Retinol binding Protein-4 circulating levels were higher in nonalcoholic fatty liver disease vs. histologically normal liver from morbidly obese women.

We aimed to analyze the retinol binding protein-4 (RBP4) messenger RNA (mRNA) expression profiles in adipose tissues and liver of morbidly obese (MO) women with or without nonalcoholic fatty liver disease (NAFLD), and to study the relationships with other pro- and anti-inflammatory adipokines in vivo and in vitro. We performed a cross-sectional analysis of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT) and liver samples from four lean and 45 MO women with or without NAFLD by enzyme-linked immunosorbent assay and real-time reverse transcription-PCR. We also studied RBP4 expression in HepG2 hepatocytes under various inflammatory stimuli. Circulating RBP4 levels were higher in MO women, and specifically, in MO subjects with NAFLD compared with normal liver controls (lean and MO). RBP4 liver expression was higher in nonalcoholic steatohepatitis (NASH)-moderate/severe than in NASHmild. Overall RBP4 gene expression was higher in liver than in adipose tissues. Among them, the higher expression corresponded to SAT. VAT expression was lower in the MO cohort. In HepG2, RBP4 mRNA expression was reduced by tumor necrosis factor (TNF)-α and increased by adiponectin treatment. In conclusion, the results obtained in MO women with NAFLD, brings up the use of RBP4 and other adipokines as a panel of noninvasive molecular biomarkers when NAFLD is suspected. Further studies are needed with other obesity groups.Fil: Terra, Ximena. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; EspañaFil: Auguet, Teresa. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; España. Hospital Universitari Joan XXIII. Servei Medicina Interna,; EspañaFil: Broch, Montserrat. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; EspañaFil: Sabench, Fátima. Hospital Sant Joan de Reus. Servei de Cirurgia,; EspañaFil: Hernandez, Mercè. Hospital Sant Joan de Reus. Servei de Cirurgia,; EspañaFil: Pastor, Rosa M.. Hospital Universitari Joan XXIII. Laboratori de Bioquímica; EspañaFil: Quesada, Isabel María. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Mendoza. Instituto de Medicina y Biología Experimental de Cuyo; Argentina. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; EspañaFil: Lunna, Ana. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; EspañaFil: Aguilar, Carmen. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; EspañaFil: Del Castillo, Daniel. Hospital Sant Joan de Reus. Servei de Cirurgia, ; EspañaFil: Richard, Cristobal. Universitat Rovira i Virgil. Departament de Medicina i Cirurgia; España. Hospital Universitari Joan XXIII. Servei Medicina Interna,; Españ

Influència de la gastrectomia tubular en direrents models experimentals d'obesitat: Implicacions metabòliques i hormonals.

Introducció: La cirurgia bariátrica és el tractament més eficaç pels pacients amb obesitat mòrbida i que compleixin els criteris establerts per a ser tributaris de tractament. Estudis que han demostrat que la grelina és un factor important en la regulació de la ingesta ha fet que s'hagin realitzat treballs que relacionessin els nivells de grelina i les diferents tècniques quirúrgiques bariàtriques, donat que la major part de grelina es sintetitza al fundus gàstric. En el cas de la gastrectomia tubular, hi ha una exèresi de quasi la totalitat del fundus gàstric, amb el que els nivells de grelina teòricament han d'estar baixos després de la intervenció. La pèrdua de pes tan bona després de la gastrectomia tubular pot ser deguda en part a la disminució brusca de la grelina, que faria disminuir la ingesta. La gastrectomia tubular i les implicacions metabòliques que la intervenció quirúrgica produiria, es veurien reflectides en les variacions en els nivells plasmàtics de Grelina, GLP-1, Insulina i Glucèmia, així com en els canvis ponderals i de la ingesta depenent de les situacions fisiopatològiques en les quals s'aplica la intervenció quirúrgica.Aquestes situacions són: 1.- Situació de no obesitat. 2.- Obesitat exògena degut a una excessiva ingesta calòrica. 3.- Obesitat determinada genèticament. 4.- Obesitat determinada genèticament i Diabetis Mellitus tipus 2.Objectius: Analitzar l'efecte de la gastrectomia tubular sobre el pes per a cada model experimental. Analitzar l'efecte de la gastrectomia tubular sobre el volum d'ingesta per cada model experimental i la seva relació amb els canvis ponderals. Analitzar l'efecte de la gastrectomia tubular sobre els nivells de glucèmia per cada model experimental i la seva relació amb els canvis ponderals i els volum d'ingesta. Analitzar l'efecte de la gastrectomia tubular sobre els nivells de Grelina, GLP-1 i Insulina plasmàtica per cada model experimental.Mètodes: Gastrectomia tubular als diferents models experimentals: 1-rates Sprague Dawley no obeses, 2- rates Sprague Dawley obeses per dieta cafeteria, 3- rates Zucker obeses genéticament i 4- rates obeses i diabétiques genéticament (ZDF). El model 2 té un grup control que no serà intervingut i tan sols se li retira la dieta cafeteria.Resultats globals/ Conclusions: La gastrectomia tubular te un efecte metabòlic i ponderal diferent si l'apliquem a rates no obeses o a rates amb obesitat exògena. Mentre en el grup no obès es produeixen pocs canvis passades dues setmanes de la intervenció, en el model d'obesitat exògena la gastrectomia tubular aconsegueix la normalització del pes i igualar tots els paràmetres endocrino-metabòlics estudiats als obtinguts per les rates no obeses. La única excepció d'aquest comportament és el GLP- 1 que com sabem te un efecte anorexígen, i persisteix més alt en aquest en el grup de les rates obeses a pesar que el pes ja s'ha normalitzat.La gastrectomia tubular practicada en rates genèticament obeses (Model 3) té un efecte poc important tan pel que fa a la ingesta calòrica com pel que fa al pes. Aquest model es l'únic en el que es produeixen augments de pes post-intervenció encara que la intervenció fa que es situïn per sota del pes teòric per l' edat. També s'ha observat una tendència a la disminució de l'hiperinsulinisme i de la hiperglucèmia.En el model 4 de rates obeses i diabètiques, la gastrectomia tubular produeix una disminució de la ingesta amb una estabilització del pes que arriba a valors pròxims al pes ideal per la edat. La repercussió sobre l'estat metabòlic és escassa però hem pogut constatar, a diferencia dels altres grups, augments d'insulina postintervenció que no aconsegueixen corregir l'estat d'hiperglucèmia.Introduction: Bariatric surgery is the most effective treatment for patients who have morbid obesity and who comply with the criteria established to be eligible for treatment. Studies have shown that ghrelin is an important factor in regulating intake, and this has led to further studies into ghrelin levels and the various bariatric surgical techniques, because most grelin is synthesized in the gastric fundus. We should point out that sleeve gastrectomy involves the exeresis of almost the entire gastric fundus, which means that the ghrelin levels should theoretically be low after the intervention. Such good weight loss after sleeve gastrectomy may be partly due to the sudden decrease in ghrelin, which would clearly decrease intake. Sleeve gastrectomy and the metabolic implications of surgical intervention would be reflected in variations in the plasma levels of ghrelin, GLP-1, insulin and glycaemia, as well as changes in weight and calorie intake, which would depend on the physiopathological situations in which the surgical intervention takes place.These situations are: 1. Non-obese situations. 2. Exogenous obesity due to excessive calorie intake. 3. Genetically determined obesity. 4. Genetically determined obesity and type 2 diabetis mellitus.Aims: To analyse the effect of sleeve gastrectomy on weight for each experimental model. To analyse the effect of sleeve gastrectomy on intake volume for each experimental model and its relation to weight change. To analyse the effect of sleeve gastrectomy on glycaemia levels for each experimental model and its relation to weight change and intake volume. To analyse the effect of sleeve gastrectomy on levels of ghrelin, GLP-1 and plasma insulin for each experimental model.Methods: Sleeve gastrectomy in the various experimental models described. Model 2 has a control group that will not be intervened and they are only withdrawn from the cafeteria diet.Overall results/Conclusions: Sleeve gastrectomy affects metabolism and weight differently in non-obese rats (model 1) and rats with exogenous obesity (cafeteria diet model 2). While the non-obese group undergoes few changes during the first two weeks after the intervention, the weight of the exogenous obesity model normalises and all the endocrine-metabolic parameters studied are the same as those for non-obese rats. The only exception to this is GLP-1 which, as is well known, has an anorectic effect, and it remains high in the group of obese rats even though weight has normalised.Sleeve gastrectomy in genetically obese rats (model 3) has little effect on both calorie intake and weight. This is the only model in which weight increases after the intervention even though the intervention positions them below the theoretical weight for their age. It has also been observed that hyperinsulinism and hyperglycaemia tend to decrease after the gastrectomyIn model 4 (obese and diabetic rats), sleeve gastrectomy decreases intake and stabilizes weight at values that are close to the ideal weight for the age in this type of rats. The effect on the metabolic state is only slight but, unlike other animals, we have found increases in insulin after the intervention that do not manage to correct the state of hyperglycaemia

New adipokines vaspin and omentin. Circulating levels and gene expression in adipose tissue from morbidly obese women

<p>Abstract</p> <p>Background</p> <p>Vaspin 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.</p> <p>Design</p> <p>We 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.</p> <p>Results</p> <p>Serum 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.</p> <p>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.</p> <p>Conclusions</p> <p>The 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.</p

Evaluation of surgical skills in medical students using a virtual simulator. [Evaluación de las habilidades quirúrgicas durante el pregrado mediante la introducción de un simulador virtual]

10.1016/j.ciresp.2012.05.01