The ability to maintain cognitive function during aging is a complex process subject to genetic and environmental influences. Alzheimer's disease (AD) is the most common disorder causing cognitive decline among the elderly. Among those with AD, there is broad variation in the relationship between AD neuropathology and clinical manifestations of dementia. Differences in expression of genes involved in neural processing pathways may contribute to individual differences in maintenance of cognitive function.We performed whole genome expression profiling of RNA obtained from frontal cortex of clinically non-demented and AD subjects to identify genes associated with brain aging and cognitive decline. Genetic mapping information and biological function annotation were incorporated to highlight genes of particular interest. The candidate genes identified in this study were compared with those from two other studies in different tissues to identify common underlying transcriptional profiles. In addition to confirming sweeping transcriptomal differences documented in previous studies of cognitive decline, we present new evidence for up-regulation of actin-related processes and downregulation of translation, RNA processing and localization, and vesicle-mediated transport in individuals with cognitive decline.
BACKGROUND
Visceral adipose tissue (VAT) predicts incipient diabetes mellitus and cardiovascular disease. Human data is mixed regarding the benefits of selective VAT reduction.
OBJECTIVES
We investigated omentectomy added to laparoscopic Roux-en-Y gastric bypass (LRYGB) on glucose homeostasis and lipids, inflammatory markers and adipokines after 90-days in non-diabetic patients.
SETTING
Legacy Good Samaritan Hospital and Oregon Health & Science University in Portland, Oregon.
METHODS
A single-blinded, randomized study of LRYGB plus omentectomy vs. LYRGB alone in 28 subjects (7 male, 21 female). Groups were matched at baseline for gender, age, and body mass index (BMI). Eligibility included age ≥ 18 years old, a body mass index (BMI) ≥ 40 and < 50 kg/m2 without co-morbid conditions or BMI ≥ 35 and < 50 kg/m2 with co-morbid conditions. The primary outcome measures were changes in fasting plasma glucose, insulin and HOMA-IR. Secondary measures were BMI and levels of hs-CRP, TNF-α, interleukins, total and HMW adiponectin, fibrinogen, and PAI-1.
RESULTS
After surgery, BMI decreased significantly in both groups and was not different at follow-up. While many outcome parameters improved with weight loss in both groups post-operatively, only the omentectomy group experienced statistically significant decreases in fasting glucose (p<0.05), total (p=0.004) and VLDL (p=0.001) cholesterol, and an increase in the HMW:total adiponectin ratio (p=0.013).
CONCLUSIONS
Omentectomy added to a LRYGB results in favorable changes in glucose homeostasis, lipid levels, and adipokine profile at 90-days. These data support the hypothesis that selective ablation of VAT conveys metabolic benefit in non-diabetic humans.
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