Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

Unamuno, Xabier; Izaguirre, Maitane; Gómez-Ambrosi, Javier; Rodríguez, Amaia; Ramírez, Beatriz; Becerril, Sara; Valentí, Víctor; Moncada, Rafael; Silva, Camilo; Salvador, Javier; Portincasa, Piero; Frühbeck, Gema; Catalán, Victoria

doi:10.3390/nu11092069

Cited by 31 publications

(26 citation statements)

References 57 publications

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“…Increased leptin/adiponectin ratio is strongly influenced by radical measures such as bariatric surgery. Severely obese type 2 diabetes mellitus patients that underwent Roux-en-Y gastric bypass had significantly lower leptin levels and significantly higher adiponectin levels compared to baseline values (41), these modifications of adipokines could contribute to the remission of glycaemic misbalance frequently observed in this category of patients.…”

Section: Discussionmentioning

confidence: 92%

Influence of inflammation and adipocyte biochemical markers on the components of metabolic syndrome

et al. 2020

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Metabolic syndrome is associated with increased risk of cardiovascular disease. This study investigated the correlation between adipocyte and inflammation biomarkers, and metabolic syndrome and its components. The study included 80 patients with normal body-mass index and 80 obese patients. The groups were assessed for serum values of adiponectin, leptin and highly sensitive C reactive protein (hsCRP), the homeostatic model assessment of insulin resistance (HOMA-IR), as well as the influence of these biochemical markers on the prevalence of metabolic syndrome and its components. Leptin, HOMA-IR and hsCRP had statistically significant (P<0.01) higher values in the group of obese subjects, while adiponectin had statistically significant (P<0.01) lower values. The prevalence of metabolic syndrome was 35% in the obese group and 5% in the normal weight group. Adiponectin and HOMA-IR were the variables significantly associated with metabolic syndrome (P<0.01), adiponectin/HOMA-IR ratio and leptin/adiponectin ratio were also associated with metabolic syndrome (P<0.01). No relationship was found between metabolic syndrome and hsCRP. Adiponectin and adiponectin/HOMA-IR were associated with all the components of metabolic syndrome and they can be useful to identify patients with high risk of diabetes mellitus and cardiovascular disease.

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Section: Discussionmentioning

confidence: 92%

Influence of inflammation and adipocyte biochemical markers on the components of metabolic syndrome

et al. 2020

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“…We have shown that in a predominantly white cohort of adults with severe obesity who underwent laparoscopic sleeve gastrectomy, there was a substantial reduction in the LAR after 12 months, which may indicate an increase in insulin sensitivity. While several studies have measured leptin or adiponectin separately in patients after bariatric surgery 3,[6][7][8]15 , we are aware of only one other study by Unamuno et al that has considered them together as a ratio and as an indicator of adipocyte dysfunction 16 . Ours is the first study to consider these adipokines as a ratio in patients undergoing laparoscopic sleeve gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have described reductions in leptin and increases in adiponectin in adults with severe obesity undergoing bariatric surgery 3 , 6 – 8 , 15 . Recently, investigators described changes in the adiponectin: leptin ratio (ALR) in a cohort of 25 Spanish adults with type 2 diabetes who underwent Roux-en-Y gastric bypass 16 . To date, the influence of sleeve gastrectomy on the ratio of these two hormones has not been described.…”

Section: Introductionmentioning

confidence: 99%

The leptin to adiponectin ratio (LAR) is reduced by sleeve gastrectomy in adults with severe obesity: a prospective cohort study

Rafey

Fang

Ioana

et al. 2020

Sci Rep

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Bariatric surgery is known to reduce leptin and increase adiponectin levels, but the influence of sleeve gastrectomy on the leptin: adiponectin ratio (LAR), a measure of insulin sensitivity and cardiovascular risk, has not previously been described. We sought to determine the influence of sleeve gastrectomy on LAR in adults with severe obesity.In a single centre prospective cohort study of adults undergoing laparoscopic sleeve gastrectomy over a four-month period in our unit, we measured LAR preoperatively and 12 months after surgery. Of 22 patients undergoing sleeve gastrectomy, 17 (12 females, 12 with type 2 diabetes) had follow-up LAR measured at 12.1 ± 1 months. Mean body weight decreased from 130.6 ± 30.8 kg to 97.6 ± 21.6 kg, body mass index (BMI) from 46.9 ± 7.8 to 35.3 ± 7.2 kg m−2 and excess body weight from 87.5 ± 31.3 to 41.3 ± 28.8% (all p < 0.001). The reduction in leptin from 40.7 ± 24.9 to 30.9 ± 30.5 ng/ml was not significant (p = 0.11), but adiponectin increased from 4.49 ± 1.6 to 8.93 ± 6.36 µg/ml (p = 0.005) and LAR decreased from 8.89 ± 4.8 to 5.26 ± 6.52 ng/µg (p = 0.001), equivalent to a 70.9% increase in insulin sensitivity. The correlation with the amount of weight lost was stronger for LAR than it was for leptin or adiponectin alone. In this single-centre, interventional prospective cohort, patients undergoing laparoscopic sleeve gastrectomy had a substantial reduction in their LAR after 12 months which was proportional to the amount of weight lost. This may indicate an improvement in insulin sensitivity and a reduction in cardiovascular risk.

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“…In addition, improvements in insulin sensitivity and glucose homeostasis, a decrease of serum free fatty acid levels, an increase of the adiponectin/leptin ratio, and a decrease of interleukin-6 and C-reactive protein have been reported [ 38 , 39 , 40 , 41 ].…”

Section: Results Of Mbs In Adolescentsmentioning

confidence: 99%

Update on Metabolic Bariatric Surgery for Morbidly Obese Adolescents

et al. 2021

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Despite worldwide public attention and intense medical efforts, the prevalence of severe morbid obesity in children and adolescents is still rising. Similar to adults, excess adipose tissue triggers multiple immunological and metabolic pathways leading to serious co-morbidities such as impaired glucose tolerance or even type 2 diabetes (T2D), dyslipidemia, arterial hypertension, non-alcoholic fatty liver disease, and hyperuricemia. The management of severe childhood obesity requires a life-long multidisciplinary approach with a combination of lifestyle changes, nutrition, and medications. Standardized life-style intervention programs remain the first-line treatment for morbid obese children and adolescents, but unfortunately reveal limited long-term success. In such cases, metabolic bariatric surgery (MBS) has evolved from being a controversial issue to being included in distinct recommendations. According to the American Society for Metabolic and Bariatric Surgery (ASMBS) Pediatric Committee, indications for bariatric surgery in adolescence must follow very strict criteria. Adolescents with class II obesity (BMI > 120% of the 95th percentile) and a diagnosed co-morbidity or with class III obesity (BMI ≥ 140% of the 95th percentile) should be considered for MBS. These interventions represent high-risk operations, and adolescents should be treated in specialized, multidisciplinary high-volume obesity centers with long-term follow-up programs. The Roux-en-Y gastric bypass (RYGB) remains the gold standard of all malabsorptive procedures. Laparoscopic sleeve gastrectomy (LSG), which the authors pioneered as a stand-alone procedure in morbidly obese adolescents in 2008, has become the most commonly performed operation in morbidly obese adolescents at present. Recent literature proves that MBS is safe and effective in morbidly obese adolescents. Mid-term data have revealed significant improvement or even resolution of major co-morbidities. Thus, MBS for the treatment of morbidly obese adolescents has evolved from being a controversial issue to being included in distinct recommendations by several medical societies as a therapeutic strategy to reduce severe co-morbidities potentially causing end-organ damage in adulthood.

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Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

Cited by 31 publications

References 57 publications

Influence of inflammation and adipocyte biochemical markers on the components of metabolic syndrome

Influence of inflammation and adipocyte biochemical markers on the components of metabolic syndrome

The leptin to adiponectin ratio (LAR) is reduced by sleeve gastrectomy in adults with severe obesity: a prospective cohort study

Update on Metabolic Bariatric Surgery for Morbidly Obese Adolescents

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