BackgroundVaspin and omentin are recently described molecules that belong to the adipokine family and seem to be related to metabolic risk factors. The objectives of this study were twofold: to evaluate vaspin and omentin circulating levels and mRNA expression in subcutaneous and visceral adipose tissues in non-diabetic morbidly obese women; and to assess the relationship of vaspin and omentin with anthropometric and metabolic parameters, and other adipo/cytokines.DesignWe analysed vaspin and omentin circulating levels in 71 women of European descent (40 morbidly obese [BMI ≥ 40 kg/m2] and 31 lean [BMI ≤ 25]). We assessed vaspin and omentin gene expression in paired samples of visceral and subcutaneous abdominal adipose tissue from 46 women: 40 morbidly obese and 6 lean. We determined serum vaspin and plasma omentin levels with an Enzyme-Linked Immunosorbent Assay and adipose tissue mRNA expression by real time RT-PCR.ResultsSerum vaspin levels in the morbidly obese were not significantly different from those in controls. They correlated inversely with levels of lipocalin 2 and interleukin 6. Vaspin mRNA expression was significantly higher in the morbidly obese, in both subcutaneous and visceral adipose tissue.Plasma omentin levels were significantly lower in the morbidly obese and they correlated inversely with glucidic metabolism parameters. Omentin circulating levels, then, correlated inversely with the metabolic syndrome (MS). Omentin expression in visceral adipose tissue was significantly lower in morbidly obese women than in controls.ConclusionsThe present study indicates that vaspin may have a compensatory role in the underlying inflammation of obesity. Decreased omentin circulating levels have a close association with MS in morbidly obese women.

ObjectiveThe adipocyte/macrophage fatty acid-binding protein 4 (FABP4) has been described as a biomarker for adiposity and metabolic syndrome (MS). The aims of this study were to assess the relationship between FABP4 and inflammatory cytokines related to obesity, and to evaluate FABP4 mRNA expression in visceral and subcutaneous adipose tissue in non-diabetic morbidly obese women versus healthy lean women.MethodsWe analyzed circulating levels of FABP4 in 81 Spanish women: 38 lean (body mass index (BMI)<25 kg/m2) and 43 morbidly obese (BMI>40 kg/m2). We took 30 follow-up blood samples at 6 and 12 months after bariatric surgery. We assessed FABP4 gene expression in samples of subcutaneous abdominal and visceral adipose tissue. Adipose tissue mRNA expression was determined by real-time RT-PCR.ResultsIn morbidly obese women, plasma FABP4 levels were significantly higher than in non-obese patients. These levels positively correlated with BMI, homeostasis model assessment of insulin resistance (HOMA2-IR), and plasma glucose and insulin levels. Post-operative FABP4 levels decreased by a maximum of 30% after 12 months. We also found an inverse association between FABP4 and adiponectin levels, and positive correlations between FABP4 and circulating leptin, tumor necrosis factor (TNF) receptors, C-reactive protein (CRP) and interleukin 6 levels. Linear regression analysis revealed that FABP4 was more closely related to HOMA2-IR than adiponectin, CRP, TNF-RI, or leptin. Furthermore, high circulating FABP4 levels were associated with the presence of MS. FABP4 mRNA expression in visceral adipose tissue was related to its circulating levels in morbidly obese women.ConclusionsOur results indicate that serum FABP4 is associated with inflammatory factors related to obesity and MS in non-diabetic morbidly obese women.

Plasma α-ketoglutarate is superior to common liver function tests in obese patients as a surrogate biomarker of NAFLD. The measurement of this biomarker may potentiate the search for a therapeutic approach, may decrease the need for liver biopsy and may be useful in the assessment of disease progression.

In subjects with morbid obesity undergoing bariatric surgery, compared to a LCD, a preoperative 21-day intervention with VLCD is more effective in terms of reducing total body weight but not in terms of reducing the liver volume. Both types of preoperative diets have similar effects on clinical biochemical parameters, rate of surgical complications, and hospital length stay.

BackgroundLow concentrations of plasma vitamin D (25(OH)D) have been associated with the development of metabolic syndrome (MetS), obesity, diabetes and cardiovascular disease. The objective of this study was to quantify the associations between 25(OH)D and parathormone (PTH) plasma levels and obesity, the presence of MetS, diabetes or atherogenic dyslipidemia (AD) in a large sample of individuals with different degrees of adiposity.MethodsRetrospective study of all patients who had attended the obesity clinics in a Spanish hospital between 2009 and 2011, and whose concentrations of PTH, 25(OH)D, calcium and alkaline phosphatase had been determined (n=316, 75.9% women). Individuals were categorized by degree of adiposity, presence of MetS, and other comorbidities.ResultsPTH increased but 25(OH)D and calcium decreased with increasing adiposity. The prevalence of 25(OH)D deficiency or insufficiency increased with obesity (<10% when BMI<45kg/m2, and 26% when >50). The prevalence of hyperparathyroidism increased from 12% in non-obese to 47.5% in morbidly obese individuals with BMI>50 kg/m2. Low plasma 25(OH)D and high PTH concentrations were associated with an increased risk of MetS and AD. These associations disappeared, except in the case of AD for 25(OH)D when adjusting for BMI. Regression analysis revealed that BMI and age or seasonality were independent predictors of PTH and 25(OH)D levels, respectively.ConclusionsBMI was the variable most strongly associated with plasma 25(OH)D and PTH concentrations in our study. Low 25(OH)D and high PTH concentrations were not independently associated with an increased risk of MetS, or diabetes. Our data support a possible contribution of plasma 25(OH)D to the pathogenesis of hypertriglyceridemia and AD through inflammation.

Sleeve gastrectomy is a very good option for exogenous obesity. Normalization of hormonal levels led us to find an extragastric ghrelin production.

Our study demonstrates a marked decrease in fasting leptin and chemerin levels, and an increase in ghrelin levels, after bariatric surgery-induced weight loss, independently of the type of surgery performed. Further studies are needed on the interrelation between the changes in the circulating levels of these molecules and the efficacy of the bariatric surgery procedures to induce the beneficial metabolic changes and to sustain body weight loss.

Specific miRNA expression profiles have been shown to be associated with nonalcoholic fatty liver disease (NAFLD). We examined the correlation between the circulating levels and hepatic expression of miR122 and miR33a/b*, the key lipid metabolism-related gene expression and the clinicopathological factors of obese women with NAFLD. We measured miR122 and miR33a/b* expression in liver samples from 62 morbidly obese (MO), 30 moderately obese (ModO), and eight normal-weight controls. MiR122 and miR33a/b* expression was analyzed by qRT-PCR. Additionally, miR122 and miR33b* circulating levels were analyzed in 122 women. Hepatic miR33b* expression was increased in MO compared to ModO and controls, whereas miR122 expression was decreased in the MO group compared to ModO. In obese cohorts, miR33b* expression was increased in nonalcoholic steatohepatitis (NASH). Regarding circulating levels, MO patients with NASH showed higher miR122 levels than MO with simple steatosis (SS). These circulating levels are good predictors of histological features associated with disease severity. MO is associated with altered hepatic miRNA expression. In obese women, higher miR33b* liver expression is associated with NASH. Moreover, multiple correlations between miRNAs and the expression of genes related to lipid metabolism were found, that would suggest a miRNA-host gene circuit. Finally, miR122 circulating levels could be included in a panel of different biomarkers to improve accuracy in the non-invasive diagnosis of NASH.