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

In situ saphenous vein bypass grafting - still first line treatment? : A prospective study comparing surgical results between diabetic and non-diabetic populations

BACKGROUND: This prospective study compares results of infrainguinal revascularisation with autologous vein in diabetic and non-diabetic populations.PATIENTS AND METHODS: 101 patients (diabetics (A) n = 50 and non-diabetics (B) n = 51) were operated upon with an in situ saphenous vein bypass to the popliteal artery below knee or to crural arteries, due to critical ischemia. Data on operative details, morbidity, mortality, secondary interventions and graft patency, were collected prospectively. All patients were followed up for 5 years.RESULTS: The two groups were similar except that diabetics more often suffered from gangrene or tissue loss. The distal anastomoses were constructed significantly more distally in diabetics. There were no differences in perioperative bleeding, length of operation, hospital stay or 30 d mortality. The 5 year patency did not differ significantly between groups, A 68 % vs. B 72 %. The limb salvage was equal in both groups, 86 % after 5 years. Mortality during follow up was significantly higher among diabetics, at two years A 31 % vs. B 14 %.CONCLUSIONS: Distal revascularisation with in situ technique is a durable procedure that can be performed with very good results in both diabetics and non-diabetics. The survival among diabetics is however significantly lower, although reaching 69 % at two years

Early Revascularization after Admittance to a Diabetic Foot Center Affects the Healing Probability of Ischemic Foot Ulcer in Patients with Diabetes.

There is limited information about whether time from recognition of decreased perfusion to revascularization affects the probability of healing in a patient with a diabetic foot ulcer. The aim of the present study was to examine whether time to revascularization after referral to a multidisciplinary foot center was related to the outcome of foot ulcers in patients with diabetes and severe peripheral arterial disease (PAD)

Direct evidence of active sympathetic vasodilatation in the skin of the human foot.

1. During operative aorto-femoral vascular reconstructions on sixteen patients, the sympathetic chain was stimulated electrically between the L2 and L4 ganglia while blood flow was monitored by laser doppler flowmeters from the skin on the sole of the foot and the ankle and by an electromagnetic flowmeter from the deep femoral artery. Epidural anaesthesia to at least the T6 level was used which excluded reflex effects. 2. Stimulation (10 Hz) at 1-12 mA current strengths for 30 s evoked both reductions and increases of blood flow in glabrous and hairy skin. Initial short-lasting flow increases (durations 9-19 s) followed by sustained decreases were common: sometimes there were sustained flow increases at low and decreases at high current strengths. 3. In the deep femoral artery (supplying predominantly muscle) only flow reductions were evoked. 4. The results provide evidence for sympathetically mediated vasodilatation in the skin of the human foot whereas leg muscles may be supplied by vasoconstrictor nerves only

Reconstructive vascular surgery and the extent of tissue damage due to diabetic foot ulcers relates to risk of new ulceration in patients with PAD.

There is limited information regarding new ulceration following the healing of ischaemic foot ulcers in diabetic patients. Our aim is to study new ulcerations in the same foot as the previous ulcer(s) in patients with diabetes and severe peripheral artery disease (PAD)