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Eur J Endocrinol ; 150(2): 195-200, 2004 Feb.
Article in English | MEDLINE | ID: mdl-14763917

ABSTRACT

BACKGROUND: Endothelial dysfunction and inflammation are present in both type 2 diabetes mellitus (T2DM) and obesity. In this paper we compared the role of weight loss and of glycaemic control in determining circulating levels of ICAM-1, endothelin-1 (ET-1), and E-selectin in patients with morbid (grade 3) obesity. METHODS AND RESULTS: ICAM-1, E-selectin, and ET-1 were higher in obese patients (n=96) than in lean controls (n=30); among obese patients, the three molecules were higher in T2DM patients (n=26) than in patients with normal (NGT, n=43) or impaired (IGT, n=27) glucose tolerance. Sixty-eight obese patients had a significant weight loss induced by bariatric surgery, and showed a significant decrease in blood glucose, HbA1c and all molecules, so that ICAM-1, E-selectin, and ET-1 were not different in NGT, IGT and T2DM patients, and in lean controls; in 13 patients with a small weight loss induced by diet, changes were not significant, in spite of a significant reduction in blood glucose and HbA1c. At stepwise regression, changes in ICAM-1, ET-1, and E-selectin significantly correlated only with change in body mass index. CONCLUSIONS: These data indicate that weight loss is more important than glycaemic control in regulating circulating levels of ICAM-1, ET-1, E-selectin in morbidly obese subjects.


Subject(s)
Blood Glucose/metabolism , E-Selectin/blood , Endothelin-1/blood , Intercellular Adhesion Molecule-1/blood , Obesity, Morbid/metabolism , Adult , Body Weight/physiology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Female , Follow-Up Studies , Glucose Intolerance/blood , Glycated Hemoglobin/analysis , Humans , Insulin Resistance/physiology , Male , Matched-Pair Analysis , Middle Aged , Obesity, Morbid/complications , Reference Values , Regression Analysis , Weight Loss/physiology
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