitus was enrolled. Biochemical and anthropometrical evaluations were conducted at basal and 9 months after surgery. RESULTS: The mean patient age was 46.6 ± 13.1 years, and the mean preoperative body mass index (BMI) was 47.1 ± 18.1. A significant decrease in BMI, weight, waist circumference, fat mass, glucose, LDL cholesterol, total cholesterol, and triglyceride levels was observed after 9 months. Serum basal GLP-1 levels did not change after surgery (0.65 ± 0.18 ng/ml vs. 0.66 ± 0.17 ng/ml; n.s.). Postsurgical correlation analysis showed a negative association between basal GLP-1 and HDL cholesterol (r = -0.57; p < 0.01). CONCLUSIONS: Fasting GLP-1 concentrations did not change after massive weight loss with biliopancreatic diversion in morbidly obese patients without diabetes mellitus.

The deleterious effect of bariatric surgery on cortical and trabecular bone density in the femurs of non-obese, type 2 diabetic Goto-Kakizaki rats.

BACKGROUND: The effects of type 2 diabetes on bone mass and microstructure are not clear. The aim of this study was to evaluate bone microstructural properties and volumetric bone mineral density (vBMD) in type 2 diabetic Goto-Kakizaki non-obese rats after gastrojejunal bypass and their relationship with hormonal parameters. METHODS: We designed an experimental study in Goto-Kakizaki rats with and without gastrojejunal bypass, performing densitometric and microstructural studies of the distal femur using X-ray computed microtomography (micro-CT). Levels of insulin, glucagon, leptin, and glucagon-like peptide-1 (GLP-1) were also determined. RESULTS: We observed reduced cortical (1,488.92 ± 98.2 vs. 1,727.92 ± 133.45 mg/cm(3), p = 0.028) and trabecular (180.8 ± 9 vs. 261.23 ± 45.54 mg/cm(3), p = 0.036) vBMD in operated rats. Bone volume fraction (BV/TV) and trabecular connectivity were reduced in operated rats, while there was a reduction in cortical thickness and an increase in rod-like trabeculae at the expense of plate-like trabeculae. Leptin was reduced (1,042 ± 549 vs. 2,447 ± 1,035 pg/ml, p = 0.05) and GLP-1 increased (1.62 ± 0.32 vs. 0.96 ± 0.1 ng/ml, p = 0.008) but only leptin showed a significant association with vBMD CONCLUSIONS: In type 2 diabetic Goto-Kakizaki rats, gastrojejunal bypass produces a reduction in cortical and trabecular bone mineral density and a deterioration in bone quality that could be explained, in part, by the reduction in leptin levels.

Relationship of -55C/T polymorphism of uncoupling protein 3 (UCP3) gene with metabolic syndrome by ATP III classification.

BACKGROUND AND AIMS: The relation of -55C/T polymorphism of uncoupling protein 3 (UCP3) with metabolic syndrome (MS) has been evaluated only in one previous study with contradictory results. The aim of our study was to investigate the association of -55C/T polymorphism of UCP3 gene with MS. DESIGN: A population of 817 obese Caucasian patients was analyzed in a cross-sectional survey. Genotype of UCP3 gene -55C/T was studied. To estimate the prevalence of MS , the definitions of the ATPIII were considered. RESULTS: Five hundred and ninety-four patients (72.7%) had the genotype -55CC (wild group), whereas 223 patients (27.3%) had the genotype -55C/T. Genotype -5TT was not detected. Prevalence of mutant UCP genotypes was similar in patients with MS (75.7% wild genotype and 24.3% mutant genotype) and without MS (69.7% wild genotype and 30.3% mutant genotype). Odds ratio of MS wild vs. mutant genotype was 1.17 CI 95%: 0.99-1.38). Total cholesterol and low density lipoprotein (LDL) cholesterol concentrations were lower in mutant-type group than wild-type group in patients with MS. No differences in other parameters were detected between genotypes in the same group of MS. CONCLUSION: -55C/T UCP polymorphism is not major risk factor for the MS. However, in mutant group of -55CC UCP3 gene in patients with MS, total cholesterol and LDL cholesterol were lower than wild-type patients.