Obesity, chronic kidney disease progression and the role of the adipokine C1q/TNF related protein-3 / Relación entre la adipoquina C1q/TNF-Related Protein 3, obesidad y progresión de la enfermedad renal crónica

Introduction and aims: Obesity is a risk factor for incident chronic kidney disease (CKD). C1q/TNF related protein 3 (CTRP3) is an adipokine with multiple effects and may modulate the association between obesity and vascular diseases. The aim of the study is to explore potential links between obesity, CTRP3 levels and CKD progression. Methods: Patients with stage 3 and 4 CKD without previous cardiovascular events were enrolled and divided into groups according to body mass index (BMI) and sex. Demographic, clinical, analytical data and CTRP3 levels were collected at baseline. During follow-up, renal events (defined as dialysis initiation, serum creatinine doubling or a 50% decrease in estimated glomerular filtration rate were registered). Results: 81 patients were enrolled. 27 were obese and 54 non-obese. Baseline CTRP3 was similar between both groups (90.1±23.8 vs 84.5±6.2; p=0.28). Of the sum, 54 were men and 27 women, with higher CTRP3 in women (81.4±24.7 vs 106±24.7;p<0.01). During a mean follow-up of 68 months, 15 patients had a renal event. Patients in the higher CTRP3 tertile had less events but without statistical significance (p=0.07). Obese patients in the higher CTRP3 tertile significantly had less renal events (p=0.049). By multiple regression analysis CTRP3 levels could not predict renal events (HR 0.98; CI95% 0.96–1.06). Conclusions: CTRP3 levels are higher in woman than men in patients with CKD, with similar levels between obese and non obese. Higher CTRP3 levels at baseline were associated with better renal outcomes in obese patients. (AU)

Introducción: La obesidad es un factor de riesgo de la enfermedad renal crónica (ERC) incidente. La proteína 3 relacionada con C1q/TNF (CTRP3) es una adipoquina que puede modular la asociación entre obesidad y enfermedades vasculares. El objetivo del estudio es explorar los posibles vínculos entre obesidad, CTRP3 y progresión de ERC. Métodos: Pacientes con ERC estadio 3 y 4 sin eventos cardiovasculares previos fueron reclutados y divididos según el índice de masa corporal y sexo. Los datos demográficos, clínicos, analíticos y los niveles de CTRP3 se recopilaron basalmente. Durante el seguimiento se registraron eventos renales (inicio de diálisis, duplicación de la creatinina o una disminución del 50% en la filtración glomerular estimada). Resultados: Se reclutaron 81 pacientes, 27 obesos y 54 no obesos. LA CTRP3 inicial fue similar en ambos grupos (90,1±23,8 vs. 84,5±6,2; p=0,28). Del total, 54 eran varones y 27 mujeres, con mayor CTRP3 en mujeres (81,4±24,7 vs. 106±24,7; p<0,01). Durante un seguimiento medio de 68 meses, 15 pacientes sufrieron un evento renal. Los pacientes en el tercil superior de CTRP3 tuvieron menos eventos, pero sin significación estadística (p=0,07). Los pacientes obesos en el tercil superior de CTRP3 tuvieron significativamente menos eventos renales (p=0,049). Por análisis de regresión múltiple, los niveles de CTRP3 no pudieron predecir eventos renales (HR: 0,98; IC 95%: 0,96-1,06). Conclusiones: Los niveles de CTRP3 son más altos en mujeres que en varones en pacientes con ERC, con niveles similares entre obesos y no obesos. Valores iniciales mayores de CTRP3 se asociaron con mejores resultados renales en pacientes obesos. (AU)

Modulation of rectal cancer stemness, patient outcome and therapy response by adipokines

Response to chemoradiotherapy (CRT) in patients with locally advanced rectal cancer is highly variable. Identification of CRT non-responders and definite accurate biomarkers of response are unmet needs. In turn, adipokines might impact on colorectal cancer development. We hypothesized that imbalance in leptin and adiponectin modulates stemness potential CRT response in rectal cancer. Pre-CRT serum and tissue samples were collected from a cohort of locally advanced rectal cancer patients (n = 33), submitted to long-course CRT and proctectomy. Adiponectin and leptin were measured by ELISA in serum. In tumour biopsies, mRNA expression of stemness-related genes was evaluated by qRT-PCR and transcription factor STAT3 by immunoblotting. Correlations with clinical data and accuracy of potential CRT response biomarkers were evaluated. Carcinoembryonic antigen (CEA) but not leptin or adiponectin distinguished CRT responders from non-responders (p < 0.05). However, higher leptin and lower adiponectin serum levels were associated with positive extramesorectal nodes and extramural vascular invasion. mRNA expression of stemness factors was inversely correlated with adiponectin but positively correlated with leptin. STAT3 phosphorylation presented similar results. CEA levels together with STAT3 activation and OCT4/KLF4 expression accurately identified rectal cancer patients, CRT non-responders (AUROC 0.80; p < 0.05). Adipokines might impact rectal cancer stemness and patient prognosis. The leptin/STAT3 signalling axis provides the rational for a potential biomarker panel that identifies rectal cancer patients who will not benefit from CRT treatment. (AU)

CTRP6 suppresses neutrophil extracellular traps formation to ameliorate sepsis-induced lung injury through inactivation of ERK pathway

extracellular traps formation contributes to inflammatory lung injury in sepsis. C1q/tumor necrosis factor–related protein-6 (CTRP6) is a paralog of adiponectin and exerts anti- inflammatory and antioxidant properties. The role of CTRP6 in sepsis-associated inflammatory lung injury was investigated in this study. Methods: Mice were injected with lipopolysaccharides (LPS) intraperitoneally to establish the mouse sepsis model. They were first tail-vein injected with adenovirus-mediated overexpression CTRP6 (Ad-CTRP6) and then subjected to the LPS injection. Pathological changes in lungs were detected by hematoxylin and eosin staining. Inflammation cytokine levels in bronchoalveolar lavage fluid were assessed by qRT-PCR and ELISA. Flow cytometry was used to detect the number of neutrophils in bronchoalveolar lavage fluid, and immunofluorescence was performed to assess neutrophil extracellular traps. Results: Lipopolysaccharides induced pulmonary congestion, interstitial edema, and alveolar wall thickening in the lungs, as well as upregulated lung histology score and wet/dry weight ratio. CTRP6 was reduced in lung tissues of septic mice. Injection with Ad-CTRP6 ameliorated extensive histopathological changes in LPS-induced mice and decreased lung histology score and wet/dry weight ratio. Overexpression of CTRP6 reduced the levels of TNF-α, IL-6, and IL-1β in septic mice. Injection with Ad-CTRP6 also decreased the number of neutrophils and downregulated Cit-H3 and myeloperoxidase polymers in septic mice. Protein expression of p-ERK in septic mice was reduced by overexpression of CTRP6. Conclusion: CTRP6 attenuated septic lung injury, exerted anti-inflammatory effect, and suppressed neutrophil extracellular traps formation against sepsis through inactivation of extracellular signal-regulated kinase signaling (AU)

Vaspin attenuates steatosis-induced fibrosis via GRP78 receptor by targeting AMPK signaling pathway

Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease that is rapidly becoming a public health problem. An imbalance in lipid distribution to the hepatocytes and metabolism causes hepatocyte steatosis. Vaspin is a newly discovered adipokine that has been linked to a variety of metabolic disorders. The effects of vaspin on steatosis and fibrosis pathogenesis and related mechanisms are unclear. Thus, this study investigated the molecular mechanism of vaspin on hepatocyte steatosis and fibrosis. HepG2 cells were treated with 1.2 mM free fatty acid and the intracellular lipid values were measured by flow cytometry and Nile red assay. RT-qPCR was used to assess the effect of vaspin and blocking of the GRP78 receptor on the expression of lipogenesis, oxidation, uptake, and secretion of fatty acid (FA), as well as AMPK activity. In co-cultured HepG2 and LX-2 cell lines, the expression of main proteins of hepatocyte fibrosis was analyzed using Western blot analysis. In the HepG2 cell line, we discovered that vaspin increased oxidation, FA secretion and gene expression, and AMPK activity and decreased lipogenesis and FA uptake and gene expression. Western blot analysis in co-cultured HepG2 and LX-2 cell lines showed that α-SMA and TGF-β1 protein expression decreased. The data demonstrated that vaspin acts as a novel regulator of hepatocyte steatosis through the GRP78 receptor, effectively reducing hepatocyte fibrosis through AMPK activation and decreasing NF-κB gene expression. (AU)

Comparación de los efectos de 12 semanas de tres tipos de entrenamiento de resistencia (tradicional, circular e intervalado) sobre los niveles de neuregulina 4, adiponectina y leptina en hombres no atléticos con obesidad / Comparison of the effects of 12 weeks of three types of resistance training (traditional, circular and interval) on the levels of neuregulin 4, adiponectin and leptin in non-athletic men with obesity

Objectives: The purpose of this study was to compare three types of resistance training including traditional, circular and interval in non-athletic men with obesity in comparison to a control group for neuregulin 4, adiponectin and leptin responses. Material and method: The sample of the study included 44 non-athletic men with obesity, who were randomly divided into the 4 equal groups (10 per each group): traditional, circular, and interval resistance training as well as a control group. Neuregulin 4 , leptin and adiponectin were analyzed using ELISA commercial kits. Results: The results of mixed-design ANOVA with repeated measures showed that there was a significant interaction between the type of resistance training used and time on neuregulin 4 (F (3, 40) = 80.22, P= 0.005, ES = 0.85), leptin (F (3, 40) = 27.53, P= 0.005, ES = 0.67) and adiponectin (F (3, 40) = 12.44, P= 0.005, ES = 0.48). Considering the main effect of groups, results indi­cated that there was a significant difference between types of resistance training and control group in neuregulin 4 (F (1, 40) =41.31, P=0.005, ES = 0.75), adiponectin (F (1, 40) =15.08, P=0.005, ES = 0.53) and leptin (F (1, 40) =32.05, P = 0.005, ES = 0.70). Conclusion: Findings suggest that resistance training, especially interval resistance training can lead to increase the plasma level of neuregulin 4 , adiponectin and decrease leptin in non-athletic men with obesity. Interval training showed superior effects on all study outcomes followed by circular and traditional training, respectively.(AU)

Objetivo: El propósito de este estudio fue comparar tres tipos de entrenamiento de resistencia, incluido el tradicional, el circular y el intervalo en hombres no atléticos con obesidad, en comparación con un grupo de control para las respuestas de neuregulin 4 , adiponectin y leptin. Material y método: La muestra del estudio incluyó a 44 hombres no deportistas con obesidad, que fueron divididos alea­toriamente en 4 grupos iguales (10 por cada grupo): entrenamiento de resistencia tradicional, circular e intervalado, así como un grupo de control. Se analizaron neuregulin 4, leptin y adiponectin utilizando kits comerciales de ELISA. Resultados: Los resultados del ANOVA de diseño mixto con medidas repetidas mostraron que hubo una interacción sig­nificativa entre el tipo de entrenamiento de resistencia utilizado y el tiempo con neuregulin 4 (F (3, 40) = 80,22, p = 0,005, ES = 0,85), leptin (F (3, 40) = 27,53, p = 0,005, ES = 0,67) y adiponectin (F (3, 40) = 12,44, p = 0,005, ES = 0,48). Considerando el efecto principal de los grupos, los resultados indicaron que hubo una diferencia significativa entre los tipos de entrenamiento de resistencia y el grupo de control en neuregulin 4 (F (1, 40) = 41,31, p = 0,005, ES = 0,75), adiponectin (F (1, 40) = 15,08, p = 0,005, ES = 0,53) y leptin (F (1, 40) = 32,05, p = 0,005, ES = 0,70). Conclusión: Los resultados sugieren que el entrenamiento de resistencia, especialmente el entrenamiento de resistencia a intervalos, puede aumentar el nivel plasmático de neuregulin 4, adiponectin y disminuir leptin en hombres obesos no atléticos. El entrenamiento por intervalos mostró efectos superiores en todos los resultados del estudio seguido del entrenamiento circular y tradicional, respectivamente.(AU)

ADIPQ gene polymorphism rs266729 (-11377 C>G) and metabolic syndrome risk in a Mexican population of western Mexico / El polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ y el riesgo de síndrome metabólico en una población mexicana del occidente de México

INTRODUCTION: obesity often leads to deregulation and disrupting of the function of adipokines, which leads to various altered conditions, including metabolic syndrome (MetS). Adiponectin is one of the main adipokines secreted by adipocytes. The ADIPQ gene polymorphism rs266729 (-11377 C>G) is significantly associated with metabolic alterations related to obesity in different populations. Mexico has a high prevalence of obesity and risk factors associated with MetS. We investigated the association of the ADIPQ gene polymorphism rs266729 (-11377 C>G) with MetS in a Mexican population of western Mexico. METHODS: a total of 101 MetS patients and 70 unrelated healthy subjects were genotyped for ADIPQ polymorphism rs266729 using the restriction fragment length polymorphism method. RESULTS: we found a higher frequency of the minor allele G in MetS patients, as compared to that observed in the control group (OR = 2.17; 95 % CI, 1.26-3.70; p = 0.003). Also, the GG genotype was significantly associated with MetS risk under codominant (OR = 4.0; 95 % CI, 1.32-11.71; p = 0.014), dominant (OR = 2.16; 95 % CI, 1.12-4.03; p = 0.018), and recessive (OR = 3.33; 95 % CI, 1.14-9.45; p = 0.033) genetic models. CONCLUSION: our findings suggest that the minor allele G in the ADIPQ gene polymorphism rs266729 constitutes a risk factor for the development of MetS in a Mexican population of western Mexico

INTRODUCCIÓN: la obesidad frecuentemente tiene como consecuencia una desregulación y disrupción de la función de las adipocinas, que dan lugar a varias alteraciones, incluyendo el síndrome metabólico (SM). La adiponectina es una de las principales adipocinas secretadas por los adipocitos. El polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ se ha asociado significativamente con alteraciones metabólicas relacionadas con la obesidad en diferentes poblaciones. México tiene una alta prevalencia de obesidad y de factores de riesgo asociados al SM. En el presente estudio investigamos la asociación del polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ con el SM en una población mexicana del occidente de México. Metodos: a un total de 101 pacientes con SM y 70 sujetos sanos no relacionados se les identificó el polimorfismo rs266729 por el método de la PCR-RFLP. RESULTADOS: encontramos una mayor frecuencia del alelo menor G en los pacientes con SM, en comparación con la frecuencia observada en el grupo de control (OR = 2,17; IC 95 %: 1,26-3,70; p = 0,003). Asimismo, el genotipo GG se asoció significativamente con el SM bajo los modelos genéticos codominante (OR = 4,0; IC 95 %: 1,32-11,71; p = 0,014), dominante (OR = 2,16; IC 95 %: 1,12-4,03; p = 0,018) y recesivo (OR = 3,33; IC 95 %: 1,14-9,45; p = 0,033). CONCLUSIÓN: nuestros resultados sugieren que el alelo menor G del polimorfismo rs266729 (-11377 C>G) del gen ADIPOQ representa un factor de riesgo para el desarrollo de SM en la población mexicana del occidente de México

A prospective study in women: açaí (Euterpe oleracea Martius) dietary intake affects serum p-selectin, leptin, and visfatin levels / Un estudio prospectivo en mujeres: la ingesta dietética de açaí (Euterpe oleracea Martius) afecta a los niveles séricos de p-selectina, leptina y visfatina

BACKGROUND: açaí is the fruit of the palm tree Euterpe oleracea Martius, which is native to the Amazon region. This fruit has been extensively studied due to its potential effects on human health. Studies have also evaluated the potential effect of açaí on the inflammatory response, but there are still few studies that have assessed this property in humans. OBJECTIVE: in this study we aimed to evaluate the effects of 200 g of açaí pulp consumption per day during four weeks on a rich panel of inflammatory biomarkers. METHODS: a prospective nutritional intervention study was conducted on forty apparently healthy women who consumed 200 g of açaí pulp per day for four weeks. A panel of serum inflammatory markers were evaluated before and after the nutritional intervention, namely, cell adhesion molecules (ICAM-1, IVAM-1, P-selectin, MCP-1, and fractalkine), interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-17) and adipokines (adiponectin, leptin, visfatin, and adipsin). The data were analyzed using paired Student's t-test to evaluate the effect of the intervention using PASW Statistics, version 18.0, and a p-value of < 0.05 was considered significant. RESULTS: four weeks of açaí pulp consumption decreased p-selectin, leptin, and visfatin concentrations in the serum of the participating women. CONCLUSION: these results show that consumption of açaí pulp was able to modulate important biomarkers of the inflammatory process in apparently healthy women

INTRODUCCIÓN: el açaí es el fruto de la palmera Euterpe oleracea Martius, originaria de la región amazónica. Esta fruta ha sido ampliamente estudiada debido a sus posibles efectos sobre la salud humana. Los estudios también han evaluado el efecto potencial del açaí sobre la respuesta inflamatoria, pero todavía hay pocos estudios que hayan evaluado esta propiedad en seres humanos. OBJETIVO: en este estudio, nuestro objetivo ha sido evaluar los efectos del consumo de 200 g de pulpa de açaí por día durante cuatro semanas sobre un rico panel de biomarcadores inflamatorios. MÉTODOS: se ha realizado un estudio prospectivo de intervención nutricional en el que cuarenta mujeres aparentemente sanas han consumido 200 g de pulpa de açaí al día durante cuatro semanas. Se ha evaluado un panel de marcadores inflamatorios séricos antes y después de la intervención nutricional, a saber, moléculas de adhesión celular (ICAM-1, IVAM-1, P-selectina, MCP-1 y fractalquina), interleucinas (IL-1β, IL-6, IL-8, IL-10 e IL-17) y adipocinas (adiponectina, leptina, visfatina y adipsina). Los datos han sido analizados mediante la prueba de la t de Student pareada para evaluar el efecto de la intervención mediante el PASW Statistics, versión 18.0, y todo valor de p < 0,05 se consideró significativo. RESULTADOS: después de cuatro semanas de consumo de pulpa de açaí disminuyeron las concentraciones de p-selectina, leptina y visfatina en el suero de las mujeres participantes. CONCLUSIÓN: estos resultados muestran que el consumo de pulpa de açaí ha sido capaz de modular importantes biomarcadores del proceso inflamatorio en mujeres aparentemente sanas

Interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet in obese women / La terapia interdisciplinaria tuvo efectos positivos en el estado inflamatorio, mediado por la leptina, la adiponectina y la calidad de la dieta en mujeres obesas

BACKGROUND: obesity is a chronic disease associated with inadequate eating habits and reduced levels of physical activity. Because of obesity, the risk for comorbidities is increased, especially for cardiovascular diseases, insulin resistance, and increased pro-inflammatory factors. The aim of the present investigation was to analyze potential correlations between pro/anti-inflammatory adipokines, glycemic index, and other markers of diet quality using a metabolic profile in women undergoing interdisciplinary weight loss therapy. METHODS: thirty-two women with obesity were enrolled in a 12-week program of interdisciplinary therapy combining a clinical, nutritional, and physical exercise approach. Body composition, quality of diet, metabolic profile, and pro/anti-inflammatory adipokines were analyzed. RESULTS: the therapy showed to be effective in reducing body weight (from 93.16 ± 16.96 to 88.36 ± 16.23; p = 0.0000001), body mass index (from 34.01 ± 4.00 to 32.29 ± 3.96; p = 0.0000001), and body fat (from 38.25 ± 5.05 to 36.13 ± 5; p = 0.0000001). There was also an improvement in lipid profile, including total cholesterol (from 196.16 ± 34.78 to 183.53 ± 43.15; p = 0.001), non-HDL-cholesterol (from 142 ± 30.05 to 1333.69 ± 35.41; p = 0.01), VLDL-cholesterol (from 27.13 ± 12.4 to 22.06 ± 8.55; p = 0.002), triglycerides (from 135.88 ± 61.21 to 110.75 ± 43.09; p = 0.002) and glucose metabolism, including glucose (from 97.13 ± 10.43 to 92.6 ± 6.6; p = 0.004), and insulin (from 13.05 ± 5.54 to 11.29 ± 4.85; p = 0.03). As for food intake, there was a decrease in calorie consumption (from 1991.45 ± 677.78 to 1468.88 ± 390.56; p = 0.002), carbohydrates (from 50.37 ± 6 to 47.04 ± 8.67; p = 0.04), lipids (from 31.83 ± 5.53 to 30.37 ± 7.04; p = 0.3), and glycemic load (from 80.53 ± 39.88 to 54.79 ± 23.69; p = 0.02), and an increased consumption of proteins (from 18.3 ± 2.39 to 22.89 ± 4.9; p = 0.002). Positive correlations were demonstrated between insulin concentration and waist circumference (r = 0.82; p = 0.003); leptin and body fat and abdominal circumference (r = 0.74; p = 0.01); and LDL-cholesterol fraction and total cholesterol consumption (r = 0.69; p = 0.027). Negative correlations were demonstrated between leptin and monosaturated fat consumption (r = -0.71; p = 0.02); and adiponectin and liver enzyme GGT levels (r = -0.65; p = 0.04). CONCLUSIONS: interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet. Our findings suggest the effectiveness and clinical relevance of the interdisciplinary clinical therapy applied for obesity

INTRODUCCIÓN: la obesidad es una enfermedad crónica asociada con hábitos alimentarios inadecuados y niveles reducidos de actividad física. Debido a la obesidad, el riesgo de comorbilidad aumenta, especialmente el de las enfermedades cardiovasculares, la resistencia a la insulina y el aumento de los factores proinflamatorios. El objetivo de la presente investigación fue analizar las posibles correlaciones entre las adipocinas pro/antiinflamatorias, el índice glucémico y otros marcadores de calidad de la dieta con el perfil metabólico en mujeres sometidas a terapia interdisciplinaria para perder peso. MÉTODOS: treinta y dos mujeres con obesidad participaron en 12 semanas de terapia interdisciplinaria en la que se combinaron los enfoques clínico, nutricional y de ejercicio físico. Se analizaron la composición corporal, la calidad de la dieta, el perfil metabólico y las adipocinas pro/antiinflamatorias. RESULTADOS: la terapia demostró ser efectiva para reducir el peso corporal (de 93,16 ± 16,96 a 88,36 ± 16,23; p = 0,0000001), el índice de masa corporal (de 34,01 ± 4,00 a 32,29 ± 3,96; p = 0,0000001) y la grasa corporal (de 38,25 ± 5,05 a 36,13 ± 5,00; p = 0,0000001). También hubo una mejora del perfil lipídico, incluidos el colesterol total (de 196,16 ± 34,78 a 183,53 ± 43,15; p = 0,001), el colesterol no HDL (de 142,00 ± 30,05 a 1333,69 ± 35,41; p = 0,01), el VLDL-colesterol (de 27,13 ± 12,4 a 22,06 ± 8,55; p = 0,002), y el metabolismo de la glucosa, incluyendo la glucosa (de 97,13 ± 10,43 a 92,6 ± 6,6; p = 0,004) y la insulina (de 13,05 ± 5,54 a 11,29 ± 4,85; p = 0,03). En cuanto a la ingesta de alimentos, hubo disminución en el consumo de calorías (de 1991,45 ± 677,78 a 1468,88 ± 390,56; p = 0,002), carbohidratos (de 50,37 ± 6,00 a 47,04 ± 8,67; p = 0,04), lípidos (de 31,83 ± 5,53 a 30,37 ± 7,04; p = 0,3) y carga glucémica (de 80,53 ± 39,88 a 54,79 ± 23,69; p = 0,02), y aumento del consumo de proteínas (de 18,3 ± 2,39 a 22,89 ± 4,90; p = 0,002). Se demostraron correlaciones positivas entre la concentración de insulina y la circunferencia de la cintura (r = 0,82; p = 0,003); la leptina, la grasa corporal y la circunferencia abdominal (r = 0,74; p = 0,01), y la fracción de colesterol LDL y el consumo total de colesterol (r = 0,69; p = 0,027). Se demostraron correlaciones negativas entre la leptina y el consumo de grasa monosaturada (r = -0,71; p = 0,02), y la adiponectina y la enzima hepática GGT (r = -0,65; p = 0,04). CONCLUSIONES: la terapia interdisciplinaria tuvo efectos positivos sobre el estado inflamatorio, mediado por la leptina, la adiponectina, y la calidad de la dieta. Nuestros hallazgos sugieren la efectividad y la relevancia clínica de la terapia clínica interdisciplinaria aplicada a la obesidad

Efecto de la leche fermentada de cabra sobre la composición corporal, el metabolismo basal y el control de la ingesta en ratas / Effect of fermented goat milk on body composition, basal metabolism, and food intake control in rats

Introducción: es conocido que la dieta juega un papel clave en la composición corporal y afecta al balance energético; sin embargo, la información es limitada acerca de la influencia de alimentos y nutrientes específicos como es el caso de los productos lácteos, un grupo básico de alimentos y una importante fuente de nutrientes en la dieta. Objetivos: evaluar la influencia del consumo de leche fermentada de cabra o vaca sobre la composición corporal y la regulación del apetito en animales adultos. Material y métodos: se han utilizado 20 ratas Wistar macho adultas, alimentadas durante 30 días con dietas basadas en leche fermentada de vaca o de cabra. Se analizaron la evolución de la composición corporal y las concentraciones plasmáticas de adipoquinas (leptina y adiponectina), hormonas reguladoras del metabolismo intermediario (grelina, insulina, hormona estimulante de la glándula tiroides, triyodotironina y tiroxina) y ácidos grasos no esterificados (AGNE). Resultados: el peso y el porcentaje de grasa corporal fueron menores (p < 0,001) y la masa magra fue mayor (p < 0,01) en los animales alimentados con la dieta basada en leche fermentada de cabra. No se registraron diferencias entre dietas para las concentraciones plasmáticas de hormonas tiroideas y de insulina. Las concentraciones plasmáticas de grelina y adiponectina disminuyeron (p < 0,001), y las de leptina y AGNE aumentaron (p < 0,001) con la dieta basada en leche fermentada de cabra. Conclusión: el consumo habitual de leche fermentada de cabra disminuye la adiposidad y el peso corporal en las ratas adultas al incrementar el gasto energético, la lipólisis y la sensación de saciedad

Introduction and objective: it is known that diet plays a key role in body composition and affects energy balance. However, scarce information is available in the scientific literature about the influence of food and specific nutrients such us dairy products, a basic food group and an important source of nutrients in the diet. The objective of this work was to evaluate the influence of fermented dairy products (goat or cow milk) on body composition and appetite regulation in adult animals. Material and methods: twenty adult male Wistar albino rats were fed fermented goat or cow milk-based diets for 30 days. The evolution of body composition and plasma concentrations of adipokines (leptine and adiponectine), intermediary metabolism regulating hormones (ghrelin, insulin, thyroid stimulating hormone, triyodotironine, thyroxine), and non-esterified fatty acid (NEFA) were analyzed. Results: body weight and body fat percentage were lower (p < 0.001) in rats fed fermented goat milk versus those fed fermented cow milk, whereas lean mass percentage was higher (p < 0.01). Plasma thyroid hormone and insulin concentrations did not show significant differences between diets. The fermented goat milk-based diet decreased ghrelin and adiponectin levels (p < 0.001), and increased leptine and NEFA concentrations (p < 0.001). Conclusion: fermented goat milk consumption decreases adiposity and body weight in adult rats by increasing energy expenditure, lipolysis, and satiety sensation

Association of the rs10830963 polymorphism in MTNR1B with fasting glucose, serum adipokine levels and components of metabolic syndrome in adult obese subjects / Asociación del polimorfismo rs10830963 en MTNR1B con los niveles de glucosa en ayunas, de adipocitoquinas y componentes del síndrome metabólico en sujetos obesos adultos

Background and objectives: the aim of the present investigation was to describe the association of this single nucleotide polymorphism (SNP) with fasting glucose levels, serum adipokine levels and diabetes mellitus. Methods: the study involved a population of 1,002 adult obese subjects. Measurements of anthropometric parameters, blood pressure, fasting blood glucose, C-reactive protein (CRP), insulin concentration, insulin resistance (HOMA-IR), HOMA-B, lipid profi le and adipocytokines levels were performed. Genotype of MTNR1B gene polymorphism (rs10830963) was evaluated. Results: fasting glucose levels (GG: 101.5 ± 19.1 mg/dl vs GT: 103.5 ± 8.1 units vs TT: 107.2 ± 8.0 mg/dl; p = 0.01) and HOMA-IR (GG: 3.1 ± 1.6 units vs GT: 3.4 ± 1.1 units vs TT: 3.7 ± 1.0 units; p = 0.02) were higher in subjects with GG genotype than in other genotypes. Total adiponectin levels (CC: 20.5 ± 8.4 ng/dl vs CG: 21.8 ± 5.4 ng/dl vs GG: 15.4 ± 1.4 ng/dl; p = 0.02) and HOMA-B (CC: 2.3 ± 0.8 units vs CG: 2.2 ± 1.1 units vs GG: 1.9 ± 0.9 units; p = 0.01) were lower in subjects with GG genotype than GC or CC genotypes. Logistic regression analysis showed an increased risk of hyperglicemia (OR = 1.31, 95% CI = 1.12-2.78, p = 0.03) and diabetes mellitus (OR = 1.37, 95% CI = 1.14-2.86, p = 0.04). Conclusions: this study showed that the MTNR1B rs10830963 polymorphism was associated with increased fasting glucose levels, HOMA-IR, and risk of DM2. This SNP was associated with decreased adiponectin levels and HOMA-B.

Introducción y objetivos: el objetivo de la presente investigación fue describir la asociación del polimorfi smo del gen MTNR1B (rs10830963) con los niveles de glucosa en ayunas, los niveles séricos de adipocitoquinas y la diabetes mellitus. Métodos: el estudio incluyó una población de 1.002 adultos obesos. Se realizó la determinación de parámetros antropométricos, presión arterial, glucosa en sangre en ayunas, proteína C reactiva (CRP), concentración de insulina, resistencia a la insulina (HOMA-IR), HOMA-B, perfi l lipídico y niveles de adipocitoquinas. Se evaluó el genotipo del polimorfi smo del gen MTNR1B (rs10830963). Resultados: los niveles de glucosa en ayunas (GG: 101,5 ± 19,1 mg/dl vs. GT: 103,5 ± 8,1 unidades vs. TT: 107,2 ± 8,0 mg/dl; p = 0,01) y HOMA-IR (GG: 3,1 ± 1,6 unidades vs. GT: 3,4 ± 1,1 unidades vs. TT: 3,7 ± 1,0 unidades, p = 0,02) fueron más altos en sujetos con genotipo GG que en otros genotipos. Los niveles totales de adiponectina (CC: 20,5 ± 8,4 ng/dl vs. CG: 21,8 ± 5,4 ng/dl vs. GG: 15,4 ± 1,4 ng/dl, p = 0,02) y HOMA-B (CC: 2,3 ± 0,8 unidades vs. CG: 2,2 ± 1,1 unidades frente a GG: 1,9 ± 0,9 unidades, p = 0,01) fueron menores en sujetos con genotipo GG que en genotipos GC o CC. El análisis de regresión logística mostró un mayor riesgo de hiperglicemia (OR = 1,31, IC 95% = 1,12-2,78, p = 0,03) y diabetes mellitus (OR = 1,37, IC 95% = 1,14-2,86, p = 0,04). Conclusiones: este estudio mostró que el polimorfi smo MTNR1B rs10830963 se asoció con un aumento de los niveles de glucosa en ayunas, HOMA-IR y riesgo de DM2. Este SNP se asoció con niveles de adiponectina disminuidos y HOMA-B

Anthropometric measure and adipokine levels of a young undergraduate population with a usual diet / Medidas antropométricas y niveles de adipocinas de una población joven de pregrado con dieta habitual

Background: obesity is the excessive accumulation of adipose tissue related to food intake and other factors. The aim of this study was to evaluate the intake of nutrients, anthropometric parameters, health indicators, adipokines and insulin levels in a population of young undergraduates. Method: in this study, 378 young undergraduates were invited to participate. Due to the inclusion criteria and their own decision of participating, 90 attended the anthropometric, health indicators: waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and homeostatic model assessment-insulin resistance index (HOMA-IR) studies and completed the questionnaire of frequency of food intake; and 34 participants were selected to perform the determination of biochemical parameters, insulin and adipokines levels: leptin, IL-6, IL-8, tumor necrosis factor alpha (TNF- α), monocyte chemoattractant protein-1 (MCP-1) and hepatocyte growth factor (HGF). Results: according to WC, WHR and WHtR (women: 104 ± 20, 0.87 ± 0.08, 0.6 ± 0.13; men: 112 ± 10, 0.95 ± 0.09, 0.64 ± 0.06, respectively), obese population showed health, cardiovascular and metabolic risk. Overweight population showed cardiometabolic risk. In general, lipid intake was higher than 30%, being animal fat the most consumed. The levels of leptin (women: 17.2 ± 9.2, 28 ± 11.3, 36.8 ± 17.8; men: 4.3 ± 3.6, 9.5 ± 3.1, 24.6 ± 16.4 to lean overweight and obese, respectively) and insulin (women: 408 ± 182, 438 ± 187, 768 ± 167; men: 244 ± 88, 520 ± 256, 853 ± 590) increased along with body mass index (BMI), body fat percentage (BFP), visceral fat area (VFA), WC, WHR and WHtR. Lean (2.4 ± 1.3), overweight (2.2 ± 0.9) and obese (4.3 ± 1.1) women and overweight (2.8 ± 1.2) and obese (5.0 ± 3.1) men showed insulin resistance according to HOMA-IR. Significant correlation between leptin and HOMA-IR was found (p = 0.41). BMI, BFP, VFA, WC, and WHtR positively correlated with leptin (p = 0.67, 0.75, 0.66, 0.60, 0.67, respectively) and insulin (p = 0.37, 0.40, 0.48, 0.49, 0.42, respectively), while WHR only with insulin (p = 0.43). No significant differences were found in the other adipokines. Conclusion: the use of health indicators such VFA, WC, WHR, WHtR and HOMA-IR are useful tools in the determination of health, cardio vascular and metabolic risk and are correlated with levels of leptin and insulin in the studied population

Introducción: la obesidad es la acumulación excesiva de tejido adiposo relacionada con la ingesta de alimentos y otros factores. El objetivo de este estudio fue evaluar la ingesta de nutrientes, parámetros antropométricos, indicadores de salud, adipocinas y niveles de insulina en una población de jóvenes universitarios con una dieta habitual. Método: en este estudio se invitó a participar a 378 jóvenes universitarios. Debido a los criterios de inclusión y su propia decisión de participar, 90 asistieron a los estudios antropométricos y de indicadores de salud: circunferencia de cintura (WC), índice de cadera cintura (WHR), índice de cintura-talla (WHtR) y modelo homeostático de evaluación-índice de resistencia a la insulina (HOMA-IR) y completaron el cuestionario de frecuencia de ingesta de alimentos. Treinta y cuatro participantes fueron seleccionados para realizar la determinación de los parámetros bioquímicos, niveles de insulina y adipocinas (leptina, IL-6, IL-8, factor de necrosis tumoral alfa [TNF- α], proteína quimioatractante de monocitos-1 [MCP-1] y factor de crecimiento hepático [HGF]). Resultados: de acuerdo con WC, WHR y WHtR (mujeres: 104 ± 20, 0,87 ± 0,08, 0,6 ± 0,13; hombres: 112 ± 10, 0,95 ± 0,09, 0,64 ± 0,06, respectivamente), la población obesa mostró riesgo cardiovascular, metabólico y para la salud. La población con sobrepeso mostró riesgo cardiometabólico. En general, la ingesta de lípidos fue superior al 30% y la grasa animal fue la más consumida. Los niveles de leptina (mujeres: 17,2 ± 9,2, 28 ± 11,3, 36,8 ± 17,8; hombres: 4,3 ± 3,6, 9,5 ± 3,1, 24,6 ± 16,4 para delgados, sobrepeso y obesos, respectivamente) e insulina (mujeres: 408 ± 182, 438 ± 187, 768 ± 167; hombres: 244 ± 88, 520 ± 256, 853 ± 590) aumentaron junto con el índice de masa corporal (BMI), porcentaje de grasa corporal (BFP), área de grasa visceral (VFA), WC, WHR y WHtR. Las mujeres delgadas (2,4 ± 1,3), con sobrepeso (2,2 ± 0,9) y obesas (4,3 ± 1,1) y los hombres con sobrepeso (2,8 ± 1,2) y obesos (5,0 ± 3,1) mostraron resistencia a la insulina de acuerdo con HOMA-IR. Se encontró una correlación significativa entre leptina y HOMA-IR (p = 0,41). BMI, BFP, VFA, WC y WHtR correlacionaron positivamente con leptina (p = 0,67, 0,75, 0,66, 0,60 y 0,67, respectivamente) e insulina (p = 0,37, 0,40, 0,48, 0,49 y 0,42, respectivamente), mientras que el WHR solo con insulina (p = 0,43). No se encontraron diferencias signifi cativas en las otras adipocinas. Conclusión: el uso de indicadores de salud como VFA, WC, WHR, WHtR y HOMA-IR es una herramienta útil en la determinación del riesgo metabólico, cardiovascular y de salud, y dichos indicadores correlacionaron con los niveles de leptina e insulina en la población estudiada

Are cord blood visfatin concentrations different depending on birth weight category? / Niveles de visfatina en sangre del cordón umbilical, ¿son diferentes según la categoría de peso al nacer?

Background and objective: Increased visceral adipose tissue mass is strongly associated to metabolic disorders. Visfatin is a visceral fat adipocytokine. There is epidemiological evidence of a link between a suboptimal gestational environment and a greater propensity to develop metabolic disease in adult life. The objective of this study was to establish whether visfatin concentrations in umbilical cord blood are different in newborns small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Subjects and methods: Term newborns from an university medical center were included in the study. A blood sample was taken from the umbilical cord vein of each baby immediately after birth. Visfatin was measured using an enzyme immunoassay in the study population, consisting of 35 subjects in the SGA group, 58 in the AGA group, and 35 in the LGA group. Results: Cord blood visfatin concentrations were not different in the three groups, with respective values of 2.78 (1.86-4.49) ng/mL, 3.28 (1.98-4.97) ng/mL, and 3.46 (2.48-5.38) ng/mL in the SGA, AGA and LGA groups (p=0.141). Gestational weight gain (GWG) (14.09±6.37kg) was negatively associated to visfatin levels (r=−0.218, p=0.036). GWG is an independent predictor of visfatin concentrations (r2=−0.067, p=0.027). Conclusions: There were no differences in cord blood visfatin concentrations depending on birth weight. GWG is an independent predictor of visfatin levels in the cord blood of term newborns

Antecedentes y objetivo: El aumento de la masa de tejido adiposo visceral está fuertemente asociado con trastornos metabólicos. La visfatina es una adipocitoquina de la grasa visceral. Existe evidencia epidemiológica de un vínculo entre un entorno gestacional subóptimo y una mayor propensión a desarrollar enfermedades metabólicas en la vida adulta. El objetivo de este estudio es determinar si las concentraciones de visfatina en la sangre del cordón umbilical son diferentes entre recién nacidos pequeños para edad gestacional (PEG), apropiados para edad gestacional (AEG) y grandes para edad gestacional (GEG). Materiales y métodos: Se incluyeron los recién nacidos a término de un centro médico universitario. Se tomó una muestra de sangre de la vena del cordón umbilical de cada niño inmediatamente después del nacimiento. La visfatina se midió mediante inmunoensayo enzimático en la población de estudio, que incluyó 35 sujetos en el grupo PEG, 58 en el AEG y 35 en el GEG. Resultados: Las concentraciones de visfatina en sangre del cordón umbilical no fueron diferentes entre los 3 grupos de estudio, 2,78 (1,86-4,49) ng/ml, 3,28 (1,98-4,97) ng/ml, 3,46 (2,48-5,38) ng/ml para el PEG, AEG y GEG, respectivamente (p=0,141). El aumento de peso gestacional (GWG) (14,09±6,37kg) se asoció negativamente con los niveles de visfatina (r=−0,218, p=0,036). El GWG es un predictor independiente de los niveles de visfatina (r2=−0,067, p=0,027). Conclusiones: Los niveles de visfatina en sangre del cordón umbilical no tienen un comportamiento diferenciado según el peso al nacer. El GWG es un predictor independiente de los niveles de visfatina en la sangre del cordón umbilical de recién nacidos a término

Physical training improves thermogenesis and insulin pathway, and induces remodeling in white and brown adipose tissues

Physical training (PT) has been considered as a treatment in metabolic syndrome (MS), since it induces thermogenic activity in brown (BAT) and white (WAT) adipose tissues. We evaluated the therapeutic effect of PT on activity of WAT and BAT in rats with MS induced by high-fat diet (30% lard) for 13 weeks and submitted, for the last 6 weeks, to swimming or kept sedentary (SED) rats. MS-SED rats compared to control diet (CT-SED) rats showed low physical fitness and high levels of glucose, insulin, homeostasis evaluation of insulin resistance (HOMA-IR), homeostasis evaluation of the functional capacity of Beta-cells (HOMA-Beta), and blood pressure. The gastrocnemius muscle decreased in peroxisome proliferator-activated receptor gamma coactivator 1-alpha and beta (PGC-1alfa, PGC-1beta), and uncoupled protein 2 and 3 (UCP2 and UCP3) expressions. Both WAT and BAT increased in the adipocyte area and decreased in blood vessels and fibroblast numbers. WAT increased in expression of pro-inflammatory adipokines and decreased in anti-inflammatory adipokine and adiponectin. WAT and gastrocnemius showed impairment in the insulin signaling pathway. In response to PT, MS rats showed increased physical fitness and restoration of certain biometric and biochemical parameters and blood pressure. PT also induced thermogenic modulations in skeletal muscle, WAT and BAT, and also improved the insulin signaling pathway. Collectively, PT was effective in treating MS by inducing improvement in physical fitness and interchangeable effects between skeletal muscle, WAT and BAT, suggesting a development of brown-like adipocyte cells

Body mass index is associated with interleukin-1, adiponectin, oxidative stress and ioduria levels in healthy adults / El índice de masa corporal está asociado con los niveles de interleucina-1, adiponectina, estrés oxidativo y yoduria en adultos sanos

Background: iodine contributes to maintain the balance of the reduced and oxidized species and is also required for thyroid hormones synthesis as triiodothyronine (T3), which regulates energy metabolism in adults. Increased body mass index (BMI) is associated with inflammatory markers, oxidative stress, and abnormalities in adipocytokines secretions that are associated with obesity and chronic disease. Objective: the aim of the study is to investigate the association between ioduria, oxidative stress, total antioxidant status, adiponectin and interleukin-1 (IL-1) with BMI in healthy adults. Methods: a cross-sectional study was performed in 114 healthy adult volunteers, aged 25-44 years, divided according to their BMI in three groups: normal weight (BMI < 25), overweight (BMI ≤ 25 to < 30), obesity (BMI ≥ 30). Adiponectin and IL-1 were measured by immune-enzymatic assays; oxidative stress, by determination of malondialdehyde (MDA); and total antioxidant status (TAS) and ioduria were measured by colorimetric assays. Statistical association was done by Spearman’s test. Results: overweight and obese subjects have higher serum levels of MDA, TAS and IL-1 vs normal weight subjects. Moreover, overweight and obese subjects have lower levels of iodine and adiponectin vs normal weight subjects. MDA was positively related only with obese subjects (r = 0.787, p = 0.008) and TAS with overweight (r = 0.398, p = 0.049) and obese subjects (r = 0.448, p = 0.030). In contrast, a reverse correlation with ioduria was found in obese subjects (r = 0.463, p = 0.001). Adiponectin was negatively related only in obese subjects (r = -0.477, p = 0.001), while, IL-1 was positively related with the increase of BMI (overweight r = 0.287, p = 0.050; and obesity r = 0.515, p = 0.006).Conclusion: alteration in IL-1, adiponectin and oxidative stress levels were found to be related to overweight and obesity; also, iodine levels decreased when BMI increased, contributing to loss of redox equilibrium. All this data may play an important role in etiopathogenesis of chronic disease related to the increase of BMI

Antecedentes: el yodo contribuye a mantener el balance de especies reducidas y oxidadas y también es requerido para la síntesis de hormonas tiroideas como la triyodotironina (T3), que regula el metabolismo energético en el adulto. El incremento en el índice de masa corporal esta asociado con marcadores inflamatorios, estrés oxidativo y anormalidades en la secreción de adipocitocinas que están asociadas con la obesidad y enfermedades crónicas degenerativas. Objetivo: el objetivo del estudio es investigar la asociación entre yodaría, estrés oxidativo, estado antioxidante total, adiponectina, e interleucina 1, con el IMC en adultos saludables. Métodos: se realizo un estudio transversal con 114 adultos, 33 hombres y 81 mujeres, de entre 25 y 44 años, a los cuales se les midieron sus características clínicas, antropométricas y parámetros sociodemográficos. Los niveles de adiponectina e interleucina 1 se midieron por inmunoensayo; el estrés oxidativo, el estado antioxidante total y la yodaría, por métodos colorimétricos. Resultados: los sujetos con sobrepeso y obesidad tienen altos niveles de MDA, FRAP e IL-1 vs. los sujetos con peso normal. Sin embargo, los sujetos con sobrepeso y obesidad tienen bajos niveles de yodo y adiponectina vs. los sujetos con normopeso. El estrés oxidativo (MDA) se relacionó positivamente solo en sujetos obesos (r = 0,787, p = 0,008) y el estado antioxidante (FRAP) con sobrepeso (r = 0,398, p = 0,049) y obesidad (r = 0,448, p = 0,030). En contraste, se encontró una asociación entre yoduria y sujetos obesos (r = 0,463, r = 0,001). Los niveles de adiponectina se relacionaron negativamente solo en sujetos obesos (r = -0,477, p = 0,001), mientras que la IL-1 fue positivamente relacionada con el incremento de BMI (sobrepeso r = 0,287, p = 0,050; y obesidad r = 0,515, p = 0,006). Conclusión: La alteración en los niveles de interleucina-1, adiponectina y estrés oxidativo se relacionaron en sujetos con sobrepeso y obesidad; además, los niveles de yodo disminuyeron con el incremento del IMC, contribuyendo a la pérdida del equilibrio redox. Estos datos juegan un papel importante en la etiopatogenesis relacionada con enfermedades crónicas relacionadas con el incremento del IMC

Impacto de la obesidad en la fisiopatología de la enfermedad degenerativa discal y en la morbilidad y resultados de la cirugía de columna lumbar / Impact of obesity in the pathophysiology of degenerative disk disease and in the morbidity and outcome of lumbar spine surgery

La obesidad (IMC > 30 kg/m2 ) es una pandemia con graves implicaciones médicas y económicas. Existe una creciente evidencia que relaciona procesos relacionados con el metabolismo del tejido adiposo, preferentemente abdominal, con un estado inflamatorio crónico de baja intensidad mediado por adipocinas y otras sustancias que favorecen la lesión discal y el dolor lumbar crónico. La obesidad condiciona en gran medida la evaluación preoperatoria y la técnica quirúrgica en cirugía de columna. Diversos metaanálisis confirman un aumento de complicaciones tras cirugía lumbar en el paciente obeso (especialmente infecciones y trombosis venosas). Sin embargo, los resultados funcionales de estas intervenciones son favorables aunque inferiores a los de la población no obesa, teniendo en cuenta que parten de valores basales inferiores y el pronóstico de los obesos tratados conservadoramente es mucho peor. El impacto de una reducción de peso preoperatoria no se ha estudiado de forma prospectiva en este tipo de pacientes

Obesity (BMI > 30 Kg/m2 ) is a pandemic with severe medical and financial implications. There is growing evidence that relates certain metabolic processes within the adipose tissue, preferentially abdominal fat, with a low-intensity chronic inflammatory state mediated by adipokines and other substances that favor disk disease and chronic low back pain. Obesity greatly conditions both the preoperative evaluation and the spinal surgical technique itself. Some meta-analyses have confirmed an increase of complications following lumbar spine surgery (mainly infections and venous thrombosis) in obese subjects. However, functional outcomes after lumbar spine surgery are favorable although inferior to the nonobese population, acknowledging that obese patients present with worse baseline function levels and the prognosis of conservatively treated obese cohorts is much worse. The impact of preoperative weight loss in spine surgery has not been prospectively studied in these patients

Relación de la variante rs1800777 del gen CETP (proteína transportadora de ésteres de colesterol) con la masa grasa y HDL colesterol, en sujetos obesos con diabetes mellitus tipo 2 / Relation of variant rs180077 of gen cholesterol ester transfer protein variant, with fat mass, HDL-cholesterol in obese subjects with diabetes mellitus type 2

Antecedentes: existe poca evidencia sobre el papel de los polimorfismos de CETP en sujetos obesos diabéticos. Objetivos: evaluar la asociación del polimorfismo (rs1800777) del gen CETP sobre parámetros antropométricos, perfil lipídico y adipocitoquinas en pacientes obesos con diabetes mellitus. Material y métodos: un total de 229 obesos con diabetes mellitus tipo 2 fueron reclutados. Una impedancia bioeléctrica, la presión arterial, ingesta dietética, ejercicio y bioquímica fueron analizados. Resultados: un total de 217 pacientes (94,8%) presentaron el genotipo GG y 12 pacientes GA (5,2%) (no se detectó el genotipo AA). El peso (delta: 14,4 ± 2,1 kg, p = 0,01), índice de masa corporal (delta: 2,2 ± 1,1 kg/m2, p = 0,01), masa grasa (delta: 11,2 ± 3,1 kg, p = 0,02), circunferencia de la cintura (delta: 3,9 ± 2,0 cm, p = 0,02), índice cintura-cadera (delta: 0,04 ± 0,02 cm; p = 0,01), triglicéridos (delta: 48,6 ± 9,1 mg / dl, p = 0,03) y leptina (delta: 58,6 ± 15,9 mg/dl, p = 0,02) fueron superiores en los pacientes con el alelo A que en los no portadores del alelo A. El HDL-colesterol fue menor en los portadores de alelo A que los no portadores (delta: 5,6 ± 1,1 mg/dl, p = 0,03). Manteniéndose las diferencias en los análisis multivariantes en los niveles de HDL colesterol, masa grasa y peso. Conclusión: nuestros resultados muestran una asociación del polimorfismo en posición +82 del gen CETP sobre los niveles de HDL colesterol, y parámetros de adiposidad en pacientes obesos con diabetes mellitus tipo 2 (AU)

Background: There is few evidence of cholesterol ester transfer protein (CETP) in subjects with obesity and diabetes mellitus. Objectives: We examined the association of the polymorphism (rs1800777) of CETP gene on anthropometric parameters, lipid profile and adipokines in subjects with obesity and diabetes mellitus type 2. Material and methods: A population of 229 obese subjects with diabetes mellitus type 2 was enrolled. An electrical bioimpedance, blood pressure, dietary intake, exercise and biochemical analyses were recorded. Results: Two hundred and seventeen subjects (94.8%) had genotype GG and 12 GA (5.2%) (genotype AA was not detected). Weight (delta: 14.4 ± 2.1 kg, p = 0.01), body mass index (delta: 2.2 ± 1.1 kg/m2, p = 0.01), fat mass (delta: 11.2 ± 3.1 kg, p = 0.02), waist circumference (delta: 3.9 ± 2.0 cm, p = 0.02), waist to hip ratio (delta: 0.04 ± 0.02 cm; p = 0.01), tryglicerides (delta: 48.6 ± 9.1 mg / dl, p = 0.03) and leptin levels (delta: 58.6 ± 15.9 mg/dl, p = 0.02) were higher in A allele carriers than non A allele carriers. Levels of HDL-cholesterol were lower in A allele carriers than non-carriers (delta: 5.6 ± 1.1 mg/dl, p = 0.03). In regression analysis, HDl cholesterol, weight and fat mass remained in the model with the SNP. Conclusion: Our results show an association of this CETP variant at position +82 on HDL cholesterol, levels and adiposity parameters in obese subjects with diabetes mellitus type 2 (AU)

Hígado graso no alcohólico y diabetes tipo 2: epidemiología, fenotipo y fisiopatología del paciente con diabetes e hígado graso no alcohólico / Non-alcoholic fatty liver disease and type 2 diabetes mellitus: epidemiology, phenotype and pathophysiology in patients with diabetes and non-alcoholic fatty liver disease

El hígado graso no alcohólico (HGNA) se considera actualmente la enfermedad hepática más frecuente en el ámbito mundial, con una prevalencia del 25-30% en la población general y del 70% entre los diabéticos. El HGNA aumenta considerablemente el riesgo de sufrir diabetes mellitus tipo 2 (DM2) y los pacientes con HGNA y DM2 corren mayor riesgo de desarrollar patologías hepáticas más graves, como esteatohepatitis no alcohólica (EHNA), fibrosis, cirrosis o carcinoma hepatocelular. En el contexto de DM2, el HGNA se ha relacionado con ciertas alteraciones metabólicas, como resistencia a la insulina hepática, mayor hiperglucemia, hiperinsulinemia grave y dislipemia aterogénica. Asimismo, los pacientes diabéticos con HGNA corren mayor riesgo de sufrir enfermedad cardiovascular e insuficiencia renal crónica, así como mayor riesgo de mortalidad por complicaciones hepáticas. La patología del HGNA se ha asociado con diversos factores como la resistencia a la insulina y la lipotoxicidad hepática, valores alterados de adipocinas y disbiosis intestinal. Mientras que la resistencia a la insulina hepática está implicada en el desarrollo del HGNA al provocar una acumulación excesiva de lípidos en el hígado, ciertas especies lipídicas procedentes principalmente de la lipólisis del tejido adiposo pueden contribuir al desarrollo de EHNA al causar lipotoxicidad hepática. Además, la microbiota intestinal se ha asociado recientemente con el HGNA y su progresión a EHNA, principalmente a través del aumento de las concentraciones circulantes de metabolitos hepatotóxicos, como lipopolisacáridos o etanol

Non-alcoholic fatty liver disease (NAFLD) is currently the most common liver disease worldwide, with an estimated prevalence ranging from 25-30% in the general population and over 70% in patients with type diabetes mellitus (DM2). The presence of NAFLD has been shown to significantly increase the risk of DM2, and patients with NAFLD and DM2 are at higher risk of developing more severe liver diseases, such as non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. In the setting of DM2, NAFLD has been linked to several metabolic disorders including hepatic insulin resistance, higher hyperglycaemia, severe hyperinsulinemia, and atherogenic dyslipidaemia. In addition, patients with NAFLD and DM2 have an increased risk of cardiovascular disease and chronic kidney disease, and exhibit a higher liver-related mortality rate. NAFLD has been associated with various factors such as hepatic insulin resistance and hepatic lipotoxicity, altered adipokine levels, and intestinal dysbiosis. The development of NAFLD is influenced by hepatic insulin resistance by inducing excessive fat accumulation in the liver and by several lipid species mainly derived from adipose tissue lipolysis with lipotoxic effects in the liver. Furthermore, the gut microbiota has recently been linked to NAFLD and its progression to NASH, mainly through an increase in circulating levels of hepatotoxic metabolites such as lipopolysaccharides or ethanol

Irisin is weakly associated with usual physical activity in young overweight women / La irisina se asocia débilmente con la actividad física habitual en mujeres jóvenes con sobrepeso

Purpose: To determine if irisin plasma levels are associated with regular physical activity, body composition and metabolic parameters in women subjected to calorie restriction. Subjects and methods: We studied 42 women aged 34 ± 13 years with a body mass index of 27.7 ± 1.8 kg/m2, who were subjected to a calorie restriction for three months. At baseline and at the end of the study, weight, waist and hip circumference, laboratory parameters, body composition by DEXA, resting and activity energy expenditure by indirect calorimetry and 72 hours actigraphy were measured. Fasting serum irisin was quantified using an ELISA kit. Results: After the intervention period, participants lost 1.5 (0.4-3.4) kg and irisin levels did not change. Irisin baseline levels were positively but weakly correlated with the level of physical activity. This association was lost at the end of the intervention. No association was found between irisin levels and body composition or insulin sensitivity or their changes after calorie restriction. No association between serum irisin levels and PGC-1α expression in peripheral blood mononuclear cells and serum irisin was observed. Conclusions: Fasting serum irisin was weakly associated with usual physical activity and did not change after calorie restriction (AU)

Objetivo: determinar si los niveles plasmáticos de irisina se asocian con la actividad física regular, composición corporal y parámetros metabólicos en mujeres sometidas a restricción calórica. Material y métodos: estudiamos 42 mujeres de 34 ± 13 años con un índice de masa corporal de 27,7 ± 1,8 kg/m2, quienes fueron sometidas a una restricción calórica durante tres meses. Al comienzo y final del estudio, se midieron peso, circunferencias de cintura y cadera, parámetros de laboratorio, composición corporal usando DEXA y gasto energético en reposo y en actividad mediante calorimetría indirecta y actigrafía. La irisina en ayunas se midió utilizando un kit ELISA. Resultados: después del periodo de intervención, las participantes bajaron 1,5 (0,4-3,4) kg y los niveles de irisina no cambiaron. La irisina basal se relacionó de forma positiva pero débil con el nivel de actividad física de las participantes. Esta asociación se perdió al final de la intervención. No se encontró una asociación entre los niveles de irisina y la composición corporal o sensibilidad a insulina o el cambio de estos parámetros después del periodo de restricción calórica. No se observó asociación entre los niveles de irisina y la expresión de PGC-1α en monocitos periféricos. Conclusiones: La irisina en ayunas se asoció débilmente con la actividad física habitual y no cambió después de la restricción calórica (AU)

Composición corporal y concentraciones de adipocitoquinas en hemodiálisis: la ganancia de grasa abdominal como factor de riesgo cardiovascular añadido / Body composition analysis and adipocytokine concentrations in haemodialysis patients: abdominal fat gain as an additional cardiovascular risk factor

Introducción: La grasa abdominal y, sobre todo, su ganancia a lo largo del tiempo, se ha consolidado como un factor de riesgo cardiovascular en pacientes urémicos. Objetivos: Analizar los cambios en la grasa abdominal en los pacientes de hemodiálisis (HD) a lo largo de un año y estudiar sus posibles relaciones con los cambios en los niveles circulantes de adipocitocinas. Como objetivo secundario intentamos validar los datos obtenidos por bioimpedancia eléctrica (BIA) con los obtenidos por absorciometría dual de rayos X (DXA). Material y métodos: Se realizó un estudio prospectivo de un año de duración en 18 pacientes en HD. En cada paciente se cuantificó, basalmente y al cabo de un año, la composición corporal por BIA y DXA y se determinaron varios parámetros bioquímicos incluyendo adipocitocinas. Resultados: Se evidenció un aumento significativo del ángulo de fase [4,8° (4,1-5,6) frente a 5,2° (4,4-5,8); p<0,05], del agua intracelular por BIA [48,3% (43,1-52,3) frente a 50,3% (45,7-53,4); p<0,05] y del cociente entre el porcentaje de grasa de distribución androide/ginecoide (A/G) medido por DXA [1,00 (0,80-1,26) frente a 1,02 (0,91; 1,30); p<0,05]. Se encontró una relación estadísticamente significativa entre las concentraciones de leptina y adiponectina tanto con el porcentaje de masa grasa medida por BIA como con la grasa abdominal estimada mediante DXA (p<0,01). Conclusión: Los pacientes en HD experimentan una ganancia de grasa con el tiempo, especialmente en localización abdominal, evidenciada por un aumento del cociente A/G, lo que podría explicar el aumento del riesgo cardiovascular que presentan (AU)

Introduction: Abdominal fat and its increment over time in particular has become a cardiovascular risk factor in uraemic patients. Objectives: To analyse changes in abdominal fat in haemodialysis patients over one year and study their possible correlation with the variation in adipocytokine serum levels. As a secondary objective, we tried to validate the data obtained by bioelectrical impedance analysis (BIA) with data obtained by dual X-ray absorptiometry (DXA). Material and methods: A prospective one-year study was performed in 18 patients on haemodialysis (HD). In each patient, body composition by BIA and DXA was estimated at baseline and after one year. Several adipocytokine and biochemical parameters were determined. Results: A significant increase in phase angle [4.8° (4.1-5.6) vs. 5.2° (4.4-5.8), P<.05], BIA intracellular water [48.3% (43.1-52.3) vs. 50.3% (45.7-53.4), P<.05] and the ratio between the percentage of android/gynecoid (A/G) distribution of fat measured by DXA [1.00 (0.80-1.26) vs. 1.02 (0.91-1.30), P<.05] was observed. A statistically significant relationship between leptin and adiponectin concentrations and the percentage of fat mass measured by BIA, as well as the abdominal fat percentage estimated by DXA, was found (P<.01). Conclusion: HD patients exhibit a gain in fat mass over time, especially in the abdomen, evidenced by an increased A/G ratio. These findings might explain the increased cardiovascular risk in these patients (AU)

Multiparametric evaluation of preoperative MRI in early stage breast cancer: prognostic impact of peri-tumoral fat

Purpose. Obesity is associated with adverse outcomes in breast cancer patients. Fat-specific cytokines (adipokines) have been proposed as key drivers of breast cancer progression, invasion, and metastasis. We aimed at assessing correlations between peri-tumoral fat, quantified on magnetic resonance imaging (MRI) and pathologic factors potentially impacting therapy recommendations. Methods. We retrospectively reviewed records of 63 patients with early stage breast cancer who underwent preoperative MRI imaging using appropriately weighted series for breast and tumor contouring. Fat volumes were generated through voxel intensity filtering. The peri-tumoral region was defined as the intersection of a 1-cm spherical extension around the tumor and the breast contour. Peri-tumoral fat was defined as the fraction of a fat content in this volume. Surgical pathology records were used to extract clinical data. Statistical analyses were conducted using Pearson and Spearman correlation coefficients. Results. Among reviewed patients, 45 had T1 tumors (1.22 ± 0.85 cm diameter) and 18 had T2 tumors (2.08 ± 1.06 cm). Axillary lymph nodes were dissected in 31 and positive in 17 patients analyzed. Peri-tumoral fat ratio ranged between 25 and 99 %. Peri-tumoral fat ratio significantly correlated with the nodal-positive ratio of positive axillary lymph nodes (r = 0.532). Peri-tumoral fat ratio demonstrated optimally prominent correlation among obese patients upon body mass index categorical stratification. Conclusions. In women with early stage breast cancer, peri-tumoral fat correlates positively with the ratio of pathologically involved axillary nodes. This work highlights a novel method for quantitating peri-tumoral fat content. Preoperative breast MRI may be utilized to predict extent of axillary disease (AU)

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