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

Abstract

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.

Explorative research on glucolipid metabolism and levels of adipokines in pseudohypoparathyroidism type 1 patients

“…But the difference in LAR rest between BMI-based subgroups but not molecular subgroups suggested that the impact of body fat accumulation on peripheral leptin level may out-weighted the negative feedback regulation of the leptin-melanocortin pathway due to the malfunction of Gsα. The BMI related differences in LAR further suggested the possible insulin resistance, as previous investigation on elder female and severely obese population have associated higher LAR with worse insulin sensitivity [ 20 , 21 ], and the similarity in LAR between PHP1A and PHP1B group could be explained by the indifferent BMI of them.…”

Explorative research on glucolipid metabolism and levels of adipokines in pseudohypoparathyroidism type 1 patients

“…But the difference in LAR rest between BMI-based subgroups but not molecular subgroups suggested that the impact of body fat accumulation on peripheral leptin level may out-weighted the negative feedback regulation of the leptinmelanocortin pathway due to the malfunction of Gsα. The BMI related differences in LAR further suggested the possible insulin resistance, as previous investigation on elder female and severely obese population have associated higher LAR with worse insulin sensitivity [20,21], and the similarity in LAR between PHP1A and PHP1B group could be explained by the indifferent BMI of them.…”

Effects of a Calorie-Restricted Cafeteria Diet and Oleuropein Supplementation on Adiposity and mRNA Expression of Energy Balance Related Genes in Obese Male Rats

“…WAT also secretes adiponectin, an anorexigenic adipokine responsible for, among other functions, the suppression of hepatic glucose production and fatty acid oxidation (lipolysis). Consequently, the leptin/adiponectin ratio (LAR) is considered a measure of whole-body insulin sensitivity and cardiovascular risk in humans [ 42 , 43 ]. Our results showed an increase of more than three times the STD Lep mRNA expression levels due to the CAF diet, in accordance with the higher relative weight of mWAT exhibited by the animals fed this diet.…”