OBJECTIVE -The purpose of this study was to clarify the effects of maternal obesity on insulin sensitivity and secretion in offspring.RESEARCH DESIGN AND METHODS -Fifty-one offspring of both sexes of obese (Ob group) and 15 offspring of normal-weight (control group) mothers were studied. Plasma glucose, insulin, and C-peptide were measured during an oral glucose tolerance test (OGTT). Insulin sensitivity was calculated using the oral glucose insulin sensitivity index, and insulin secretion and ␤-cell glucose sensitivity were computed by a mathematical model. Fasting leptin and adiponectin were also measured. Body composition was assessed by dual-X-ray absorptiometry. , P Ͻ 0.01) but did not differ significantly in women. ␤-Cell glucose sensitivity was not statistically different between groups. A multivariate analysis of variance showed that maternal obesity and offspring sex concurred together with BMI and ␤-cell glucose sensitivity to determine the differences in insulin sensitivity and secretion observed in offspring. RESULTSCONCLUSIONS -Obese mothers can give birth to normal birth weight babies who later develop obesity and insulin resistance. The maternal genetic/epigenetic transmission shows a clear sexual dimorphism, with male offspring having a higher value of insulin sensitivity (although not statistically significant) associated with significantly higher insulin secretion than female offspring.

Surgically induced weight loss is capable of reversing low-grade inflammation, at least partially. The relationships between sCD14, MBL, BPI, and glucose sensitivity, and the role of TNF-alpha in obesity warrant further investigation.

VALERA MORA, MARIA E., ANTONINO SCARFONE, VENANZIO VALENZA, MENOTTI CALVANI, ALDO V. GRECO, GIOVANNI GASBARRINI, AND GELTRUDE MINGRONE. Ghrelin does not influence gastric emptying in obese subjects. Obes Res. 2005;13: 739 -744. Objective: To evaluate the relationship between fasting plasma concentrations of ghrelin and gastric emptying in obese individuals compared with lean subjects. Research Methods and Procedures:We included 20 obese patients (9 men and 11 women, BMI Ͼ 30 kg/m 2 ) and 16 nonobese control subjects (7 men and 9 women, BMI Յ 25 kg/m 2 ). Gastric emptying of solids (egg sandwich labeled with radionuclide) was measured at 120 minutes with (99m)Tc-single photon emission computed tomography imaging. Ghrelin and leptin were analyzed by radioimmunoassay and ELISA methods, respectively. Results: The gastric half-emptying time was similar in obese men and women (67.8 Ϯ 14.79 vs. 66.6 Ϯ 13.56 minutes) but significantly shorter (p Ͻ 0.001) than in the control population (men: 88.09 Ϯ 11.72 minutes; women: 97.25 Ϯ 10.31 minutes). Ghrelin levels were significantly lower in obese subjects (131.37 Ϯ 47.67 vs. 306.3 Ϯ 45.52 pg/mL; p Ͻ 0.0001 in men and 162.13 Ϯ 32.95 vs. 272.8 Ϯ 47.77 pg/mL; p Ͻ 0.0001 in women). A negative correlation between gastric emptying and fasting ghrelin levels was observed only in lean subjects (y ϭ Ϫ0.2391x ϩ 157.9; R 2 ϭ 0.95). Also, in the lean group, ghrelin was the only significant independent determinant of gastric emptying, explaining 98% of the variance (adjusted R 2 ) in a multiple regression analysis. Discussion: This report shows that, in humans, gastric emptying is faster in obese subjects than in lean controls and that, whereas ghrelin is the best determinant of gastric kinetics in healthy controls, this action is lost in obesity.

VALERA MORA, MARIA E., MELANIA MANCO, ESMERALDA CAPRISTO, CATERINA GUIDONE, AMERIGO IACONELLI, DONATELLA GNIULI, GIUSEPPINA ROSA, MENOTTI CALVANI, AND GELTRUDE MINGRONE. Growth hormone and ghrelin secretion in severely obese women before and after bariatric surgery. Obesity. 2007;15:2012-2018. Objective: The objective was to evaluate ghrelin and growth hormone (GH) interactions and responses to a growth hormone-releasing hormone (GHRH)/arginine test in severe obesity before and after surgically-induced weight loss. Research Methods and Procedures: Our study population included 11 severely obese women 39 Ϯ 12 years of age, with a mean BMI of 48.6 Ϯ 2.4 kg/m 2 , re-studied in a phase of stabilized body weight, with a BMI of 33.4 Ϯ 1.2 kg/m 2 , 18 months after having successfully undergone biliopancreatic diversion (BPD). A GHRH/arginine test was performed before and 18 months after BPD to evaluate ghrelin and GH interactions. Active ghrelin, measured by radioimmunoassay (RIA), and GH, measured by chemiluminescence assay, were assayed before and after the GHRH/ arginine test. Results: Fasting serum GH levels and GH area under the curve (AUC) significantly increased from 0.2 Ϯ 0.05 ng/mL to 1 Ϯ 0.3 ng/mL (p Ͻ 0.05) and from 514.76 Ϯ 98.7 ng/mL for 120 minutes to 1957.3 Ϯ 665.1 ng/mL for 120 minutes after bariatric surgery (p Ͻ 0.05), respectively. Although no significant change in fasting ghrelin levels was observed (573 Ϯ 77.9 before BPD vs. 574.1 Ϯ 32.7 after BPD), ghrelin AUC significantly increased from Ϫ3253.9 Ϯ 2180.9 pg/mL for 120 minutes to 1142.3 Ϯ 916.4 pg/mL for 120 minutes after BPD (p Ͻ 0.05). Fasting serum insulin-like growth factor (IGF)-1 concentration did not change significantly (133.6 Ϯ 9.9 ng/mL before vs. 153.3 Ϯ 25.2 ng/mL after BPD). Discussion: Our study demonstrates that the mechanisms involved in ghrelin and GH secretion after the secretagogue stimulus (GHRH/arginine) are consistent with patterns observed in other populations.