Association of resistin (rs3138167) gene polymorphism with metabolic response after a hypocaloric Mediterranean diet / Asociación del polimorfismo del gen de la resistina (rs3138167) con la respuesta metabólica trasuna dieta mediterránea hipocalórica

Background: the single nucleotide polymorphism (SNP) (rs3138167) is a polymorphism that has been associated with metabolic disorder in obese subjects and its effect on the metabolic response after a dietary intervention has not been evaluated. Objective: our aim was to analyze the effects of the rs3138167 on metabolic changes secondary to weight loss with a hypocaloric diet with a Mediterranean pattern. Method: one thousand and eight Caucasian obese patients were evaluated. Before and after 12 weeks on a hypocaloric diet with Mediterranean pattern, an anthropometric evaluation and a biochemical analysis were performed. The statistical analysis was performed as a dominant model (CC vs CT + TT). Results: the values of insulin, HOMA-IR and resistin were higher in T allele carriers than non-T allele carriers in pre- and post-intervention time. In non-T allele carriers, resistin, insulin, HOMA-IR, triglycerides and C-reactive protein levels decreased. The improvement was statistically superior in non-T allele carriers; resistin (-1.2 ± 0.2 ng/dl; p = 0.02), triglycerides (-18.3 ± 4.3 mg/dl; p = 0.02), C-reactive protein (-2.6 ± 0.3 mg/dl; p = 0.02), insulin -4.4 ± 1.9 mUI/l; p = 0.02) and HOMA-IR (-2.1 ± 0.7; p = 0.03). Conclusion: we report an association of rs3138167 with a worse metabolic response (insulin, HOMA-IR, triglyceride and C-reactive protein) in T allele carriers after weight loss with a hypocaloric diet with Mediterranean pattern.(AU)

Antecedentes: el polimorfismo de nucleótido único (SNP) (rs3138167) se ha asociado con trastorno metabólico en sujetos obesos y no se ha evaluado su efecto sobre la respuesta metabólica después de una intervención dietética.Objetivo: nuestro objetivo fue analizar los efectos del polimorfismo rs3138167 sobre los cambios metabólicos secundarios a la pérdida de peso con una dieta hipocalórica de patrón mediterráneo. Métodos: se evaluaron 1.008 pacientes caucásicos con obesidad. Antes y tras 12 semanas de dieta hipocalórica con patrón mediterráneo, se realizaron una evaluación antropométrica y un análisis bioquímico. El análisis estadístico se realizó como un modelo dominante (CC vs. CT + TT). Resultados: los valores de insulina, HOMA-IR y resistina fueron más elevados en los portadores del alelo T, tanto antes como después de la intervención dietética. En los no portadores del alelo T, los niveles de resistina, insulina, HOMA-IR, triglicéridos y proteína C reactiva disminuyeron. Las mejorías fueron estadísticamente significativas, de manera superior en los no portadores del alelo T; resistina (-1,2 ± 0,2 ng/dl; p = 0,02), triglicéridos (-18,3 ± 4,3 mg/dl; p = 0,02), proteína C reactiva (-2,6 ± 0,3 mg/dl; p = 0,02), insulina -4,4 ± 1,9 mUI/l; p = 0,02) y HOMA-IR (-2,1 ± 0,7; p = 0,03). Conclusión: describimos una asociación del rs3138167 con una peor respuesta metabólica en los portadores del alelo T (insulina, HOMA-IR, triglicéridos y proteína C reactiva) tras la pérdida de peso con una dieta hipocalórica de patrón mediterráneo.(AU)

Use of Muscle Ultrasonography in Morphofunctional Assessment of Amyotrophic Lateral Sclerosis (ALS).

Amyotrophic lateral sclerosis (ALS) is a progressive disease with a high prevalence of malnutrition that can influence prognosis. The main objective of this study is to compare the validity of muscle ultrasonography in the diagnosis of malnutrition and the prognosis of patients with ALS. METHODS: This is a prospective observational study that analyzes the nutritional status of patients at the beginning of nutritional monitoring. The morphofunctional assessment included the examination of anthropometric variables such as weight, height, body mass index (BMI), arm circumference, and calf circumference. Additionally, electrical bioimpedanciometry (BIA) was used to measure electrical parameters and estimate other relevant metrics. Muscle ultrasonography® (quadriceps rectus femoris (QRF)) assessed muscle mass parameters, including muscle area index (MARAI), anteroposterior diameter of the QRF (Y-axis) (cm), transverse diameter of the QRF (X-axis) (cm), and the sum of the quadriceps thickness (RF+VI) (cm), as well as muscle quality parameters such as echogenicity and the Y-X index. RESULTS: A total of 37 patients diagnosed with amyotrophic lateral sclerosis (ALS) were included in this study. Of these patients, 51.4% were men. The mean age was 64.27 (12.59) years. A total of 54.1% of the patients had a bulbar onset of amyotrophic lateral sclerosis, and 45.9% had spinal onset. The percentage of subjects with malnutrition diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria was 45.9% of patients. There was a direct correlation between muscle mass parameters assessed by muscle ultrasonography (RF+VI) and active mass markers measured by bioimpedanciometry (body cellular mass index (BCMI) (r = 0.62; p < 0.01), fat-free mass index (FFMI) (r = 0.75; p < 0.01), and appendicular skeletal mass index (ASMI) (r = 0.69; p < 0.01)). There was a direct correlation between echogenicity and resistance (r = 0.44; p = 0.02), as well as between the fat-free mass index and the Y-X index (r = 0.36; p = 0.14). Additionally, there was a negative correlation between echogenicity and BCMI (r = -0.46; p < 0.01) and ASMI (r = 0.34; p = 0.06). Patients with low quadriceps thickness (male < 2.49 cm; female < 1.84 cm) showed an increased risk of hospital admission adjusted by age, sex, and presence of dysphagia (OR: 7.84 (CI 95%: 1.09-56.07); p-value = 0.04), and patients with low-quality mass (Y-X index < 0.35) had a higher risk of hospital admission adjusted by age, sex, and presence of dysphagia (OR: 19.83 (CI 95%: 1.77-222.46); p-value = 0.02). CONCLUSIONS: In patients with ALS, ultrasonography echogenicity was inversely related to BCMI, FFMI, and ASMI, and the Y-X index was directly related to FFMI. The lowest quartiles of quadriceps thickness and Y-X index are risk factors for hospital admission.

The Polymorphism rs17300539 in the Adiponectin Promoter Gene Is Related to Metabolic Syndrome, Insulin Resistance, and Adiponectin Levels in Caucasian Patients with Obesity.

Background and Aims: The present study was designed to investigate SNP rs17300539 in the ADIPOQ gene and its relationships with obesity, metabolic syndrome (MS), and serum circulating adiponectin. Methods: The present design involved a Caucasian population of 329 subjects with obesity. Anthropometric and adiposity parameters, blood pressure, biochemical parameters, and the percentage of patients with metabolic syndrome were recorded. The ADIPOQ gene variant (rs17300539) genotype was evaluated. Results: The percentage of patients with different genotypes of the rs17300539 polymorphism in this sample was 86.0% (n = 283) (GG), 11.2% (n = 37) (GA), and 2.7% (n = 9) (AA). The allele frequency was G (0.76) and A (0.24). Applying the dominant genetic model (GG vs. GA + AA), we reported differences between genotype GG and genotype GA + AA for serum adiponectin levels (Delta: 7.5 ± 1.4 ng/mL; p = 0.03), triglycerides (Delta: 41.1 ± 3.4 mg/dL; p = 0.01), fastingcirculating insulin (Delta: 4.9 ± 1.1 mUI/L; p = 0.02), and insulin resistance as HOMA-IR (Delta: 1.4 ± 0.1 units; p = 0.02). The remaining biochemical parameters were not related to the genotype of obese patients. The percentages of individuals with MS (OR = 2.07, 95% CI = 1.3-3.88; p = 0.01), hypertriglyceridaemia (OR = 2.66, 95% CI = 1.43-5.01; p = 0.01), and hyperglycaemia (OR = 3.31, 95% CI = 1.26-8.69; p = 0.02) were higher in GG subjects than patients with A allele. Logistic regression analysis reported an important risk of the presence of metabolic syndrome in GG subjects (OR = 1.99, 95% CI = 1.21-4.11; p = 0.02) after adjusting for adiponectin, dietary energy intakes, gender, weight, and age. Conclusions: The GG genotype of rs17300539 is associated with hypertriglyceridaemia, insulin resistance, low adiponectin levels, and a high risk of metabolic syndrome and its components.

Association of resistin (rs3138167) gene polymorphism with metabolic response after a hypocaloric Mediterranean diet.

BACKGROUND: the single nucleotide polymorphism (SNP) (rs3138167) of resistin (RETN) gene is a polymorphism that has been associated with metabolic disorder in obese subjects and its effect on the metabolic response after a dietary intervention has not been evaluated. OBJECTIVE: our aim was to analyze the effects of the rs3138167 RETN gene polymorphism on metabolic changes secondary to weight loss with a hypocaloric diet with a Mediterranean pattern. METHOD: one thousand and eight Caucasian obese patients were evaluated. Before and after 12 weeks on a hypocaloric diet with Mediterranean pattern, an anthropometric evaluation and a biochemical analysis were performed. The statistical analysis was performed as a dominant model (CC vs CT + TT). RESULTS: the values of insulin, HOMA-IR and resistin were higher in T allele carriers than non-T allele carriers in pre- and post-intervention time. In non-T allele carriers, resistin, insulin, HOMA-IR, triglycerides and C-reactive protein levels decreased. The improvement was statistically superior in non-T allele carriers; resistin (-1.2 ± 0.2 ng/dl; p = 0.02), triglycerides (-18.3 ± 4.3 mg/dl; p = 0.02), C-reactive protein (-2.6 ± 0.3 mg/dl; p = 0.02), insulin -4.4 ± 1.9 mUI/l; p = 0.02) and HOMA-IR (-2.1 ± 0.7; p = 0.03). CONCLUSION: we report an association of rs3138167 with a worse metabolic response (insulin, HOMA-IR, triglyceride and C-reactive protein) in T allele carriers after weight loss with a hypocaloric diet with Mediterranean pattern.

Nutritional Ultrasonography, a Method to Evaluate Muscle Mass and Quality in Morphofunctional Assessment of Disease Related Malnutrition.

Nutritional ultrasonography is an emerging technique for measuring muscle mass and quality. The study aimed to evaluate the relationship between the parameters of body mass and quality of ultrasonography with other parameters of morphofunctional assessment in patients with disease-related malnutrition (DRM). METHODS: A cross-sectional study was developed on 144 patients diagnosed with DRM according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional evaluation was assessed with anthropometric variables, handgrip strength and bioelectrical impedanciometry (BIA). Nutritional ultrasonography of quadriceps rectus femoris (QRF) was made (muscle mass (Muscle Area of Rectus Femoris index (MARFI)), Y axis and muscle quality (X-Y index and echogenicity). RESULTS: The mean age of patients was 61.4 (17.34) years. The prevalence of sarcopenia in the sample was 33.3%. Patients with sarcopenia (S) had lower values of MARFI [(S: 1.09 (0.39) cm2/m2; NoS: 1.27 (0.45); p = 0.02), Y axis (S: 0.88 (0.27); NoS: 1.19 (0.60); p < 0.01) and X-Y index (S: 1.52 (0.61); NoS: 1.30 (0.53); p < 0.01)]. There was a correlation between BIA parameters (phase angle) and muscle mass ultrasonographic variables (MARFI) (r = 0.35; p < 0.01); there was an inverse correlation between muscle quality ultrasonographic variables (echogenicity) and handgrip strength (r = -0.36; p < 0.01). In the multivariate analysis adjusted by age, the highest quartile of the X-Y index had more risk of death OR: 4.54 CI95% (1.11-18.47). CONCLUSIONS: In patients with DRM and sarcopenia, standardized muscle mass and muscle quality parameters determined by ultrasonography of QRF are worse than in patients without sarcopenia. Muscle quality parameters had an inverse correlation with electric parameters from BIA and muscle strength. The highest quartile of the X-Y index determined by ultrasonography was associated with increased mortality risk.

Effect on Body Composition of a Meal-Replacement Progression Diet in Patients 1 Month after Bariatric Surgery.

BACKGROUND: Progression diets after bariatric surgery (BS) are restricted in calories and protein, and they may induce a worsening of body composition. The aim of this study was to evaluate the effect of a modified diet with an oral nutritional supplement that is hyperproteic and normocaloric over the body composition. METHODS: A two-arm ambispective observational cohort study was designed. Forty-four patients who underwent sleeve gastrectomy were included in the study. Thirty patients received a progression diet with a normocaloric, hyperproteic oral nutritional supplement during the first two weeks after surgery (820 kcal, 65.5 g protein). They were compared with a historical cohort of 14 patients treated with a standard progression diet (220 kcal, 11.5 g protein). Anthropometric and body composition (using electrical bioimpedanciometry) data were analyzed before BS and 1 month after the surgery. RESULTS: The mean age was 47.35(10.22) years; 75% were women, and the average presurgical body mass index (BMI) was 45.98(6.13) kg/m2, with no differences between both arms of intervention. One month after surgery, no differences in the percentage of excess weight loss (%PEWL) were observed between patients in the high-protein-diet group (HP) and low-protein-diet group (LP) (HP: 21.86 (12.60)%; LP: 18.10 (13.49)%; p = 0.38). A lower loss of appendicular skeletal muscle mass index was observed in the HP (HP: -5.70 (8.79)%; LP: -10.54 (6.29)%; p < 0.05) and fat-free mass index (HP: 3.86 (8.50)%; LP:-9.44 (5.75)%; p = 0.03), while a higher loss of fat mass was observed in the HP (HP: -14.22 (10.09)%; LP: -5.26 (11.08)%; p < 0.01). CONCLUSIONS: In patients undergoing gastric sleeve surgery, the addition of a normocaloric, hyperproteic formula managed to slow down the loss of muscle mass and increase the loss of fat mass with no differences on total weight loss.

Real World Practice Study of the Effect of a Specific Oral Nutritional Supplement for Diabetes Mellitus on the Morphofunctional Assessment and Protein Energy Requirements.

Introduction: The prevalence of malnutrition in patients with diabetes mellitus is high. In these patients, monitoring nutritional intervention is complex. Aims: To evaluate the evolution in the nutritional status in patients with diabetes/prediabetes and malnutrition with a diabetes-specific enteral formula. Methods: Real-life study of one arm in 60 patients with diabetes and prediabetes, performing a dietary adaptation with diabetes-specific oral nutritional supplementation. A morphofunctional assessment was performed, consisting of intake assessment, anthropometry, body composition (bioimpedance and muscle ultrasound), handgrip strength and biochemical markers. The diagnosis of malnutrition was made using the criteria of the Global Leadership Initiative on Malnutrition (GLIM). The variables were measured at baseline and 3 months after starting the intervention. Results: The mean age was 67.13 (14.9) years. In total, 30 (50%) of the patients were women. Of the total, 60% of the patients had diabetes mellitus and 40% of the patients had prediabetes. The initial body mass index was 24.65 (5.35) kg/m2. It was observed that 80% of the patients had malnutrition, whereas after the intervention, the prevalence was 51.7% (p < 0.01). At the beginning of the study, 20% of the patients suffered from sarcopenia and after the intervention it was 16.7% (p = 0.19). Conclusions: Medical Nutrition Therapy with an adapted oral diet associated with diabetes-specific oral nutritional supplementation reduces malnutrition in patients at nutritional risk and disturbances of carbohydrate metabolism.

Prevalencia y factores asociados a la hiponatremia en pacientes con nutrición enteral / Hyponatremia among patients with total enteral tube feeding: prevalence and associated clinical factors

Introducción: la hiponatremia es el trastorno electrolítico más frecuente a nivel hospitalario. En pacientes con nutrición enteral (NE) puede influir en el abordaje terapéutico, así como en la selección del preparado nutricional. Objetivos: describir la prevalencia de la hiponatremia en pacientes con NE y factores asociados. Métodos: estudio retrospectivo de 1651 pacientes no críticos con NE, valorados por el Servicio de Endocrinología y Nutrición desde enero de 2014 hasta enero de 2020. Se recogieron la edad, el sexo, el índice de masa corporal (IMC) (kg/m2), el estado nutricional mediante el cuestionario Mini Nutritional Assessment (MNA), el diagnóstico principal y la presencia de hiponatremia al inicio y durante la NE. Resultados: del total, el 53,9 % fueron hombres, con una mediana de edad de 76,8 [65,7-85,3] años. El diagnóstico principal más frecuente fue la patología neurológica (37,3 %). El 26,1 % de los pacientes presentaron hiponatremia: un 11,0 % al inicio de la NE y el 16,7% durante su administración. La hiponatremia fue más frecuente en aquellos con patología digestiva (28,7 %) e infecciosa (27,65 %). Según el MNA, hasta el 41,1 % presentaron desnutrición y la frecuencia de esta fue estadísticamente superior en los pacientes con que en aquellos sin hiponatremia (76,3 % vs. 55,8 %; p < 0,001). En el análisis multivariante, únicamente la desnutrición se asoció de manera significativa con la presencia de hiponatremia, con una OR de 2,86 [IC 95 %: 1,5-4,88]. Conclusiones: la hiponatremia se detectó en un tercio de los pacientes con NE. Su presencia fue hasta 2 veces más frecuente en los pacientes desnutridos, independientemente de la edad, el sexo, el IMC y la patología basal (AU)

Introduction: hyponatremia is the most frequent disturbance in hospitalized patients. This situation may influence the therapeutic approach in patients with total enteral tube feeding (TEN). Objective: to study the prevalence of hyponatremia and the clinical factors that are associated with increased risk in a population with TEN. Methods: a retrospective study from January 2014 to January 2020; 1,651 non-critically ill patients receiving TEN were included who were assessed by the Department of Endocrinology and Nutrition. Data collected included sex, age, body mass index (BMI) (kg/m2), and nutritional status by Mini Nutritional Assessment (MNA); main disease diagnosis and development of hyponatremia at onset or during TEN were also included. Results: in all, 53.9 % of the total sample were males aged 76.8 [65.7-85.3] years. Neurological pathology was the most frequent primary diagnosis on admission (37.3 %). We found hyponatremia in 26.1 % —11.0 % at onset and 16.7 % during TEN—. Hyponatremia was more frequent in patients with digestive disease (28.7 %) and infectious disease (27.65 %). According to the MNA questionnaire 41.1 % were malnourished and nutritional status was worse in patients with hyponatremia (76.3 % vs. 55.8 %; p < 0.001). By multivariate analysis, malnutrition was only associated with hyponatremia status; OR, 2.86 [95 % CI: 1.5-4.88]. Conclusions: in this study, hyponatremia was detected in a third of patients. This was up to two more times as common in malnourished patients; however, age, sex, BMI, and baseline pathology were not related (AU)

[Hyponatremia among patients with total enteral tube feeding: prevalence and associated clinical factors]. / Prevalencia y factores asociados a la hiponatremia en pacientes con nutrición enteral.

Introduction: Introduction: hyponatremia is the most frequent disturbance in hospitalized patients. This situation may influence the therapeutic approach in patients with total enteral tube feeding (TEN). Objective: to study the prevalence of hyponatremia and the clinical factors that are associated with increased risk in a population with TEN. Methods: a retrospective study from January 2014 to January 2020; 1,651 non-critically ill patients receiving TEN were included who were assessed by the Department of Endocrinology and Nutrition. Data collected included sex, age, body mass index (BMI) (kg/m2), and nutritional status by Mini Nutritional Assessment (MNA); main disease diagnosis and development of hyponatremia at onset or during TEN were also included. Results: in all, 53.9 % of the total sample were males aged 76.8 [65.7-85.3] years. Neurological pathology was the most frequent primary diagnosis on admission (37.3 %). We found hyponatremia in 26.1 % -11.0 % at onset and 16.7 % during TEN-. Hyponatremia was more frequent in patients with digestive disease (28.7 %) and infectious disease (27.65 %). According to the MNA questionnaire 41.1 % were malnourished and nutritional status was worse in patients with hyponatremia (76.3 % vs. 55.8 %; p < 0.001). By multivariate analysis, malnutrition was only associated with hyponatremia status; OR, 2.86 [95 % CI: 1.5-4.88]. Conclusions: in this study, hyponatremia was detected in a third of patients. This was up to two more times as common in malnourished patients; however, age, sex, BMI, and baseline pathology were not related.

Introducción: Introducción: la hiponatremia es el trastorno electrolítico más frecuente a nivel hospitalario. En pacientes con nutrición enteral (NE) puede influir en el abordaje terapéutico, así como en la selección del preparado nutricional. Objetivos: describir la prevalencia de la hiponatremia en pacientes con NE y factores asociados. Métodos: estudio retrospectivo de 1651 pacientes no críticos con NE, valorados por el Servicio de Endocrinología y Nutrición desde enero de 2014 hasta enero de 2020. Se recogieron la edad, el sexo, el índice de masa corporal (IMC) (kg/m2), el estado nutricional mediante el cuestionario Mini Nutritional Assessment (MNA), el diagnóstico principal y la presencia de hiponatremia al inicio y durante la NE. Resultados: del total, el 53,9 % fueron hombres, con una mediana de edad de 76,8 [65,7-85,3] años. El diagnóstico principal más frecuente fue la patología neurológica (37,3 %). El 26,1 % de los pacientes presentaron hiponatremia: un 11,0 % al inicio de la NE y el 16,7% durante su administración. La hiponatremia fue más frecuente en aquellos con patología digestiva (28,7 %) e infecciosa (27,65 %). Según el MNA, hasta el 41,1 % presentaron desnutrición y la frecuencia de esta fue estadísticamente superior en los pacientes con que en aquellos sin hiponatremia (76,3 % vs. 55,8 %; p < 0,001). En el análisis multivariante, únicamente la desnutrición se asoció de manera significativa con la presencia de hiponatremia, con una OR de 2,86 [IC 95 %: 1,5-4,88]. Conclusiones: la hiponatremia se detectó en un tercio de los pacientes con NE. Su presencia fue hasta 2 veces más frecuente en los pacientes desnutridos, independientemente de la edad, el sexo, el IMC y la patología basal.

Muscular Ultrasonography in Morphofunctional Assessment of Patients with Oncological Pathology at Risk of Malnutrition.

Background: Muscular ultrasonography is a technique that allows assessing the amount and quality of muscle in a specific body region. The aim of the study was to compare the value of muscle ultrasonography in diagnosis of malnutrition with techniques such as anthropometry, handgrip strength and impedanciometry in patients with oncological pathology. Methods: Cross-sectional study in 43 patients with oncological pathology and high nutritional risk. Classical anthropometry (body mass index (BMI), arm circumference (AC), calf circumference (CC) and estimated appendicular muscle mass index (ASMI)) was performed. Body composition was measured with impedanciometry (BIA), phase angle (PA) and fat-free mass index (FFMI) and muscle ultrasonography of quadriceps rectus femoris (muscle area (MARA) and circumference (MCR) in section transverse). Malnutrition was diagnosed using the GLIM criteria and sarcopenia was assessed using EWGSOP2 criteria. Results: The mean age was 68.26 years (±11.88 years). In total, 23/20 of the patients were men/women. The BMI was 23.51 (4.75) kg/m2. The ASMI was 6.40 (1.86) kg/m2. The MARA was 3.31 cm2 in ultrasonography. In impedanciometry, phase angle was 4.91 (0.75)°; the FFMI was 17.01 kg/m2 (±2.65 kg/m2). A positive correlation was observed between the MARA with anthropometric measurements (AC: r = 0.39, p = 0.009; CC: r = 0.44, p < 0.01; ASMI: r = 0.47, p < 0.001); and with BIA (FFMI: r = 0.48, p < 0.01 and PA: r = 0.45, p < 0.001). Differences were observed when comparing the MARA based on the diagnosis of sarcopenia (Sarcopenia: 2.47 cm2 (±0.54 cm2); no sarcopenia: 3.65 cm2 (±1.34 cm2); p = 0.02). Conclusions: Muscle ultrasonography correlates with body composition measurement techniques such as BIA and anthropometry in patients with cancer.

Influence of Obesity on Bone Turnover Markers and Fracture Risk in Postmenopausal Women.

Background and aims: The relationship between obesity and bone metabolism is controversial. In recent decades, the protective role of obesity in the development of osteoporosis is questioned. The aims of this study are the following: to evaluate the differences in bone turnover markers between postmenopausal women with and without obesity and to compare the risk of fracture at five years between these groups. Methods: An observational longitudinal prospective cohort study of postmenopausal women with obesity (O) (body mass index (BMI) > 30 kg/m2) and non-obesity (NoO) (BMI < 30 kg/m2) is designed. 250 postmenopausal women are included in the study (NoO: 124 (49.6%) and O: 126 (50.4%)). It measures epidemiological variables, dietary variables (calcium intake, vitamin D intake, smoking, alcohol consumption, and physical activity), biochemicals (ß-crosslap, type I procollagen amino-terminal peptide (P1NP), 25OH-vitamin D, and parathyroid hormone (PTH)), anthropometric variables, and fracture data five years after the start of the study. The mean age is 56.17 (3.91) years. Women with obesity showed lower levels of vitamin D (O: 17.27 (7.85) ng/mL, NoO: 24.51 (9.60) ng/mL; p < 0.01), and higher levels of PTH (O: 53.24 (38.44−65.96) pg/mL, NoO: 35.24 (25.36−42.40) pg/mL; p < 0.01). Regarding the bone formation marker (P1NP), it was found to be high in women without obesity, O: 45.46 (34.39−55.16) ng/mL, NoO: 56.74 (45.34−70.74) ng/mL; p < 0.01; the bone resorption marker (ß-crosslap) was found to be high in women with obesity, being significant in those older than 59 years (O: 0.39 (0.14) ng/mL, NoO 0.24 (0.09) ng/mL; p < 0.05). No differences are observed in the risk of fracture at 5 years based on BMI (OR = 0.90 (95%CI 0.30−2.72); p = 0.85). Conclusions: Postmenopausal women with obesity showed lower levels of bone formation markers; older women with obesity showed higher markers of bone resorption.

The risk variant of CDKAL1 (rs7756992) impairs fasting glucose levels and insulin resistance improvements after a partial meal-replacement hypocaloric diet.

BACKGROUND: The CDKAL1 (CDK5 Regulatory Subunit Associated Protein 1 Like 1) gene encodes cyclin-dependent kinase 5 (CDK5) regulatory subunit-associated proten1 like 1. This protein has been shown to contribute to the glucose-dependent regulation of insulin secretion in pancreatic islets. AIMS: The aim of our study was to analyze the effects of the rs7756992 genetic variant of CDKAL1 gene on fasting glucose and insulin resistance after weight loss secondary to partial meal replacement hypocaloric diet (pMRHD). METHODS: This was a non-randomized, single-treatment study with a formula-diet in 44 obese subjects. The patients received nutritional education and a modified diet with two intakes of a normocaloric hyperproteic formula for 3-months. Anthropometric parameter and biochemical profile were measured at basal time and after 3 months. The variant of CDKAL1 gene rs7756992 was assessed. RESULTS: The following genetic distribution was observed; [27AA (61.3%), 12 AG (27.3%) and 5 GG (11.4%)]. After the pMRHD, body weight, the body mass index (BMI), fat mass, waist circumference and blood pressure decreased in both genotypes. Non-G allele carriers showed a significant improvement in fasting glucose levels (AA vs. AG + GG) (-6.1 ±â€¯1.4 md/dl vs. -1.2 ±â€¯0.7 mg/dl; p = 0.01), fasting insulin levels (-3.6 ±â€¯0.2 mU/l vs. -1.3 ±â€¯0.6 mU/l; p = 0.02) and HOMA-IR (-1.2 ±â€¯0.2 units vs. -0.3 ±â€¯0.2 units; p = 0.01). Fasting plasma glucose levels were higher in G allele carriers than non G allele carriers. CONCLUSIONS: Our data suggest that the genetic variant (rs7756992) of CDKAL1 gene is associated with glycaemic status after a pMRHD, with greater improvements in fasting glucose, insulin and HOMA-IR in subjects without the G allele.

The risk variant of CDKAL1 (rs7756992) impairs fasting glucose levels and insulin resistance improvements after a partial meal-replacement hypocaloric diet. / La presencia de la variante de riesgo de CDKAL1 (rs7756992) altera los niveles de glucosa en ayunas y la resistencia a la insulina después de una dieta hipocalórica con reemplazo parcial de comidas.

BACKGROUND: The CDKAL1 (CDK5 Regulatory Subunit Associated Protein 1 Like 1) gene encodes cyclin-dependent kinase 5 (CDK5) regulatory subunit-associated proten1 like 1. This protein has been shown to contribute to the glucose-dependent regulation of insulin secretion in pancreatic islets. AIMS: The aim of our study was to analyze the effects of the rs7756992 genetic variant of CDKAL1 gene on fasting glucose and insulin resistance after weight loss secondary to partial meal replacement hypocaloric diet (pMRHD). METHODS: This was a non-randomized, single-treatment study with a formula-diet in 44 obese subjects. The patients received nutritional education and a modified diet with two intakes of a normocaloric hyperproteic formula for 3-months. Anthropometric parameter and biochemical profile were measured at basal time and after 3 months. The variant of CDKAL1 gene rs7756992 was assessed. RESULTS: The following genetic distribution was observed; [27AA (61.3%), 12 AG (27.3%) and 5 GG (11.4%)]. After the pMRHD, body weight, the body mass index (BMI), fat mass, waist circumference and blood pressure decreased in both genotypes. Non-G allele carriers showed a significant improvement in fasting glucose levels (AA vs. AG + GG) (-6.1 ± 1.4 md/dL vs. -1.2 ± 0.7 mg/dl; p = 0.01), fasting insulin levels (-3.6 ± 0.2 mU/L vs. -1.3 ± 0.6 mU/L; p = 0.02) and HOMA-IR (-1.2 ± 0.2 units vs. -0.3 ± 0.2 units; p = 0.01). Fasting plasma glucose levels were higher in G allele carriers than non G allele carriers. CONCLUSIONS: Our data suggest that the genetic variant (rs7756992) of CDKAL1 gene is associated with glycaemic status after a pMRHD, with greater improvements in fasting glucose, insulin and HOMA-IR in subjects without the G allele.

A circadian rhythm-related MTNR1B genetic variant (rs10830963) modulates glucose metabolism and insulin resistance after body weight loss secondary to biliopancreatic diversion surgery / La variante genética MTNR1B (rs10830963), relacionada con el ritmo circadiano, modula el metabolismo de la glucosa y la resistencia a la insulina después de la pérdida de peso corporal secundaria a una cirugía de derivación biliopancreática

OBJECTIVE: the rs10830963 SNP of the MTNR1B gene may be related with biochemical changes after weight loss induced by caloric restriction. We investigated the role of this SNP on biochemical parameters after biliopancreatic diversion (BPD) surgery in morbid obese subjects. PATIENTS AND METHODS: one hundred and fifty-four patients with morbid obesity, without diabetes mellitus type 2, were enrolled. Their biochemical and anthropometric parameters were recorded before the procedure and after one, two, and three years of follow-up. All subjects were genotyped (rs10830963) at baseline. RESULTS: the decrease in fasting insulin levels seen after the first year (delta: -3.9 ± 1.2 mIU/L vs. -1.8 ± 1.1 mIU/L; p = 0.03), the second year (delta: -5.0 ± 0.3 mIU/L vs. -2.3 ± 0.2 mIU/L; p = 0.01) and the third year (delta: -5.1 ± 1.9 mIU/L vs. -2.8 ± 1.1 mIU/L; p = 0.02) was higher in non-G-allele carriers than in G-allele carriers. Additionally, the improvement of HOMA-IR levels at year one (delta: -0.7 ± 0.2 mIU/L vs. -0.2 ± 0.2 mIU/L; p = 0.03), year two (delta: -1.0 ± 0.3 mIU/L vs. -0.5 ± 0.2 mIU/L; p = 0.01) and year three (delta: -1.2 ± 0.3 mIU/L vs. -0.4 ± 0.2 mIU/L; p = 0.03) was also higher in non-G-allele carriers than in G-allele carriers. Finally, basal glucose levels after the first year (delta: -10.1 ± 2.4 mg/dL vs. -3.6 ± 1.8 mg/dL; p = 0.02), the second year (delta: -16.0 ± 2.3 mg/dL vs. -8.4 ± 2.2 mg/dL; p = 0.01) and the third year (delta: -17.4 ± 3.1 mg/dL vs. -8.8 ± 2.9 mg/dL; p = 0.03) were higher in non-G-allele carriers than in G-allele carriers, too. Improvements seen in comorbidities were similar in both genotype groups. CONCLUSION: our study showed an association of the rs10830963 MTNR1B polymorphism after massive weight loss with lower glucose response, insulin resistance, and fasting insulin levels in G-allele carriers

OBJETIVO: la variante SNP rs10830963 del gen MTNR1B podría estar relacionada con cambios bioquímicos tras la pérdida de peso inducida por una restricción calórica. El objetivo de este trabajo es evaluar el papel de este SNP en los parámetros bioquímicos después de la cirugía de derivación biliopancreática (DBP). PACIENTES Y MÉTODOS: se reclutaron un total de 154 pacientes con obesidad mórbida sin diabetes mellitus de tipo 2. La valoración bioquímica y antropométrica se realizó antes de la intervención y tras 1, 2 y 3 años de seguimiento. Todos los sujetos fueron genotipados (rs10830963) en el momento basal. RESULTADOS: la disminución de los niveles de insulina en ayunas después del primer año (delta: -3,9 ± 1,2 mUI/L vs. -1,8 ± 1,1 mUI/L; p = 0,03), el segundo año (delta: -5,0 ± 0,3 mUI/L vs. -2,3 ± 0,2 mUI/L; p = 0,01) y el tercer año (delta: -5,1 ± 1,9 mUI/L vs. -2,8 ± 1,1 mUI/L; p = 0,02) fueron mayores en los no portadores del alelo G que en los portadores. Además, la mejora de los niveles de HOMA-IR en el primer año (delta: -0,7 ± 0,2 mUI/L ± -0,2 ± 0,2 mUI/L; p = 0,03), segundo año (delta: -1,0 ± 0,3 mUI/L vs. -0,5 ± 0,2 mUI/L; p = 0,01) y en el tercer año (delta: -1,2 ± 0,3 mUI/L vs. -0,4 ± 0,2 mUI/L; p = 0,03) también fueron mayores en los no portadores del alelo G. Finalmente, los niveles basales de glucosa después del primer año (delta: -10,1 ± 2,4 mg/dL vs. -3,6 ± 1,8 mg/dL; p = 0,02), el segundo año (delta: -16,0 ± 2,3 mg/dL vs. - 8,4 ± 2,2 mg/dL; p = 0,01) y el tercer año (delta: -17,4 ± 3,1 mg/dL vs. -8,8 ± 2,9 mg/dL; p = 0.03) fueron mayores en los no portadores del alelo G. Las comorbilidades mejoraron en ambos genotipos de manera similar. CONCLUSIÓN: nuestro estudio mostró una asociación del polimorfismo rs10830963 MTNR1B tras una pérdida de peso posquirúrgica con una menor respuesta de los niveles de glucosa, resistencia a la insulina e insulina en ayunas en portadores del alelo G

A circadian rhythm-related MTNR1B genetic variant (rs10830963) modulates glucose metabolism and insulin resistance after body weight loss secondary to biliopancreatic diversion surgery.

INTRODUCTION: Objective: the rs10830963 SNP of the MTNR1B gene may be related with biochemical changes after weight loss induced by caloric restriction. We investigated the role of this SNP on biochemical parameters after biliopancreatic diversion (BPD) surgery in morbid obese subjects. Patients and methods: one hundred and fifty-four patients with morbid obesity, without diabetes mellitus type 2, were enrolled. Their biochemical and anthropometric parameters were recorded before the procedure and after one, two, and three years of follow-up. All subjects were genotyped (rs10830963) at baseline. Results: the decrease in fasting insulin levels seen after the first year (delta: -3.9 ± 1.2 mIU/L vs. -1.8 ± 1.1 mIU/L; p = 0.03), the second year (delta: -5.0 ± 0.3 mIU/L vs. -2.3 ± 0.2 mIU/L; p = 0.01) and the third year (delta: -5.1 ± 1.9 mIU/L vs. -2.8 ± 1.1 mIU/L; p = 0.02) was higher in non-G-allele carriers than in G-allele carriers. Additionally, the improvement of HOMA-IR levels at year one (delta: -0.7 ± 0.2 mIU/L vs. -0.2 ± 0.2 mIU/L; p = 0.03), year two (delta: -1.0 ± 0.3 mIU/L vs. -0.5 ± 0.2 mIU/L; p = 0.01) and year three (delta: -1.2 ± 0.3 mIU/L vs. -0.4 ± 0.2 mIU/L; p = 0.03) was also higher in non-G-allele carriers than in G-allele carriers. Finally, basal glucose levels after the first year (delta: -10.1 ± 2.4 mg/dL vs. -3.6 ± 1.8 mg/dL; p = 0.02), the second year (delta: -16.0 ± 2.3 mg/dL vs. -8.4 ± 2.2 mg/dL; p = 0.01) and the third year (delta: -17.4 ± 3.1 mg/dL vs. -8.8 ± 2.9 mg/dL; p = 0.03) were higher in non-G-allele carriers than in G-allele carriers, too. Improvements seen in comorbidities were similar in both genotype groups. Conclusion: our study showed an association of the rs10830963 MTNR1B polymorphism after massive weight loss with lower glucose response, insulin resistance, and fasting insulin levels in G-allele carriers.

INTRODUCCIÓN: Objetivo: la variante SNP rs10830963 del gen MTNR1B podría estar relacionada con cambios bioquímicos tras la pérdida de peso inducida por una restricción calórica. El objetivo de este trabajo es evaluar el papel de este SNP en los parámetros bioquímicos después de la cirugía de derivación biliopancreática (DBP). Pacientes y métodos: se reclutaron un total de 154 pacientes con obesidad mórbida sin diabetes mellitus de tipo 2. La valoración bioquímica y antropométrica se realizó antes de la intervención y tras 1, 2 y 3 años de seguimiento. Todos los sujetos fueron genotipados (rs10830963) en el momento basal. Resultados: la disminución de los niveles de insulina en ayunas después del primer año (delta: -3,9 ± 1,2 mUI/L vs. -1,8 ± 1,1 mUI/L; p = 0,03), el segundo año (delta: -5,0 ± 0,3 mUI/L vs. -2,3 ± 0,2 mUI/L; p = 0,01) y el tercer año (delta: -5,1 ± 1,9 mUI/L vs. -2,8 ± 1,1 mUI/L; p = 0,02) fueron mayores en los no portadores del alelo G que en los portadores. Además, la mejora de los niveles de HOMA-IR en el primer año (delta: -0,7 ± 0,2 mUI/L ± -0,2 ± 0,2 mUI/L; p = 0,03), segundo año (delta: -1,0 ± 0,3 mUI/L vs. -0,5 ± 0,2 mUI/L; p = 0,01) y en el tercer año (delta: -1,2 ± 0,3 mUI/L vs. -0,4 ± 0,2 mUI/L; p = 0,03) también fueron mayores en los no portadores del alelo G. Finalmente, los niveles basales de glucosa después del primer año (delta: -10,1 ± 2,4 mg/dL vs. -3,6 ± 1,8 mg/dL; p = 0,02), el segundo año (delta: -16,0 ± 2,3 mg/dL vs. ­ 8,4 ± 2,2 mg/dL; p = 0,01) y el tercer año (delta: -17,4 ± 3,1 mg/dL vs. -8,8 ± 2,9 mg/dL; p = 0.03) fueron mayores en los no portadores del alelo G. Las comorbilidades mejoraron en ambos genotipos de manera similar. Conclusión: nuestro estudio mostró una asociación del polimorfismo rs10830963 MTNR1B tras una pérdida de peso posquirúrgica con una menor respuesta de los niveles de glucosa, resistencia a la insulina e insulina en ayunas en portadores del alelo G.

ACYL-CoA synthetase long-chain 5 polymorphism is associated with weight loss and metabolic changes in response to a partial meal-replacement hypocaloric diet / El polimorfismo de la ACYL-CoA-sintetasa de cadena larga 5 se asocia a pérdida de peso y cambios metabólicos en respuesta a una dieta hipocalórica parcial de reemplazo

BACKGROUND: we hypothesize that the acyl CoA synthetase 5 (ACSL5) genotype may influence weight loss secondary to energy restriction. AIMS: the aim of our study was to analyze the effects of the rs2419621 genetic variant of the ACSL5 gene on weight change and metabolic parameters after a partial meal-replacement hypocaloric diet. METHODS: this was a non-randomized, single-treatment study with a formula-diet in 44 obese subjects with body mass index (BMI) greater than 35 kg/m2. Patients received nutritional education and a modified diet with two intakes of a normocaloric hyperproteic formula during 3 months. Anthropometric parameters and biochemical profile were measured at baseline and after 3 months. The rs2419621 variant of the ACSL5 gene was assessed using real-time polymerase chain reaction. RESULTS: T-allele carriers showed greater improvement in body weight (CC vs. CT + TT; -7.4 ± 2.1 kg vs. -9.3 ± 1.8 kg; p = 0.01), body mass index (-3.1 ± 0.4 kg/m2 vs. -3.4 ± 0.5 kg/m2; p = 0.02), fat mass (-5.2 ± 1.4 kg vs. -6.4 ± 1.2 kg; p = 0.01) and waist circumference (-6.1 ± 1.1 cm vs. -8.6 ± 0.8 cm; p = 0.02) than non-T-allele carriers. Only subjects with the T allele showed significant improvement in triglyceride levels (-4.6 ± 2.4 md/dL vs. -14.4 ± 2.3 mg/dL; p = 0.01). Finally, improvements in insulin (-2.0 ± 0.3 mU/L vs. -4.5 ± 0.5 mU/L; p = 0.01) and HOMA-IR (-0.4 ± 0.2 units vs. -1.3 ± 0.3 units; p = 0.02) were higher in T-allele carriers than in non-T-allele carriers. CONCLUSIONS: our data suggest that the genetic variant (rs2419621) of the ACSL5 gene is associated with diet response after a partial-meal replacement intervention, with greater improvements in adiposity and biochemical parameters in subjects with the T allele

ANTECEDENTES: se hipotetiza que el genotipo de la acil-CoA-sintetasa 5 (ACSL5) podría influir en la pérdida de peso secundaria a la restricción de energía. OBJETIVOS: el objetivo de nuestro estudio fue analizar los efectos de la variante genética rs2419621 del gen ACSL5 sobre el cambio de peso y los parámetros metabólicos después de una dieta hipocalórica parcial de reemplazo. MÉTODOS: estudio no aleatorizado, de centro único, con una fórmula dietética, en 44 sujetos obesos con un índice de masa corporal (IMC) superior a 35 kg/m2. Los pacientes recibieron educación nutricional y una dieta modificada con dos tomas de una fórmula hiperproteica normocalórica durante 3 meses. Los parámetros antropométricos y el perfil bioquímico se determinaron en el tiempo basal y tras 3 meses. La variante rs2419621 del gen ACSL5 se evaluó mediante reacción en cadena de la polimerasa en tiempo real. RESULTADOS: los portadores del alelo T mostraron mejorías de peso corporal (CC vs. CT + TT; -7,4 ± 2,1 kg vs. -9,3 ± 1,8 kg; p = 0,01), índice de masa corporal (-3,1 ± 0,4 kg/m2 vs. -3,4 ± 0,5 kg/m2; p = 0,02), masa grasa (-5,2 ± 1,4 kg vs. -6,4 ± 1,2 kg; p = 0,01) y circunferencia de la cintura (-6,1 ± 1,1 cm vs. -8,6 ± 0,8 cm; p = 0,02) superiores a las de los portadores de alelos distintos de T. Solo los sujetos con alelo T mostraron una mejoría significativa en los niveles de triglicéridos (-4,6 ± 2,4 md/dL vs. -14,4 ± 2,3 mg/dL; p = 0,01). Por último, la mejoría de la insulina (-2,0 ± 0,3 mU/L vs. -4.5 ± 0.5 mU/L; p = 0,01) y HOMA-IR (-0,4 ± 0,2 unidades vs. -1,3 ± 0,3 unidades; p = 0,02) fueron mayores en los portadores de alelos T que en los portadores de alelos no T. CONCLUSIONES: nuestros resultados sugieren que la variante genética (rs2419621) del gen ACSL5 está asociada a la respuesta a la dieta después una dieta hipocalórica parcial de reemplazo, con una mejoría superior de los parámetros relacionados con la adiposidad y los parámetros bioquímicos en los sujetos con alelo T

[Effect of a Mediterranean-pattern diet on the metabolic response secondary to weight loss; role of the single nucleotide polymorphism (rs16147) of neuropeptide Y]. / Efecto de una dieta de patrón mediterráneo en la respuesta metabólica secundaria a la pérdida de peso; papel del polimorfismo de un único nucleótido (rs16147) del gen del neuropéptido Y.

INTRODUCTION: Background and aims: intervention studies that evaluate the effect of rs16147 on metabolic response and weight change after dietary intervention are scarce. We propose to evaluate the role of the rs16147 genetic variant in the metabolic effects produced by a hypocaloric Mediterranean-pattern diet with high content of omega-9. Material and methods: a sample of 363 obese subjects was recruited. At the baseline visit the patients were randomly assigned to one of two hypocaloric diets for 12 weeks (diet M, Mediterranean pattern; diet C, standard hypocaloric). All patients, at baseline and at 12 weeks, had biochemical and anthropometric variables measured, and genotyping performed for the rs16147 variant. Results: in all subjects, and with both diets, the parameters of adiposity, blood pressure, and circulating leptin improved. In obese subjects with allele (A) insulin levels (GG vs. GA + AA) (-0.9 ± 1.1 IU/L vs. -4.4 ± 1.0 IU/L; p = 0.01) and HOMA-IR (-0.3 ± 0.1 units vs. -1.2 ± 0.3 units; p = 0.02) decreased significantly with diet M. Subjects carrying the minor allele showed a significant decrease in basal insulin levels (GG vs. GA + AA) (0.7 ± 0.3 IU/L vs. -2.2 ± 0.9 IU/L: p = 0.02) and HOMA-IR (-0.3 ± 0.2 units vs. -0.7 ± 0.1 units: p = 0.01) after diet C. This decrease in circulating insulin and HOMA-IR levels in patients with allele A was significantly higher with diet M than with diet C. Conclusions: the A allele of the rs16147 variant produces a better metabolic response in terms of insulin resistance and basal insulin secondary to weight loss with two different hypocaloric diets in obese subjects, with improvement being higher with the Mediterranean diet.

INTRODUCCIÓN: Introducción y objetivos: los estudios de intervención que evalúan el efecto del rs16147 sobre la respuesta metabólica y el cambio de peso después de una intervención dietética son escasos. Evaluamos el papel de la variante genética rs16147 en los efectos metabólicos que produce una dieta hipocalórica de patrón mediterráneo y alto contenido en omega-9. Material y métodos: se reclutó una muestra de 363 sujetos obesos. En visita basal, los pacientes se asignaron aleatoriamente, durante 12 semanas, a recibir una de dos dietas: dieta M, de patrón mediterráneo, o dieta C, hipocalórica estándar. Se determinaron momento basal y a las 12 semanas, una serie de variables bioquímicas y antropométricas, realizándose el genotipado de la variante rs16147. Resultados: en todos los sujetos con ambas dietas mejoraron los parámetros de adiposidad, tensión arterial y leptina circulante. En sujetos obesos con el alelo menor (A), los niveles de insulina (GG vs. GA + AA) (-0,9 ± 1,1 UI/L vs. -4,4 ± 1,0 UI/L; p = 0,01) y HOMA-IR (-0,3 ± 0,1 unidades vs. -1,2 ± 0,3 unidades; p = 0,02) disminuyeron significativamente con dieta M. Los sujetos portadores del alelo menor tras dieta C mostraron disminución significativa de niveles de insulina basal (GG vs. GA + AA) (0,7 ± 0,3 UI/L vs. -2,2 ± 0,9 UI/L: p = 0,02) y HOMA-IR (-0,3 ± 0,2 unidades vs. -0,7 ± 0,1 unidades: p = 0,01). Esta disminución de los niveles de insulina circulante y HOMA-IR en los pacientes con alelo A fue significativamente superior con la dieta M que con la dieta S. Conclusiones: el alelo A de la variante rs16147 se relaciona con mejor respuesta metabólica, en términos de resistencia a insulina e insulina basal secundaria a pérdida de peso, a dos dietas hipocalóricas, siendo superior el efecto obtenido con una dieta de patrón mediterráneo.

ACYL-CoA synthetase long-chain 5 polymorphism is associated with weight loss and metabolic changes in response to a partial meal-replacement hypocaloric diet.

INTRODUCTION: Aims:to analyze the effects of the rs2419621 genetic variant of the ACSL5 gene on weight change and metabolic parameters after a partial meal-replacement hypocaloric diet. Methods: this was a non-randomized, single-treatment study with a formula-diet in 44 obese subjects with body mass index (BMI) greater than 35 kg/m2. Patients received nutritional education and a modified diet with two intakes of a normocaloric hyperproteic formula during 3 months. Anthropometric parameters and biochemical profile were measured at baseline and after 3 months. The rs2419621 variant of the ACSL5 gene was assessed using real-time polymerase chain reaction. Results: T-allele carriers showed greater improvement in body weight (CC vs. CT + TT; -7.4 ± 2.1 kg vs. -9.3 ± 1.8 kg; p = 0.01), body mass index (-3.1 ± 0.4 kg/m2 vs. -3.4 ± 0.5 kg/m2; p = 0.02), fat mass (-5.2 ± 1.4 kg vs. -6.4 ± 1.2 kg; p = 0.01) and waist circumference (-6.1 ± 1.1 cm vs. -8.6 ± 0.8 cm; p = 0.02) than non-T-allele carriers. Only subjects with the T allele showed significant improvement in triglyceride levels (-4.6 ± 2.4 md/dL vs. -14.4 ± 2.3 mg/dL; p = 0.01). Finally, improvements in insulin (-2.0 ± 0.3 mU/L vs. -4.5 ± 0.5 mU/L; p = 0.01) and HOMA-IR (-0.4 ± 0.2 units vs. -1.3 ± 0.3 units; p = 0.02) were higher in T-allele carriers than in non-T-allele carriers. Conclusions: our data suggest that the genetic variant (rs2419621) of the ACSL5 gene is associated with diet response after a partial-meal replacement intervention, with greater improvements in adiposity and biochemical parameters in subjects with the T allele.

INTRODUCCIÓN: Antecedentes: se hipotetiza que el genotipo de la acil-CoA-sintetasa 5 (ACSL5) podría influir en la pérdida de peso secundaria a la restricción de energía. Objetivos: el objetivo de nuestro estudio fue analizar los efectos de la variante genética rs2419621 del gen ACSL5 sobre el cambio de peso y los parámetros metabólicos después de una dieta hipocalórica parcial de reemplazo. Métodos: estudio no aleatorizado, de centro único, con una fórmula dietética, en 44 sujetos obesos con un índice de masa corporal (IMC) superior a 35 kg/m2. Los pacientes recibieron educación nutricional y una dieta modificada con dos tomas de una fórmula hiperproteica normocalórica durante 3 meses. Los parámetros antropométricos y el perfil bioquímico se determinaron en el tiempo basal y tras 3 meses. La variante rs2419621 del gen ACSL5 se evaluó mediante reacción en cadena de la polimerasa en tiempo real. Resultados: los portadores del alelo T mostraron mejorías de peso corporal (CC vs. CT + TT; -7,4 ± 2,1 kg vs. -9,3 ± 1,8 kg; p = 0,01), índice de masa corporal (-3,1 ± 0,4 kg/m2 vs. -3,4 ± 0,5 kg/m2; p = 0,02), masa grasa (-5,2 ± 1,4 kg vs. -6,4 ± 1,2 kg; p = 0,01) y circunferencia de la cintura (-6,1 ± 1,1 cm vs. -8,6 ± 0,8 cm; p = 0,02) superiores a las de los portadores de alelos distintos de T. Solo los sujetos con alelo T mostraron una mejoría significativa en los niveles de triglicéridos (-4,6 ± 2,4 md/dL vs. -14,4 ± 2,3 mg/dL; p = 0,01). Por último, la mejoría de la insulina (-2,0 ± 0,3 mU/L vs. -4.5 ± 0.5 mU/L; p = 0,01) y HOMA-IR (-0,4 ± 0,2 unidades vs. -1,3 ± 0,3 unidades; p = 0,02) fueron mayores en los portadores de alelos T que en los portadores de alelos no T. Conclusiones: nuestros resultados sugieren que la variante genética (rs2419621) del gen ACSL5 está asociada a la respuesta a la dieta después una dieta hipocalórica parcial de reemplazo, con una mejoría superior de los parámetros relacionados con la adiposidad y los parámetros bioquímicos en los sujetos con alelo T.

Effect of Two Meal Replacement strategies on Cardiovascular Risk Parameters in Advanced Age Patients with Obesity and Osteoarthritis.

BACKGROUND AND AIMS: Meal replacement diets consist of replacing one or more meals with an artificial nutritional supplement. The objective of this study was to compare the effect of one against two meal replacement strategies on body composition and cardiovascular risk parameters in patients with obesity. METHODS: A randomized clinical trial was designed with a modified hypocaloric diet with an artificial nutritional preparation replacing one or two meals for three months in patients with obesity and osteoarthritis pending orthopedic surgery. An anthropometric evaluation and a measurement of the body composition were done with bioelectrical impedance measurement at the beginning and at three months. RESULTS: A total of 112 patients were recruited. Fifty-two patients (46.4%) were randomized to one replacement and 60 patients (53.6%) to two meal replacements. Eighty-one patients (72.3%) were women, and the average age was 61 (11.03) years. The percentage of weight loss at three months was 8.27 (4.79)% (one meal replacement: 7.98 (5.97)%; two meal replacements: 8.50 (3.48)%; p = 0.56). A decrease in fat mass measured by the fat mass index (FMI) was detected (one meal replacement: -2.15 (1.45) kg/m2 vs. two meal replacements: -2.78 (2.55) kg/m2; p > 0.05), and a relative increase in fat-free mass was observed (one meal replacement: +3.57 (4.61)% vs. two meal replacements: +2.14 (4.45)%; p > 0.05). A decrease in HOMA-IR, systolic blood pressure (SBP), and total cholesterol was observed in both groups without differences between them. CONCLUSIONS: The substitution strategies of one or two meal replacements were effective in weight loss and fat mass decrease without differences between the two groups. An improvement in lipid parameters, glycemic control, and systolic blood pressure was observed without differences between strategies.

[Influence of rs670 variant of APOA1 gene on serum HDL response to an enriched-polyunsaturated vs. an enriched-monounsaturated fat hypocaloric diet]. / Influencia de la variante rs670 del gen APOA1 en la respuesta HDL sérica a una dieta hipocalórica enriquecida con grasas poliinsaturadas frente a una enriquecida con grasas monoinsaturadas.

INTRODUCTION: Background and objectives: genetic variants of the APOA1 gene have been related to lipid profile in obese subjects. Our aim was to analyze the effects of the rs670 APOA1 gene polymorphism on metabolic changes secondary to an enriched-polyunsaturated fat vs. an enriched-monounsaturated fat hypocaloric diet. Methods: 360 Caucasian obese subjects were randomly allocated to two groups. One group received an enriched-polyunsaturated fat (diet P) and the other an enriched-monounsaturated fat hypocaloric diet (diet M) during 12 weeks. The effects on serum biomarkers related to lipid and carbohydrate metabolism were evaluated before and after the dietary intervention. Results: after both diets, body mass index, weight, fat mass, waist circumference, systolic blood pressure, plasma leptin concentration, and waist circumference decreased in all patients. After 12 weeks of intervention with diet P, plasma insulin levels and HOMA-IR decreased in A-allele carriers: delta: -7.3 ± 2.2 IU/L (p = 0.01), and delta: -2.8 ± 0.5 units (p = 0.02), respectively. The same changes in delta were observed after diet M in A-allele carriers: insulin delta: -5.9 ± 1.2 IU/L (p = 0.01), and HOMA-IR delta: -2.1 ± 0.8 units (p = 0.02). In A-allele carriers, LDL-cholesterol decreased and HDL-cholesterol increased after the dietary intervention with diet P: delta: -12.1 ± 4.3 mg/dL (p = 0.01), and delta: 2.6 ± 0.7 mg/dL (p = 0.01), respectively. No differences in lipid profile were observed after diet M. These improvements were not observed in non-A-allele carriers after both interventions. Conclusions: our study showed the association of the rs670 ApoA1 polymorphism with insulin resistance changes as induced by both diets. An enriched-polyunsaturated fat diet produced an additional improvement of HDL-cholesterol and LDL-cholesterol in A-allele carriers.

INTRODUCCIÓN: Antecedentes y objetivos: las variantes genéticas del gen APOA1 se han relacionado con el perfil lipídico en sujetos obesos. Nuestro objetivo fue analizar los efectos del polimorfismo del gen rs670 APOA1 sobre el estado metabólico tras la ingesta de dos dietas hipocalóricas enriquecidas con grasas poliinsaturadas o monoinsaturadas. Métodos: 360 sujetos obesos se asignaron al azar a dos grupos de intervención. Un grupo recibió dieta enriquecida en grasas poliinsaturadas (dieta P) y el otro dieta enriquecida en grasas monoinsaturadas (dieta M) durante 12 semanas. Se evaluaron los efectos sobre los biomarcadores relacionados con metabolismo lipídico y de hidratos de carbono antes y después de la intervención. Resultados: el índice de masa corporal, peso, masa grasa, circunferencia de cintura, presión arterial sistólica, concentraciones plasmáticas de leptina y circunferencia de la cintura disminuyeron en todos los pacientes tras ambas dietas. En los portadores del alelo A, después de 12 semanas con la dieta P, los niveles de insulina (delta: -7,3 ± 2,2 UI/l; p = 0,01) y HOMA-IR (delta: -2,8 ± 0,5 unidades; p = 0,02) mejoraron de manera significativa. Tras el tratamiento con la dieta M, los niveles plasmáticos de insulina (delta: -5,9 ± 1,2 UI/l; p = 0,01) y HOMA-IR (delta: -2,1 ± 0,8 unidades; p = 0,02) también mejoraron en los portadores del alelo A. Después de la intervención dietética con la dieta P, el colesterol-LDL (delta: -12,1 ± 4,3 UI/l; p = 0,01) y el colesterol-HDL (delta: 2,6 ± 0,7 unidades; p = 0,01) disminuyeron significativamente en los portadores del alelo A. Conclusiones: nuestro estudio mostró la asociación del polimorfismo rs670 ApoA1 con los cambios de resistencia a insulina inducidos por ambas dietas y aportó evidencia adicional sobre la mejoría del colesterol-HDL y el colesterol-LDL después de dieta rica en grasas poliinsaturadas en portadores del alelo A.