The use of microdialysis to characterize the endocrine production of human subcutaneous adipose tissue in vivo.

OBJECTIVE: Adipose tissue-derived factors represent important players in the metabolic regulations acting both on systemic and local level. However, their local concentrations in human adipose tissue are poorly described. METHODS: We measured 24-hour profile and post-glucose load concentrations of selected adipokines in the subcutaneous adipose tissue of 17 healthy women by in vivo microdialysis. During 24-hour period, subjects consumed two standardized meals (at 13.00 h and at 19.00 h). RESULTS: During 24-hour period, fat interleukin-6, interleukin-8/CXCL8, resistin, and hepatocyte growth factor (HGF) exhibited increase/decrease/plateau pattern and peaked at about 14.30 h. Fat leptin exhibited increase/plateau/decrease/increase pattern and reached plateau between 22.00 and 5.30 h. Fat adiponectin exhibited decrease/plateau pattern and reached plateau between 1.00 and 7.00 h. Fat plasminogen activator inhibitor-1 (PAI-1) exhibited decrease/increase pattern with the lowest value at 20.30 h. Oral glucose consumption significantly increased fat adiponectin and resistin levels and decreased fat leptin and PAI-1 levels, respectively. CONCLUSIONS: The levels of studied adipokines in subcutaneous fat exhibited significant variations during the 24-hour period after microdialysis catheter insertion that were not reflected in the circulation. Concentrations of adiponectin, resistin, leptin and PAI-1 were regulated by oral glucose ingestion from 1 to 3 h after oral glucose load in healthy women.

Laparoscopic sleeve gastrectomy without an over-sewing of the staple line.

BACKGROUND: In the past few years, laparoscopic sleeve gastrectomy (LSG) became a widely used bariatric method. Based on results of recent LSG studies, LSG is being increasingly used even as a single bariatric method. On contrary with some other reports, we do not reinforce the LSG staple line with over-sewing. Our pilot study presents treatment outcomes and results 18 months after LSG. METHODS: Sixty-one consecutive morbidly obese (MO) patients (19 male and 42 female) who underwent LSG from January 2006 to May 2008 were included into the study. The mean age, height, and weight were 37.3 years (29-57), 168 cm (151-187), and 118 kg (97-181), respectively, while mean body mass index (BMI) was 41.8 (36.1-60.4). LSG started at 6 cm from pylorus and ended at the angle of Hiss. For gastric sleeve calibration 38F, intragastric tube was used. All 61 LSG were performed without over-sewing of the staple line. In the last 24 cases, the staple line was covered with Surgiceltrade mark strips, which were however placed without any fixation to the underlying gastric tissue. RESULTS: Mean operating time was 105 min (80-170) and no conversion to open surgery. An 18-month follow-up was recorded in 39 MO patients. The mean weight loss was 31.3 (range, 21-67 kg) and mean % excess BMI loss reached 72% (range, 64-97%). Neither leak nor disruptions of the staple line and/or sleeve dilatation were recorded. CONCLUSION: LSG is an effective and safe bariatric procedure with low incidence of complications and mortality in our experience.

Serum adiponectin and resistin concentrations in patients with restrictive and binge/purge form of anorexia nervosa and bulimia nervosa.

To study the role of adipose tissue-derived hormones in the pathophysiology of eating disorders, circulating levels of adiponectin, resistin, and other hormonal and metabolic parameters were measured in 16 females with the restrictive subtype of anorexia nervosa (R-AN), 10 females with the binge/purge subtype of anorexia nervosa (P-AN), 15 females with bulimia nervosa (BN), and 12 age-matched healthy females (C). Body mass index (BMI), body fat content, and serum leptin levels were severely decreased in R-AN and moderately decreased in P-AN patients, whereas the BN group did not differ from C in these parameters. Serum soluble leptin receptor levels were increased in R-AN and P-AN and unchanged in BN patients. Circulating adiponectin levels were inversely related to BMI and were unchanged in BN patients and increased by 53% in P-AN and by 96% in R-AN relative to C group, respectively. In contrast, resistin levels in malnourished R-AN and P-AN were not different from either C or BN groups and showed no significant relationship to BMI or body fat content. We suggest that increased adiponectin levels reflect decreased body fat content in AN patients. In contrast, circulating resistin levels do not appear to be closely related to the nutritional status.

Soluble leptin receptor and leptin levels in pregnant women before and after delivery.

Soluble leptin receptor is an extracellular domain of the leptin receptor that serves as the main leptin-binding protein and may play a role in the regulation of leptin tissue effects. The aim of our study was to assess serum concentrations of leptin, soluble leptin receptor, and other hormones involved in the regulation of leptin secretion in pregnant women before and after delivery. Serum leptin, cortisol, and tumor necrosis factor alpha (TNF-alpha) concentrations in 19 pregnant women before delivery were significantly higher than in healthy nonpregnant women (33.3+/-21.0 vs. 7.9+/-3.5 ng/mL, 1068.9+/-442.2 vs. 546.6+/-165.3 nmol/L, 4.4+/-1.1 vs. 3.4+/-1.2 ng/mL, respectively). In contrast, no differences between these groups were found in soluble leptin receptor levels. Delivery significantly decreased serum leptin and cortisol levels and increased soluble leptin receptor levels (12.3+/-9.1 ng/mL, 749.6+/-205.3 nmol/L, 23.3+/-7.9 U/mL, respectively). Soluble leptin receptor levels after delivery became higher than in the control group. We conclude that serum leptin and serum soluble leptin-receptor levels are significantly affected by pregnancy and delivery. The regulation of leptin levels in this group of patients appears to be distinct and independent of soluble leptin-receptor levels.