Current research supports that obesity and insulin resistance are positively correlated with plasma endothelin‐1 (ET‐1) levels; however, the mechanisms leading to this increase in ET‐1 are not fully understood. Similarly, while some physiological effects of ET‐1 have been characterized, the full complexity of this hormone has yet to be described in tissues outside of the vascular system. To date, one of the best treatments available for morbid obesity, cardiovascular disease, and metabolic syndrome is bariatric surgery to quickly reduce body fat and the factors associated with obesity‐related disease. We hypothesize that vertical sleeve gastrectomy (VSG) will reduce plasma ET‐1 levels. This was tested by measuring plasma ET‐1 levels from twelve obese patients before VSG, 6 weeks after, and 6 months after surgery. The results indicate that 6 weeks following VSG, plasma ET‐1 levels increased by 24%; however, after 6 months, there was a 27% decrease compared to baseline. Average weight loss in this cohort was 11.3±2.4 percent body weight after 6 weeks and 21.4±5.7 percent body weight after 6 months. Interestingly, we observed an inverse relationship between baseline plasma ET‐1 and percent body weight loss 3 months (R2=0.45, p<0.05) and 6 months (R2=0.49, p=0.01) post bariatric surgery. Our results indicate that VSG reduces plasma ET‐1 levels, a possible mechanism for improved metabolic risk in these patients. These data also suggest that ET‐1 may inhibit weight loss or serve as a predictor of weight loss following bariatric surgery. Support or Funding Information This work is supported by NHLBI grant R00 HL127178 to JSS. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.
Background. Vertical sleeve gastrectomy (VSG) is a surgical weight loss procedure that resects 80% of the stomach, creating a tube linking the esophagus to the duodenum. Because of the efficacy and relative simplicity of VSG, it is preferred in the U.S with VSG currently at >61% of bariatric surgeries performed. Surprisingly, there has never been a complete molecular characterization of the human stomach fundus and corpus. Here we compare and contrast the molecular make-up of these regions. Methods. We performed a prospective study to obtain gastric tissue samples from patients undergoing VSG. Paired fundus and corpus samples were obtained Whole genome transcriptome analysis was performed by RNA sequencing, with key findings validated by qPCR. Results. Participants were primarily female (95.8%) and white (79.15%). Mean BMI, body weight, and age were 46.1 kg/m2, 121.6 kg, and 43.29 years, respectively. Overall, 432 gene transcripts were significantly different between the fundus and corpus (p<0.05). A significant correlation was found between the RNAseq data set and qPCR validation, demonstrating robust gene expression differences. Significant genes included: progastricsin, acid chitinase, gastokine 1 and 2 in both fundus and corpus. Of the very highly expressed genes in both regions, 87% were present in both the stomach's fundus and corpus, indicating substantial overlap. Conclusions. Despite significant overlap in the greater curvature gene signature, regional differences exist. Given that the mechanism of VSG is partly unresolved, the potential that the resected tissue may express genes that influence long-term body weight regulation is unknown and could influence VSG outcomes.
Background Surgical weight loss procedures like vertical sleeve gastrectomy (SG) are sufficient in resolving obesity comorbidities and are touted to reduce the burden of pro-inflammatory cytokines and augment the release of anti-inflammatory cytokines. Recent reports suggest a reduced improvement in weight resolution after SG in Black Americans (BA) versus White Americans (WA). The goal of this study was to determine if differences in immunoglobulin levels and general markers of inflammation after SG in Black Americans (BA) and White Americans (WA) may contribute to this differential resolution. Methods Personal information, anthropometric data, and plasma samples were collected from 58 participants (24 BA and 34 WA) before and 6 weeks after SG for the measurement of immunoglobulin A (IgA), IgG, IgM, C-reactive protein (CRP), and transforming growth factor (TGFβ). Logistic regression analysis was used to determine the relationship of measures of body size and weight and inflammatory markers. Results Both IgG and CRP were significantly elevated in BA in comparison to WA prior to weight loss. Collectively, IgG, TGFβ, and CRP were all significantly reduced at six weeks following SG. CRP levels in BA were reduced to a similar extent as WA, but IgG levels were more dramatically reduced in BA than WA despite the overall higher starting concentration. No change was observed in IgA and IgM. Conclusions These data suggest that SG improves markers of immune function in both BA and WA. More diverse markers of immune health should be studied in future work.
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