A very-low-calorie ketogenic diet normalises obesity-related enhanced levels of erythropoietin compared with a low-calorie diet or bariatric surgery.

PURPOSE: Nutritional ketosis synergistically with body-weight loss induced by a very-low-calorie ketogenic diet (VLCKD) has proven to be effective in improving obesity-related pathophysiology. Recently, growing attention has been focused on the relation between erythropoietin (EPO) and obesity. Thus, this study aims to investigate whether nutritional ketosis and weight loss induced by a VLCKD modify the circulating levels of EPO in patients with obesity in comparison with the effect of low-calorie diet (LCD) or bariatric surgery (BS). METHODS: EPO levels, iron status and body composition parameters were evaluated in 72 patients with overweight or obesity and 27 normal-weight subjects at baseline and after the three different weight-reduction therapies (VLCKD, LCD and BS) in 69 patients with excess body weight. ß-hydroxybutyrate levels were also measured in the VLCKD group. The follow-up was established at 2-3 months and 4-6 months. RESULTS: It was found that EPO levels were higher in morbid obesity and correlated with higher basal weight, fat mass (FM) and fat-free mass (FFM) in the overall sample. High baseline EPO levels were also correlated with higher impact on the course of weight loss and changes in FM and FFM induced by the three weight-loss interventions. Furthermore, the VLCKD induced a decrease in EPO levels coinciding with maximum ketosis, which was maintained over time, while statistically significant changes were not observed after LCD and BS. CONCLUSION: The obesity-related increased EPO levels are restored after VLCKD intervention at the time of maximum ketosis, suggesting a potential role of the nutritional ketosis induced by the VLCKD. Baseline EPO levels could be a biomarker of response to a weight-loss therapy.

APOA-5 genetic variant and a hypocaloric diet enriched in ω-6 fatty acids with Mediterranean pattern.

OBJECTIVE: The APOA5-1131C allele is related to a worse lipid profile and metabolic response to diet interventions. The present study was designed to investigate the effect of SNP rs662799 on the lipid profile of patients with obesity after a hypocaloric diet with a Mediterranean pattern enriched in ω-6 polyunsaturated fatty acids (PUFA). PATIENTS AND METHODS: A population of 362 Caucasian patients with obesity was evaluated. Anthropometric evaluation and serum parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR), glucose, C reactive protein, and adipokines) were measured at basal time and after 12 weeks. All subjects were genotyped rs662799. RESULTS: The APOA5 variant distribution among the 362 patients with obesity was the following: 87.2% (n=316) (TT) were homozygous for the T allele, 12.2% (n=44) (TC) were heterozygous, and 0.6% (n=2) (CC) were homozygous for the C allele. There were only significant differences in triglyceride levels between genotype groups. After 12 weeks of intervention, the following parameters improved in both genotype groups: adiposity parameters, systolic blood pressure, total cholesterol, LDL cholesterol, leptin, adiponectin, and ratio leptin/adiponectin. Insulin levels (delta: -3.5±0.2 UI/L vs. -1.2±0.6 UI/L; p=0.03), HOMA-IR (delta: -1.6±0.1 units vs. -0.3±0.2 units; p=0.01) and triglyceride levels (delta: -18.8±4.1 mg/dl vs. -3.7 ±3.0 mg/dl; p=0.02) decreased in non-C allele carriers. CONCLUSIONS: Our data demonstrate that the minor C allele of the APOA5 gene (rs662799) produces a worse response in triglyceride levels, insulin levels, and HOMA-IR after a ω-6 PUFA enriched hypocaloric diet with Mediterranean pattern.

RS2289487 variation in PERILIPIN gene is a predictor of weight loss and protection against impaired glucose metabolism after a meal-replacement diet in postmenopausal obese females.

OBJECTIVE: The PERILIPIN1 (PLIN1) gene encodes an adipocyte-associated protein that modulates weight. The objective was to evaluate the role of the rs2289487 genetic variant of the PLIN1 gene on weight loss and glucose metabolism secondary to a partial meal replacement (pMR) hypocaloric diet. PATIENTS AND METHODS: We conducted an interventional study in 111 postmenopausal obese females with body mass index (BMI) > 35 kg/m2. The subjects received two intakes per day of a normocaloric hyperproteic formula for 12 weeks. RESULTS: After the pMR diet, body weight, (BMI), fat mass, waist circumference, fasting insulin levels and HOMA-IR decreased in both genotype groups. The improvements in these parameters were higher in C allele carriers than in subjects with TT genotype. The percentage of patients who achieved 7.5% weight loss was higher in the C carriers (57.4% vs. 27.6%), (adjusted Odds Ratio 2.14, 95% CI = 1.33-9.40; p = 0.02). The decrease in the percentage of diabetes mellitus or impaired fasting glucose decrease was statistically significant in C allele carriers (30.2% vs. 18.9%; p = 0.01) (OR 0.54, 95% CI = 0.22-0.78; p = 0.02). CONCLUSIONS: The C allele of rs2289487 predicts the magnitude of weight loss resulting from a pMR diet. These adiposity improvements produce a better improvement in insulin resistance and the percentage of impaired glucose metabolism.

Interaction of the variant in the adiponectin gene rs3774261 with serum lipid profile and adiponectin levels after 9 months with a high monounsaturated fat hypocaloric diet with Mediterranean pattern.

OBJECTIVE: The role of ADIPOQ gene variants on weight loss and serum lipid changes after a dietary intervention is an important topic area with little scientific evidence. We designed a study in order to analyze the effects of rs3774261 of ADIPOQ gene on metabolic response and adiposity parameters after a hypocaloric Mediterranean diet pattern for 9 months and with a high amount of monounsaturated fatty acids. PATIENTS AND METHODS: 133 patients with obesity were enrolled. Adiposity parameters, blood pressure, and serum parameters (lipid profile, insulin, HOMA-IR; glucose, C reactive protein, adiponectin, resistin, and leptin levels) were measured, at basal time and after dietary intervention (3 and 9 months). All patients were genotyped rs3774261 and evaluated in a dominant model (AA vs. GA+AA). RESULTS: Genotype frequencies were 46 (34.6%) AA, 66 (49.6%) AG, and 21 (15.8%) GG. After dietary intervention and in both genotypes, BMI, weight, fat mass, systolic blood pressure, waist circumference, glucose, insulin, HOMA-IR, and leptin decreased. In patients with the AA genotype, there was a significant improvement at (3 and 9 months) in low-density lipoprotein (LDL) cholesterol levels (-10.1±0.9 mg/dl vs. -5.6±1.7 mg/dl, p=0.01) (-19.1±0.9 mg/dl vs. -6.9±0.7 mg/dl, p=0.03), total cholesterol (-9.4±0.8 mg/dl vs. -5.8±0.9 mg/dl, p=0.02) (-17.4±1.8 mg/dl vs. -9.8±1.9 mg/dl, p=0.02), triglycerides (-12.3±0.8 mg/dl vs. -8.0±0.9 mg/dl, p=0.01) (-26.1±0.8 mg/dl vs. -11.0±0.3 mg/dl, p=0.01), C reactive protein (CRP) (-0.8±0.2 mg/ dl vs. -0.4± 0.3 mg/dl, p=0.01) (-1.1±0.2 mg/ dl vs. -0.7±0.1 mg/dl, p=0.01) and adiponectin (28.2±11.1 ng/ml vs. 4.1±2.8 ng/ml, p=0.02) (30.1±8.1 ng/ml vs. 7.1±4.8 ng/ml, p=0.02). Finally, higher values of adiponectin and adiponectin/leptin ratio were detected at 3- and 9-months post-treatment in patients with AA genotype. CONCLUSIONS: G allele carriers of ADIPOQ gene variant (rs3774261) showed no improvement in serum levels of adiponectin, adiponectin/leptin ratio, total-cholesterol, LDL-cholesterol, triglycerides, and CRP after weight loss with a hypocaloric fat monounsaturated diet.

Relationship between fat-free mass and metabolic syndrome in obese females.

OBJECTIVE: A greater fat-free mass (FFM) could be negatively or positively associated with metabolic syndrome (MS). The objective of this work was to evaluate the relationship of FFM with MS, through three determinations; absolute FFM, relative to body weight FFM% and relative to squared height (FFMi). PATIENTS AND METHODS: We conducted a cross-sectional study on 1,008 obese Caucasian females. Fat-free mass index (FFMi) was calculated by dividing FFM by squared height [FFM (kg)/height (m2)]. Fat-free mass percentage (FFM%) was calculated (absolute FFM/body weight) x100. RESULTS: The odds ratio adjusted by age of having MS per tertiles were significantly higher in tertile 3 of FFM (OR=1.74, 95% CI=1.26-2.41; p=0.01) and FFMi (OR=3.38, 95% CI=2.42-3.72; p=0.001) and tertile 2 of FFM (OR=1.45, 95% CI=1.08-1.94; p=0.02) and FFMi (OR=2.37, 95% CI=1.75-3.20; p=0.01) compared with its reference (tertile-1). In contrast, odds ratio adjusted by age of having MS per tertiles were significantly lower in tertile-3 of FFM% (OR=0.29, 95% CI=0.20-0.41; p=0.01) and tertile- 2 of FFM% (OR=0.68, 95% CI=0.51-0.91; p=0.01) compared with its reference (tertile-1). CONCLUSIONS: The prevalence of MS relative to FFM varies depending on the method used to represent it.

Effect of the variant rs602662 of FUT2 gene on anthropometric and metabolic parameters in a Caucasian obese population.

OBJECTIVE: Some obese subjects with genetic variants of FUT2 gene could be implied in metabolic disorders. The aim of the present investigation was to evaluate the association between SNP rs602662 in FUT2 gene with different obesity markers. SUBJECTS AND METHODS: 166 Caucasian obese subjects were enrolled. Anthropometric parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C reactive protein and prevalence of metabolic syndrome were recorded. The genotype of FUT2 gene polymorphism (rs602662) was evaluated. RESULTS: The genotype distribution of the rs602662 variant was the following: 29.5% (n=49) (GG), 47.6% (n=79) (GA) and 22.9% (n=38) (AA). We observed statistical differences between both genotypes (GG+GA vs. AA) in BMI (Delta: 0.4±0.01 kg/m2: p=0.04), fat mass (Delta: 3.7±0.3 kg: p=0.02), body weight (Delta: 5.9±0.4 kg: p=0.02), waist circumference (Delta: 7.3+0.9 cm: p=0.03), glucose (Delta: 5.5±0.4 mg/dl: p=0.04), triglycerides (Delta: 25.9±1.4 mg/dl: p=0.01), HDL-cholesterol (Delta: -5.7±1.2 mg/dl: p=0.02), insulin (Delta: 5.0±0.9 mUI/L: p=0.02) and HOMA-IR (Delta: 1.4±0.1 units: p=0.03) levels. Percentages of metabolic syndrome, central obesity, hypertriglyceridemia, low HDL cholesterol and hyperglycemia were lower in AA obese subjects than GG+GA. Logistic regression analysis showed a decreased risk of metabolic syndrome in AA subjects (OR=0.28, 95% CI=0.11-0.71, p=0.01). CONCLUSIONS: AA genotype of FUT2 rs602662 is associated with lower BMI and a better metabolic profile than subjects with GG+GA genotypes.

Estudio en vida real para evaluar la adherencia y el sabor de un suplemento oral Nutricional hipercalórico e hiperproteico en pacientes con desnutrición en un hospital / A real-world study to evaluate adherence and flavor of a high-protein hypercaloric oral nutritional supplement in patients with malnutrition in a hospital

Objetivo: el objetivo de nuestro estudio en vida real fue evaluar en pacientes ingresados desnutridos la adherencia y las preferencias de sabor de un suplemento oral Nutricional (SON) hipercalórico e hiperproteico. Métodos: se incluyeron en este estudio en vida real un total de 34 pacientes ingresados con pérdida de peso reciente. Se administró un sabor (café, vainilla o fresa) cada día de forma aleatoria a cada paciente durante tres días consecutivos. En los primeros tres días se pidió a los pacientes que completaran dos cuestionarios destinados a reflejar la tolerancia y aceptación del SON (Renutryl®). La adherencia del SON fue evaluada durante el ingreso hospitalario. Resultados: el sabor dulce fue más elevado para el sabor fresa (4,54 ± 0,2 puntos) que para el sabor vainilla (3,13 ± 0,1 puntos; p < 0,03) y el sabor café (3,03 ± 0,1 puntos; p < 0,02). Al analizar a los pacientes que tomaron suplementos después de elegir el sabor, los pacientes que eligieron café tomaron un total de 13,3 ± 1,1 envases de promedio durante la hospitalización (0,91 ± 0,2 por día), los pacientes que eligieron fresa tomaron 13,4 ± 1,3 envases (0,92 ± 0,1 por día) y, finalmente, los pacientes que eligieron envases de vainilla tomaron 8,3 ± 0,9 envases durante el ingreso (0,61 ± 0,1 por día), con diferencias significativas a favor de los sabores de fresa y café frente al sabor de vainilla. Por otra parte, el SON elegido mayoritariamente por los pacientes al alta hospitalaria fue el pack multisabor (n = 20; 50 %).Conclusiones: las preferencias de sabor de los SON de tres sabores son similares, aunque la adherencia fue más elevada durante el ingreso con respecto a los SON con sabor a café y fresa. La dulzura puede haber influido en este hallazgo, sobre todo con el sabor fresa, con una buena tolerancia de los 3 sabores (AU)

Aim: the objective of our real-life study was to evaluate adherence and taste preferences of a hypercaloric and hyperprotein oral nutritional supplement (ONS) in malnourished hospitalized patients. Methods: a total of 34 in patients with recent weight loss were included in this study. One flavor (coffe, vanilla or strawberry) was administered each day in a random way to each patient during three consecutive days. In the first three days, patients were asked to fulfill two questionnaires intended to reflect ONS (Renutryl®) tolerance and acceptance. Adherence to the ONS was measured during hospital stay. Results: the sweet flavor was higher for strawberry (4.54 ± 0.2 points) than for the vanilla flavor (3.13 ± 0.1 points; p < 0.03) and coffee flavor (3.03 ± 0.1 points; p <0.02). When analyzing the total number of patients who took supplements after choosing the flavor, the patients who chose coffee took a total of 13.3 ± 1.1 packages on average during hospitalization (0.91 ± 0.2 per day), the patients who chose strawberry took 13.4 ± 1.3 packages (0.92 ± 0.1 per day), and finally the patients who chose vanilla packages took 8.3 ± 0, 9 packages during admission (0.61 ± 0.1 per day), with significant differences in favor of the strawberry and coffee flavors versus vanilla. The ONS chosen mostly by the patients at hospital discharge was the multiflavor pack (n = 20; 50 %). Conclusions: taste preferences for the three flavored ONSs are similar, although adherence was higher during admission to the coffee- and strawberry-flavored ONS. Sweetness may have influenced this finding, especially with the strawberry flavor, with a good tolerance of all three flavors (AU)

Estudio en vida real de una plataforma «online» para la prescripción de ejercicio físico a pacientes obesos: efecto sobre los parámetros antropométricos y bioquímicos, y sobre la calidad de vida / Real-world study of an online platform for the prescription of physical exercise to obese patients - Effect on anthropometric, biochemical parameters and quality of life

Introducción: uno de los factores de riesgo relacionados con la obesidad es el sedentarismo. La realización de ejercicio físico produce beneficios metabólicos; no obstante, su prescripción mediante herramientas online se ha evaluado escasamente. Objetivo: el objetivo de nuestro trabajo fue valorar el efecto de la prescripción de ejercicio físico mediante una plataforma online sobre los parámetros antropométricos, los factores de riesgo cardiovascular y la calidad de vida de pacientes obesos sedentarios. Material y métodos: en un total de 35 pacientes obesos se recogieron de manera basal y a las 12 semanas datos antropométricos, la masa muscular por ecografía a nivel del cuádriceps, una determinación analítica, la presión arterial y la calidad de vida con el test SF-36. Durante 12 semanas se prescribió un programa de ejercicio físico estructurado a través de una plataforma online (www.vibraup.com). Resultados: tras el programa de ejercicio físico se produjo una mejoría significativa del índice de masa corporal (-1,51 ± 0,1 kg/m2; p = 0,01), el peso (-3,7 ± 0,6 kg; p = 0,01), la circunferencia de la cintura (-6,9 ± 0,3 cm; p = 0,01), la masa grasa (-3,9 ± 0,2 kg; p = 0,01), la masa muscular (5,5 ± 1,6 kg; p = 0,01), la tensión arterial diastólica (-4,5 ± 0,4 mm Hg; p = 0,01), la insulina (-2,8 ± 0,1 UI/L; p = 0,04) y la resistencia a la insulina (HOMA-IR) (-0,9 ± 0,1 unidades; p = 0,03) . Los diferentes parámetros ecográficos del recto anterior del cuádriceps mejoraron significativamente. La prevalencia del síndrome metabólico disminuyó del 27,3 % al 12,1 % (p = 0,03). En el test de calidad de vida SF36 se obtuvo una mejoría significativa en las dimensiones de salud general (20,9 ± 4,1 puntos; p = 0,001), rol físico (6,9 ± 0,9 puntos; p = 0,01) y salud mental (14,0 ± 1,3 puntos; p = 0,01). Conclusión: la prescripción de ejercicio físico con una plataforma online a pacientes obesos mejora el peso y la masa grasa corporal, y aumenta la masa muscular (AU)

Introduction: one of the risk factors related to obesity is a sedentary lifestyle. Physical exercise produces metabolic benefits. Its prescription through online tools has been poorly evaluated, though. Objective: the objective of our study was to assess the effect of the prescription of physical exercise through an online platform on anthropometric parameters, cardiovascular risk factors, and quality of life in sedentary obese patients. Material and methods: in a total of 35 obese patients, anthropometric data, muscle mass by ultrasound at the quadriceps level, laboratory parameters, blood pressure, and quality of life using the SF36 tool were collected at baseline and at 12 weeks. For 12 weeks, a structured physical exercise program was prescribed through an online platform - www.vibraup.com. esults: after the physical exercise program with the online platform, there was a significant improvement in body mass index (-1.51 ± 0.1 kg/m2; p = 0.01), weight (-3.7 ± 0.6 kg; p = 0.01), waist circumference (-6.9 ± 0.3 cm; p = 0.01), fat mass (-3.9 ± 0.2 kg ; p = 0.01), muscle mass (5.5 ± 1.6 kg; p = 0.01), diastolic blood pressure (-4.5 ± 0.4 mm Hg; p = 0.01), insulin (-2.8 ± 0.1 IU/L; p = 0.04), and insulin resistance (HOMA-IR) (-0.9 ± 0.1 units; p = 0.03). The ultrasound parameters of the anterior rectus muscle also improved significantly. The prevalence of metabolic syndrome decreased from 27.3 % to 12.1 % (p = 0.03). The SF36 quality of life test showed a significant improvement in general health (20.9 ± 4.1 points; p = 0.001), physical role (6.9 ± 0.9 points; p = 0 .01), and mental health (14.0 ± 1.3 points; p = 0.01). Conclusion: the prescription of physical exercise with an online platform to obese patients improves weight, decreases body fat mass and increases muscle mass, with a decrease in insulin resistance and an improvement in quality of life (AU)

Role of the variant rs3774261 of adiponectin gene on adiponectin levels and ratio adiponectin/leptin after biliopancreatic diversion in morbid obese subjects.

OBJECTIVE:   Single nucleotide variants (SNVs) of ADIPOQ gene on different comorbidities are related to obesity and weight loss. Despite, there are no studies evaluating the effect of rs3774261 on metabolic variables after bariatric surgery. We evaluated the effect of SNV rs3774261 of ADIPOQ gene on biochemical changes after biliopancreatic diversion surgery in morbidly obese subjects for 3 years follow-up. PATIENTS AND METHODS: One hundred and forty-nine patients (111 females/38 males) with morbid obesity (body mass index >40 kg/m2) without diabetes mellitus type 2 were enrolled. Biochemical and anthropometric evaluation were registered before and after 1, 2, and 3 years. Genotype of rs3774261 has been studied. RESULTS: Total cholesterol, LDL-cholesterol and triglyceride levels decreased in all genotype groups during the study. Although the improvement in glucose, insulin and HOMA-IR was significant in two genotypes (AA and AG); these changes were earlier in the AA genotype than in Ag and GG genotypes. Adiponectin levels increased in a significant way in subjects with AA genotype in the 3 follow-up periods (first year delta: 16.4±0.5 ng/ml; p=0.03, second year delta: 21.3±0.5 ng/ mL; p=0.02 and third year delta: 23.6±0.7 ng/mL; p=0.01) and at 3 years in subjects with AG genotype (delta: 18.3±0.4 ng/ mL; p=0.03). The ratio adiponectin/leptin increased in a significant way in subjects with AA genotype in the 3 follow-up times (first year delta: 0.40±0.1 units; p=0.02, second year delta: 0.58±0.1 units; p=0.01 and third year delta: 0.65±0.1 ng/mL; p=0.01) and at 3 years in subjects with AG genotype (delta: 0.61±0.1 ng/ mL; p=0.02). Subjects with GG genotype did not show a significant improvement in these parameters during the follow-up. CONCLUSIONS: G allele carriers of rs3774261 showed a delay in the improvement of glucose metabolism parameters, adiponectin and adiponectin/leptin ratio.

FTO variant RS 1121980 interact with metabolic response after weight loss with a meal replacement hypocaloric diet in Caucasian obese subjects.

OBJECTIVE: One genetic variant (rs1121980) of FTO gene has been related with body mass index and visceral adiposity. The objective of our study was to investigate the role of rs1121980 genetic variant of FTO gene on weight loss and metabolic changes secondary to a partial meal replacement (pMR) hypocaloric diet. PATIENTS AND METHODS: We conducted an interventional study on 219 obese Caucasian subjects with body mass index (BMI) > 30 kg/m2. The subjects received two intakes per day of a normocaloric hyperproteic formula for 12 weeks. Adiposity and biochemical parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR) and glucose) were determined. RESULTS: After the pMR diet, body weight, BMI, fat mass, waist circumference, blood pressure, total-cholesterol, LDL-cholesterol, triglyceride, fasting insulin levels and HOMA-IR decreased in both genotype groups. The improvements in adiposity parameters and some biochemical parameters (insulin, HOMA-IR, triglyceride levels) were bigger in non-T allele carriers than in T allele carriers. The percentage of patients who achieved 7.5% weight loss was higher in the non-T carriers (76.7% vs. 48.4%), also with a different average of weight loss (-12.3±0.3 kg vs. -5.9±0.5 kg: p=0.01). The odds ratio to achieve 7.5% of weight loss was (OR= 2.22, 95% CI=1.24-4.01; p=0.02). CONCLUSIONS: Non-T allele carriers of rs1121980 show a higher magnitude of weight loss and improvement in adiposity parameters, insulin, HOMA-IR and triglyceride levels resulting from a pMR diet than T allele carriers.

Cholesteryl ester transfer protein rs5833 genetic variant affect HDL-cholesterol levels and ratio total cholesterol/HDL-cholesterol in postmenopausal obese female patient.

OBJECTIVE: One SNP in exon 9 (r5883) has been involved with high risk of cardiovascular disease in hypertensive subjects. The goal of the present study was to test the role of this genetic variant on lipid levels and Metabolic Syndrome (MS) in menopausal obese females. PATIENTS AND METHODS: The study enrolled a sample of 112 menopausal obese females. Measurements of adiposity parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C reactive protein and prevalence of MS were recorded. Genotype of CETP gene polymorphism (rs5883) was studied. RESULTS: The distribution of the rs5883 polymorphism in this menopausal obese population was 83.9% (n=94) (CC), 15.2% (n=17) (CT) and 0.9% (n=1) (TT). Adiposity parameters, blood pressure, fasting glucose levels, insulin levels, HOMA-IR, C reactive protein, total cholesterol, LDL-cholesterol and triglycerides were similar in both genotype groups (CC vs. CT+TT). Moreover, HDL cholesterol (8.5+1.2 mg/dl; p=0.01) and ratio total cholesterol/HDL-cholesterol (0.5±0.2; p=0.04) were higher in T allele carriers (dominant model). MS percentage was similar in both genotypes (37.6% vs. 27.2%; p=0.43). Logistic regression analysis showed a decreased risk of low-HDL cholesterol in T allele carriers (OR=0.18, 95% CI=0.02-0.77, p=0.03) after adjusting by dietary fatty acid intakes, body mass index and age. CONCLUSIONS: The results reported here support that CETP variant rs5883 is related with HDL-cholesterol levels and ratio total cholesterol/HDL-cholesterol.

The gene variant rs2419621 of ACYL-CoA synthetase long-chain 5 gene is associated with weight loss and metabolic changes in response to a robotic sleeve gastrectomy in morbid obese subjects.

OBJECTIVE: Genetic mechanisms have been involved in the pathogenesis of obesity and weight loss due to bariatric surgery. The aim of our work was to evaluate the effects of rs2419621 genetic variant of ACSL5 gene on weight and metabolic changes after a robotic sleeve gastrectomy. PATIENTS AND METHODS: 48 patients were enrolled. Comorbidities, biochemical and anthropometric parameters evaluation were registered before and after 3, 6 and 12 months follow up. Genotype of rs2419621 ACSL5 gene was evaluated. RESULTS: We classified the subjects with a dominant model, in two groups: those carriers T allele (TT+CT, 37.5%) and non-carriers T allele (CC, 62.5%).  We reported a statistically significant reduction of body weight, waist circumference, percentage of excess of weight loss (EWL%), blood pressure, glucose, insulin, LDL-cholesterol and triglycerides after surgery. After 12 months, delta of (EWL%; 70.1% vs. 64,2%; p=0.04), weight (40.7+4.1 kg vs. 32.5+4.8 kg; p=0.03), waist circumference (29.1+3.1 cm vs. 22.2+2.8 kg; p=0.02) and triglycerides (51.2+9.1 mg/dl vs. 32.1+8.1; p=0.02) were higher in T allele carriers than non-T allele carriers. All comorbidities improved, but the percentage of patients with hypertriglyceridemia diminished early in the 3-month follow-up in the T-allele carriers, and at 12 months, no patient with the T allele had hypertriglyceridemia. CONCLUSIONS: Our data showed that the genetic variant (rs2419621) of ACSL5 gene are associated with better improvement of adiposity and triglyceride levels in subjects with T allele, after a robotic sleeve gastrectomy.

Serum lipid and adiponectin/leptin ratio changes after a Mediterranean dietary pattern in non-g-allele carriers of the genetic variant of adiponectin gene rs822393.

OBJECTIVE: One common genetic variant rs822393 (-4522C/T) is located in the proximal promoter region of the ADIPOQ gene. The SNP rs822393 regulates adiponectin promoter activity and is associated with hypoadiponectinemia. The aim of our study was to analyze the effects after a hypocaloric diet with Mediterranean diet pattern on serum lipid and adipokine levels taking to account rs822393 of ADIPOQ. PATIENTS AND METHODS: A population of 270 obese patients was enrolled. Anthropometric parameter and serum parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR), glucose, C reactive protein, adiponectin, resistin and leptin levels) were measured, at basal time and after 3 months. All patients were genotyped in the rs822393 polymorphism. RESULTS: The genotype distribution was: 160 patients (59.3%) CC, 96 patients CT (35.6%) and 14 patients CT (5.1%). After dietary intervention, BMI, weight, fat mass, waist circumference, systolic blood pressure, insulin levels, HOMA-IR, total cholesterol and LDL- cholesterol improved significantly in both genotypes. After dietary intervention (CC vs. CT+TT), HDL-cholesterol (delta: 5.4±1.4 mg/dl vs. -1.8±0.7 mg/dl; p=0.03), serum adiponectin (delta: 21.2±4.1 ng/dl vs. 3.8±3.3 ng/dl; p=0.02) and adiponectin/leptin ratio (delta: 0.53±0.1 vs. 0.16±0.3 ng/dl; p=0.02) improved only in non-T allele carriers. Basal and post-intervention HDL cholesterol, adiponectin levels and adiponectin/leptin ratio were lower in T-allele carriers than non-T Allele carriers. CONCLUSIONS: T allele carriers show lower levels of HDL-cholesterol, adiponectin and adiponectin/leptin ratio than non-T allele carriers. During a hypocaloric diet with Mediterranean partner increases HDL Cholesterol, adiponectin levels and ratio adiponectin/leptin in non-T allele carriers.

Brain derived neurotrophic factor (BDNF) polymorphism rs 10767664 affects metabolic parameters after weight loss secondary to high fat hypocaloric diet with Mediterranean pattern.

OBJECTIVE: We evaluated the effect of the genetic variant rs10767664 of BDNF gene on anthropometric and biochemical changes after weight loss secondary to a high-fat hypocaloric diet with a Mediterranean dietary pattern. PATIENTS AND METHODS: A sample of 277 obese subjects was recruited. After subjects met the inclusion criteria, they received a nutritional intervention with a high-fat hypocaloric diet [36% of carbohydrates, 40% of fats (60.0% of monounsaturated fats, 25.0% of saturated fats and 15.0% of polyunsaturated fats) and 24% of proteins]. Biochemical and anthropometric parameters were measured at basal and 3 months. RESULTS: One hundred and seventy-nine subjects (64.6%) had the genotype AA (wild group) and 98 (35.4%) subjects had the next genotypes; AT (81 patients, 29.2%) or TT (17 patients, 6.2%) (Mutant group). The improvement of BMI, weight, fat mass, waist circumference, systolic blood pressure, leptin, total cholesterol and LDL cholesterol was similar in both genotypes after dietary intervention. Secondary to weight loss and only in non-T allele, insulin levels (AA vs. At+TT) (-5.2+0.2 UI/L vs. -2.9+0.3 UI/L: p=0.02) and HOMA-IR (-2.1+0.2 units vs. -1.1+0.1 units: p=0.02) decreased significantly. CONCLUSIONS: T allele carriers of the BDNF variant rs10767664 may be an independent predictor of the lack of improvement induced by weight loss on insulin levels and insulin resistance after a high-fat hypocaloric diet with a Mediterranean dietary pattern.

The lactase rs4988235 is associated with obesity related variables and diabetes mellitus in menopausal obese females.

OBJECTIVE: Some studies showed specific associations of the Lactase persistence (LP) genotype (CT/TT) with obesity and its related comorbidities. The aim of the present investigation was to describe the association of rs4988235 with metabolic parameters, diabetes mellitus type 2 (DM2), dairy product consumption in menopausal obese females. PATIENTS AND METHODS: The study involved a population of 86 menopausal obese females. Measurements of anthropometric parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, bone metabolism biomarkers, and prevalence of (DM2) were recorded. The genotype of the Lactase gene polymorphism (rs48988235) was evaluated. RESULTS: The distribution of the rs48988235 polymorphism was 16.3% (n=14) (CC), 38.4% (n=33) (CT) and 45.3% (n=39) (TT). The allele frequency was C (0.35) and T (0.65). In the recessive model, serum 25-OH Vitamin D, fasting glucose levels, insulin levels, and HOMA-IR were better in CC+CT genotype than TT genotype. In a dominant model, 25-OH Vitamin D, fasting glucose levels, insulin levels, and HOMA-IR were better in CC genotype than CT+TT genotype. In both genetic models, calcium, vitamin D, and milk intakes were higher in T allele carriers. In the dominant model (CT+TT genotype), logistic regression analysis showed an increased risk of hyperglycemia (OR=3.63, 95% CI=1.10-13.26, p=0.03) and prevalence of DM2 (OR=3.93, 95% CI=1.07-14.4, p=0.03), after adjusting by milk intake, BMI, and age. This association remained in recessive model (TT genotype); risk of hyperglycemia (OR=4.26, 95% CI=1.12-16.23, p=0.02) and prevalence of DM2 (OR=5.35, 95% CI=1.12-15.8, p=0.02). CONCLUSIONS: T allele of rs48988235 variant in Lactase gene is associated with better glucose metabolism and lower risk of DM2 in menopausal obese females. In addition, dietary intakes of milk, calcium, and 25-OH vitamin D were higher too.

Leptin gene polymorphism (rs 7799039;G2548A) is associated with changes in lipid profile during a partial meal-replacement hypocaloric diet.

BACKGROUND: Some studies have demonstrated a positive association of the rs7799039 genetic variant of the LEP gene with energy intake and metabolic parameters. The present study aimed to analyse the effects of the rs7799039 genetic variant of the LEP gene on metabolic parameters after weight loss secondary to a partial meal-replacement (pMR) hypocaloric diet. METHODS: We conducted a non-randomised, single-treatment study in 122 obese subjects with body mass index (BMI) > 35 kg m-2 . The subjects were treated with two intakes of a normocaloric hyperproteic formula during 12 weeks. Anthropometric parameters and biochemical profile were measured at basal time and after 12 weeks. The variant genetic variant (rs7799039) of the LEP gene was assessed by a real-time polymerase chain reaction. RESULTS: We recruited 122 subjects [26 GG (21.3%), 59 GA (29.5%) and 37 AA (30.3%)]. The mean (SD) age of the all group was 59.4 (6.3) years (range 45-63 years) and the mean (SD) BMI was 39.3 (2.8) kg m-2 (range 36.2-45.1 kg m-2 ). After the pMR hypocaloric diet, body weight, BMI, fat mass, waist circumference, fasting insulin, homeostasis model assessment for insulin resistance and blood pressure decreased in both genotypes. All of these improvements were similar in both genotypes. Moreover, after dietary intervention, only subjects without an A allele showed a significant improvement in triglycerides (GG versus GA + AA) [mean (SD) -15.3 (6.4) mg dL-1 versus -3.7 (4.3) mg dL-1 : P = 0.02], total cholesterol [-25.0 (5.3) mg dL-1 versus -8.1 (3.5) mg dL-1 : P = 0.02] and low-density lipoprotein-cholesterol [-20.7 (4.2) mg dL-1 versus -5.4 (2.3) mg dL-1 : P = 0.01]. CONCLUSIONS: Subjects with an A allele of the rs7799039 variant in the LEPR gene showed a significant improvement in low-density lipoprotein-cholesterol and triglycerides levels after weight loss secondary to a pMR hypocaloric diet.

Relation of a variant in adiponectin gene (rs266729) with metabolic syndrome and diabetes mellitus type 2 in adult obese subjects.

OBJECTIVE: Some studies in the literature indicate that ADIPOQ rs266729 polymorphism functionally regulates adiponectin promoter activity and secondarily adiponectin levels. The aim of the present investigation was to describe the association of rs266729 with diabetes mellitus (DM2), components of Metabolic syndrome (MS) and serum adiponectin levels. PATIENTS AND METHODS: The study involved a population of 1004 adult obese subjects. Measurements of anthropometric parameters, blood pressure, fasting blood glucose, C-reactive protein (CRP), insulin concentration, insulin resistance (HOMA-IR), lipid profile, adipokines levels and prevalence of MS and DM2 were recorded. The genotype of ADIPOQ gene polymorphism (rs266729) was evaluated. RESULTS: The distribution of the rs266729 polymorphism in this population was 56.7% (n=569) (CC), 33.1% (n=332) (CG) and 10.2% (n=103) (GG). Insulin and HOMA-IR levels were higher in G allele carriers than non G allele carriers. Adiponectin levels were lower in G allele carriers than non G allele carriers. In total group carriers of G allele, logistic regression analysis showed an increased risk of hyperglycaemia (OR=1.70, 95% CI=1.19-2.76, p=0.03) and prevalence of diabetes mellitus type 2 (OR=1.81, 95% CI=1.13-5.14, p=0.04), after adjusting by body mass index and age CONCLUSIONS: G allele of SNP (rs266729) of the ADIPOQ gene showed high values of insulin and HOMA-IR, and low values of adiponectin levels than non G allele carriers. G allele carriers showed higher rate of diabetes mellitus and hyperglycemia.

Effect of two different dietary fatty acid profiles and variant rs266729 in ADIPOQ on weight loss and adiponectin concentrations / Efecto de dos perfiles diferentes de ácidos grasos en la dieta y variante en el gen rs266729 de adiponectina sobre la pérdida de peso y los niveles de adiponectina

BACKGROUND: The role of ADIPOQ gene rs266729 variants on weight loss after a dietary intervention are still unclear. OBJECTIVE: To analyze the effects of the ADIPOQ gene rs266729 variant n weight loss, cardiovascular risk factors, and adiponectin levels after two hypocaloric diets with different dietary fatty profiles. DESIGN: A population of 362 obese patients was enrolled in a randomized clinical trial with two diets (Diet M, monounsaturated fat-enriched diet, and Diet P, polyunsaturated-fat enriched diet). Anthropometric measurements, an assessment of nutritional intake, and biochemical tests were performed at baseline and after 12 weeks. RESULTS: Weight loss was similar with both diets. After Diet M, only subjects with CC genotype showed significant improvements in total cholesterol (CC vs. CG ± GG) -9.0 ±1.1 mU/L vs. -4.5 ± 2.4 mg/dL, p = 0.01), LDL cholesterol (-6.0 ± 1.1 mg/dL vs. -3.0 ± 0.9 mg/dL, p = 0.03), glucose (-4.7 ± 1.1 mg/dL vs. -0.6 ± 0.5 mg/dL, p = 0.01), and insulin levels (-2.6 ±1.0 mU/L vs. -0.7 ± 0.3 mU/L, p = 0.02) and in HOMA-IR (-0.5 ± 0.2 units vs. -0.2 ± 0.4 units, p = 0.03). The same improvement was reported after Diet P in all parameters, including total cholesterol (CC vs. CG±GG) (-8.0 ± 1.2mU/L vs. -2.1 ± 1.4 mg/dL, p = 0.02), LDL cholesterol (-7.3 ± 1.2 mg/dL vs. -2.1 ± 0.8 mg/dL, p = 0.02), glucose (-3.2 ± 0.1mg/dL vs. -0.2 ± 0.5 mg/dL, p = 0.01), and insulin levels (-2.5 ± 1.0 mU/L vs. -1 ± 0.6 mU/L, p = 0.02) and HOMA-IR (-0.5 ± 0.1 units vs. −0.3 ± 0.4 units, p = 0.02). Only subjects with CC genotype showed significant increases in adiponectin levels after both diets: (Diet M: 10.3 ± 2.0 ng/dL vs. Diet P: 9.3 ± 2.9 ng/dL, p = 0.43). CONCLUSION: The CC genotype of ADIPOQ gene rs266729 variant is associated to increased adiponectin levels and decreases in LDL cholesterol, glucose, insulin, and HOMA-IR levels after weight loss

ANTECEDENTES: El papel de las variantes del gen ADIPOQ en la pérdida de peso después de una intervención dietética sigue sin estar claro. OBJETIVO: Nuestro objetivo fue analizar los efectos de la variante rs266729 del gen ADIPOQ sobre la pérdida de peso, los factores de riesgo cardiovascular y los niveles de adiponectina después de 2 dietas hipocalóricas con diferentes perfiles de grasas en la dieta. DISEÑO: Una población de 362 pacientes obesos se incluyeron en un ensayo clínico aleatorizado con 2 dietas (dieta M: dieta enriquecida con grasas monoinsaturadas y dieta P: dieta enriquecida con grasas poliinsaturadas). Antes y tras 12 semanas, se realizó una evaluación antropométrica, evaluación de la ingesta nutricional y un análisis bioquímico. RESULTADOS: La pérdida de peso fue similar con ambas dietas. Después de la dieta M, solo los sujetos con genotipo CC mostraron una mejoría significativa en el colesterol total (CC vs. CG±GG) (-9,0 ± 1,1 mU/l vs. - 4,5 ± 2,4 mg/dl; p = 0,01), colesterol LDL (-6,0 ± 1,1 mg/dl vs. - 3,0 ± 0,9 mg/dl; p = 0,03), glucosa (-4,7 ± 1,1 mg/dl vs. -0,6 ± 0,5 mg/dl; p = 0,01), niveles de insulina (-2,6 ± 1,0 mU/l vs. -0,7± 0,3 mU/l; p = 0,02) y HOMA-IR (- 0,5 ± 0,2 unidades vs. -0,2 ± 0,4 unidades; p = 0,03). La misma mejora en todos los parámetros se informó después de la dieta P; niveles de colesterol total (CC vs. CG ± GG) (-8,0 ± 1,2 mU/l vs. -2,1 ± 1,4 mg/dl; p = 0,02), colesterol LDL (-7,3 ± 1,2 mg/dl vs. -2,1 ±0,8 mg/dl; p = 0,02), glucosa (-3,2 ± 0,1 mg/dl vs. -0,2 ± 0,5 mg/dl; p = 0,01), niveles de insulina (-2,5 ±1,0 mU/l vs. -1 ±0,6 mU/l; p = 0,02) y HOMA-IR (-0,5 ± 0,1 unidades vs. -0,3 ± 0,4 unidades; p = 0,02). Solo los sujetos con genotipo CC mostraron un aumento significativo de los niveles de adiponectina después de ambas dietas: (dieta M: 10,3 ± 2,0 ng/dl vs. dieta P: 9,3 ± 2,9 ng/dl; p = 0,43). CONCLUSIÓN: El genotipo CC de la variante rs266729 del gen ADIPOQ se asocia con aumentos en los niveles de adiponectina y disminución del colesterol LDL, glucosa, insulina y HOMA-IR tras la pérdida de peso

RS9939609 FTO gene variant modified weight loss and insulin resistance after a partial meal-replacement hypocaloric diet.

OBJECTIVE: Some studies have demonstrated that the allele A of FTO rs9939609 is related to both higher waist circumference and body mass index. Subsequently, some designs related biochemical variables and body weight changes with this genetic variant. We decide to analyze the effects of rs9939609 genetic variant of FTO gene on metabolic parameters and weight loss secondary to partial meal replacements hypocaloric diets (pMRHDs) in obese subjects. PATIENTS AND METHODS: This was a non-randomized, single-treatment study with a formula-diet in 44 obese subjects. The patients received nutritional education and a pMRHDs with two intakes of normocaloric hyperproteic formula during 12 weeks. Anthropometric parameters and biochemical profiles were measured at basal time and after 12 weeks. The variant of FTO gene rs9939609 was determined. RESULTS: Genotype distribution (n=44) was (16 TT (36.4%), 17 TA (38.6%) and 11 AA (25.0%)). After the pMRHD, body weight, body mass index (BMI), fat mass, waist circumference, serum leptin levels and systolic blood pressure improved in both genotypes without statistical differences in both branches. After dietary intervention with pMRHD, subjects with A allele showed a significant improvement in total cholesterol levels (TT vs. TA+AA) (-3.8±1.4 md/dL vs. -12.6±1.7 mg/dl: p=0.01), LDL-cholesterol (-0.2±1.5 md/dL vs. -10.5±1.9 mg/dl: p=0.02), insulin levels (-1.9±0.2 mU/L vs. -3.8±0.3 mU/L: p=0.02) and HOMA-IR (-0.6±0.2 units vs. -1.1±0.1 units: p=0.01). CONCLUSIONS: Our data suggest that the genetic variant (rs9939609) of FTO gene showed better improvement of LDL-cholesterol, insulin and HOMA-IR in subjects with A allele.

Effect of two different dietary fatty acid profiles and variant rs266729 in ADIPOQ on weight loss and adiponectin concentrations.

BACKGROUND: The role of ADIPOQ gene rs266729 variants on weight loss after a dietary intervention are still unclear. OBJECTIVE: To analyze the effects of the ADIPOQ gene rs266729 variant n weight loss, cardiovascular risk factors, and adiponectin levels after two hypocaloric diets with different dietary fatty profiles. DESIGN: A population of 362 obese patients was enrolled in a randomized clinical trial with two diets (Diet M, monounsaturated fat-enriched diet, and Diet P, polyunsaturated-fat enriched diet). Anthropometric measurements, an assessment of nutritional intake, and biochemical tests were performed at baseline and after 12 weeks. RESULTS: Weight loss was similar with both diets. After Diet M, only subjects with CC genotype showed significant improvements in total cholesterol (CC vs. CG±GG) (-9.0±1.1mU/L vs. -4.5±2.4mg/dL, p=0.01), LDL cholesterol (-6.0±1.1mg/dL vs. -3.0±0.9mg/dL, p=0.03), glucose (-4.7±1.1mg/dL vs. -0.6±0.5mg/dL, p=0.01), and insulin levels (-2.6±1.0mU/L vs. -0.7±0.3mU/L, p=0.02) and in HOMA-IR (-0.5±0.2 units vs. -0.2±0.4 units, p=0.03). The same improvement was reported after Diet P in all parameters, including total cholesterol (CC vs. CG±GG) (-8.0±1.2mU/L vs. -2.1±1.4mg/dL, p=0.02), LDL cholesterol (-7.3±1.2mg/dL vs. -2.1±0.8mg/dL, p=0.02), glucose (-3.2±0.1mg/dL vs. -0.2±0.5mg/dL, p=0.01), and insulin levels (-2.5±1.0mU/L vs. -1±0.6mU/L, p=0.02) and HOMA-IR (-0.5±0.1 units vs. -0.3±0.4 units, p=0.02). Only subjects with CC genotype showed significant increases in adiponectin levels after both diets: (Diet M: 10.3±2.0ng/dL vs. Diet P: 9.3±2.9ng/dL, p=0.43). CONCLUSION: The CC genotype of ADIPOQ gene rs266729 variant is associated to increased adiponectin levels and decreases in LDL cholesterol, glucose, insulin, and HOMA-IR levels after weight loss.