Changes in VGF and C3aR1 gene expression in human adipose tissue in obesity.

The VGF gene, which has been shown to be metabolically associated with energy balance, glucose homeostasis, insulin secretion process, and biological processes related to overeating, is prominent in relation to obesity. TLQP-21 neuropeptide, derived from the VGF, is considered to promote lipolysis by the beta-adrenergic pathway through targeting the C3aR1 receptor located in the adipocyte membrane. In this study, we aimed to measure the expression levels of the VGF and C3aR1 genes in the adipose tissue of obese subjects and individuals with normal weight determined based on body mass index (BMI), and to reveal the correlation of these levels with obesity. VGF and C3aR1 gene expression levels were measured using Real Time Polymerase Chain Reaction (RT PCR) in the visceral adipose tissue (VAT) samples of 52 obese patients (BMI ≥ 35 kg/m2) and 21 non-obese controls (BMI = 18.5-24.9 kg/m2). The results were statistically analyzed. The VGF expression was lower and the C3aR1 gene expression was higher in obese patients compared to the non-obese control group (p < 0.05). In obese patients, there was a statistically significant positive correlation of 85.6% between VGF and C3aR1, in which when one level increased, the other also increased (p < 0.05, r = 0.856). The findings show that the VGF may be significantly associated with obesity and is very important since it is the first to measure the level of VGF gene expression in human adipose tissue. This research provides new evidence of a link between obesity and VGF/C3aR1 and in the future may help design strategies to combat obesity.

Colonoscopic decompression should be used before neostigmine in the treatment of Ogilvie's syndrome.

BACKGROUND: Performance of urgent colonoscopy for the purposes of diagnosis and treatment of Ogilvie's syndrome remains controversial. However, no trials have directly compared neostigmine with endoscopic therapy. This study aimed to compare the effect of neostigmine and colonoscopic decompression in the treatment of Ogilvie's syndrome. METHODS: This study was designed as a retrospective, non-randomized clinical study of sequential patients. Patients who were diagnosed as having acute colonic pseudo-obstruction were separated into two groups after conservative treatment. Group 1 comprised patients who underwent colonoscopic decompression, because they had a poor first response to neostigmine treatment. Group 2 constituted patients who had a poor first response to colonoscopic decompression, and neostigmine was added to the treatment regimen. Groups 1 and 2 were compared for the success of disease management. RESULTS: In groups 1 and 2, the average age of the patients was 63.19 years (±14.71 years) and 59.45 years (±15.31 years) (p = 0.312), respectively. No significant difference was determined between the groups in terms of distribution of sex, hospital stay, etiologies, and initial cecal sizes in imaging (p > 0.05). Response to first intervention was statistically significant (p < 0.01). Also, the total response was determined statistically significant for hospital stay if colonoscopic decompression was performed (p < 0.01). No recurrence was determined during the 1-month follow-up in both groups. Although there was no etiologic factor for neostigmine response according to univariate analysis results, colonoscopic success was decreased due to age, sex, and the presence of a cardiac disease. CONCLUSIONS: Although the success rate of neostigmine treatment was significantly lower in our homogeneous groups, no significant decrease was determined in terms of hospital stay, intensive care unit stay, and requirement of colostomy compared with colonoscopic decompression. By comparison, colonoscopic decompression, which was performed by experienced endoscopists as a first-line treatment option, was more effective as an initial therapy and was more effective at avoiding a second treatment modality.