Role of rs2282679 in 25-hydroxyvitamin D levels and insulin resistance after a sleeve gastrectomy.

BACKGROUND & AIMS: Some studies have reported links between 25-hydroxyvitamin D levels and the presence of obesity and some genetic variants. The aim of our design was to evaluate the effects of rs2282679 genetic variant of CG gene on 25-hydroxyvitamin D levels, weight loss and metabolic parameters after a robotic sleeve gastrectomy in premenopausal females with obesity. METHODS: 76 participants were enrolled. 25-hydroxyvitamin D levels, biochemical evaluation and anthropometric parameters were registered before surgery and after 3, 6 and 12 months follow up. Genotype of rs2282679 CG gene was evaluated. RESULTS: The improvements in anthropometric parameters, blood pressure and lipid profile were similar in both genotypes (TT vs TG + GG). Basal insulin levels and HOMA-IR were greater in G allele carriers than non-carriers (Delta: 6.7 ± 1.2 mUI/L; p = 0.01) and (Delta: 1.3 ± 0.1 units; p = 0.02). 25-hydroxyvitamin D levels were lower in G allele carriers than non-carriers (Delta: 8.1 ± 1.1 ng/dl; p = 0.03). The levels of insulin and HOMA-IR remained greater in G allele carriers than non-carriers throughout all the visits. The levels of 25-hydroxyvitamin D remained lower in G allele carriers than non-G allele. The average level of 25-hydroxyvitamin D at 12 months in non-G allele carriers were above 30 ng/dl (36.0 ± 3.1 ng/dl) and the level in G allele carriers were below (24.9 ± 4.9 ng/dl). CONCLUSIONS: rs 2282679 (GC) was related with low 25 hydroxyvitamin D levels and insulin resistance. In addition, the presence of G allele produced a decrease in the improvement of 25-hydroxyvitamin D levels and insulin resistance after weight loss during 12 months.

Relationship between adiponectin and muscle mass in patients with metabolic syndrome and obesity.

BACKGROUND: Adiponectin is one of the most important adipokines in human beings. Obesity and sarcopenia are associated with a low-level chronic inflammatory status, and adiponectin plays an anti-inflammatory role. AIMS: The objective of the current work was to study the association between muscle mass, determined via bioelectrical impedance (BIA), and circulating adiponectin levels among obese patients with metabolic syndrome who are older than 60 years of age. METHODS: We performed a cross-sectional study incorporating 651 patients with obesity and metabolic syndrome. Anthropometric data, BIA data (total fat mass (FM), fat-free mass (FFM), fat-free mass index (FFMi), skeletal muscle mass (SMM) and skeletal muscle mass index (SMMi)), arterial pressure, HOMA-IR (homeostasis model assessment of insulin resistance), and biochemical parameters were recorded. RESULTS: The patients were separated into two groups based on their median SMMi (skeletal muscle mass index) levels. The low-SMMi group presented adiponectin levels that were higher than those in the high-SMMi group (delta value: 4.8 + 0.7 ng/dl: p = 0.02). Serum adiponectin values were negatively correlated with fat mass (FM), fat-free mass (FFM), fat-free mass index (FFMi), SMM, and SMMi. Adiponectin presented a negative correlation with HOMA-IR and a positive correlation with HDL-cholesterol. In the final multivariate model using SMMi as a dependent variable, adiponectin levels explained 18 % of the variability (Beta -0.49, CI95% -0.89 to -0.16) after adjusting for age and gender. CONCLUSIONS: Serum adiponectin levels are negatively associated with low skeletal muscle mass among obese subjects with metabolic syndrome who are older than 60 years of age.

Role of irisin and myostatin on sarcopenia in malnourished patients diagnosed with GLIM criteria.

OBJECTIVES: Sarcopenia is characterized by the loss of muscle mass. Skeletal muscle can produce and secrete different molecules called myokines. Irisin and myostatin are antagonistic myokines, and to our knowledge, no studies of both myokines have been conducted in patients with disease-related malnutrition (DRM). This study aimed to investigate the role of circulating irisin and myostatin in sarcopenia in patients with DRM. METHODS: The study included 108 outpatients with DRM according to the Global Leadership Initiative on Malnutrition criteria. Participants had a mean age of 67.4 ± 3.4 y. Anthropometric data, muscle mass by ultrasound at the rectus femoris quadriceps (RFQ) level, impedancemetry (skeletal muscle mass [SMM], appendicular SMM [aSMM], and aSMM index [aSMMI]), dynamometry, biochemical parameters, dietary intake, circulating irisin and myostatin levels were determined in all patients. Confirmed sarcopenia was diagnosed as criteria of probable sarcopenia (low muscle strength) plus abnormal aSMMI. RESULTS: Of the 108 patients, 44 presented sarcopenia (41%); 64 did not present with the disorder (59%). The following parameters were worse in patients with sarcopenia: Patients without sarcopenia were stronger than those with the disorder (7.9 ±1.3 kg; P = 0.01). Circulating irisin levels were higher in patients without sarcopenia than those with sarcopenia (651.3 ± 221.3 pg/mL; P =0.01). Myostatin levels were similar in both groups. Finally, logistic regression analysis reported a low risk for sarcopenia (odds ratio, 0.39; 95% confidence interval, 0.19-0.92; P = 0.03) in high irisin median levels as a dichotomic parameter after adjusting for body mass index, sex, energy intake, and age. CONCLUSION: The present study reported that low levels of serum irisin were closely associated with sarcopenia in patients with DRM.

Association between the genetic variant in the vitamin D pathway (rs2282679), circulating 25-hydroxyvitamin D levels, insulin resistance and metabolic syndrome criteria / Asociación entre la variante genética en la vía de la vitamina D (rs2282679), niveles circulantes de 25-hidroxivitamina D, resistencia a la insulina y criterios de síndrome metabólico

Background and aims: some studies have reported links between 25-hydroxyvitamin D levels and the presence of metabolic syndrome. The aim of the present study was to evaluate whether an association exists among 25-hydroxyvitamin D, rs2282679 of the GC gene and metabolic syndrome (MS). Methods: the study involved a population of 134 postmenopausal obese females. Measurements of anthropometric parameters, blood pressure, bone turnover markers, fasting blood glucose, insulin resistance (HOMA-IR), lipid profile, C-reactive protein and prevalence of MS were recorded. Genotype of CG gene polymorphism (rs2282679) was evaluated. Results: insulin (delta: 4.6 ± 0.9 mUI/l; p = 0.02), triglycerides (delta: 21.6 ± 2.9 mg/dl; p = 0.04) and HOMA-IR (delta: 1.1 ± 0.9 unit; p = 0.02) were lower in TT subjects than TG + GG patients. The percentages of individuals who had MS (OR = 2.80, 95 % CI = 1.39-5.65; p = 0.02), hypertriglyceridemia (OR = 2.39, 95 % CI = 1.44-5.96; p = 0.01), and hyperglycemia (OR = 2.72, 95 % CI = 1.23-6.00; p = 0.43) were higher in G allele carriers. Logistic regression analysis showed an increased risk of MS in G allele carriers (OR = 2.36, 95 % CI = 1.11-5.91, p = 0.02) and an increased risk of 25-hydroxyvitamin D deficiency (< 20 ng/ml) (OR = 2.43, 95 % CI = 1.13-6.69, p = 0.02), too. Conclusions: a negative association among G allele and insulin resistance, hypertriglyceridemia, deficiency of 25 hydroxyvitamin D levels and MS was reported in this population. (AU)

Antecedentes y objetivos: algunos estudios han demostrado una relación entre los niveles de 25-hidroxivitamina D y la presencia del síndrome metabólico. El objetivo de este estudio fue evaluar si existe una asociación entre la 25-hidroxivitamina D, la variante rs2282679 del gen GC y el síndrome metabólico (SM). Métodos: el estudio involucró a una población de 134 mujeres obesas posmenopáusicas. Se registraron parámetros antropométricos, presión arterial, marcadores de recambio óseo, glucemia en ayunas, resistencia a la insulina (HOMA-IR), perfil lipídico, proteína C reactiva y prevalencia de SM. Se evaluó el genotipo del polimorfismo del gen CG (rs2282679). Resultados: los niveles de insulina (delta: 4,6 ± 0,9 mUI/l; p = 0.02), triglicéridos (delta: 21,6 ± 2,9 mg/dl; p = 0,04) y HOMA-IR (delta: 1,1 ± 0,9 unidades; p = 0,02) fueron menores en los sujetos TT que en los pacientes TG + GG. Los porcentajes de individuos que tenían SM (OR = 2,80, IC 95 % = 1,39-5,65; p = 0,02), hipertrigliceridemia (OR = 2,39, IC 95 % = 1,44-5,96; p = 0,01) e hiperglucemia (OR = 2,72, IC 95 % = 1,23-6,00; p = 0,43) fueron mayores en los portadores del alelo G. El análisis de regresión logística mostró un mayor riesgo de SM en los portadores del alelo G (OR = 2,36, IC 95 % = 1,11-5,91; p = 0,02) y un mayor riesgo de deficiencia de 25-hidroxivitamina D (< 20 ng/ml) (OR = 2,43, IC 95 % = 1,13-6,69; p = 0,02). Conclusiones: en esta población hemos detectado una asociación negativa entre el alelo G y la resistencia a la insulina, hipertrigliceridemia, deficiencia niveles de 25-hidroxivitamina D y SM. (AU)

Relationship between Mediterranean Diet and Phase Angle in a Sample of Patients with Obesity and Metabolic Syndrome.

INTRODUCTION: The potential influence of a Mediterranean diet (MD) on PhA values has been little researched. The aim of this study was to investigate the association between adherence of a MD and PhA on adult sample population with obesity and metabolic syndrome. METHODS: We conducted a cross-sectional study in 331 patients with obesity and metabolic syndrome. Anthropometrics' data (weight, height, body mass index, and waist circumference), bioelectrical bioimpedance (BIA) parameters (resistance reactance, PhA, fat mass [FM], fat-free mass [FFM], skeletal muscle mass [SMM]), and biochemical parameters were recorded. Dietary intakes with a 3-day written food records and MD adherence with a validated 14-item questionnaire were evaluated. Patients were divided into two groups by median value of PhA. RESULTS: Percentage of patients with high MD adherence (score >7) in high PhA group was 77.2% and in low PhA group was 41.4% (odds ratio 1.91, 95% CI = 1.27-3.54; p = 0.01). Total fat intake (saturated, monounsaturated, and polyunsaturated fats), protein intake, and cholesterol intake were higher in high PhA group than low PhA group. Total score of MD was higher in high PhA than low PhA group (3.5 ± 1.1 points; p = 0.04). FFM (3.3 ± 0.9 kg; p = 0.01), FFM index (3.9 ± 1.1 kg/m2; p = 0.01), SMM (4.6 ± 1.2 kg; p = 0.01) and SMM index (3.3 ± 0.7 kg/m2; p = 0.03) were higher in subjects of high adherence of MD group than subjects of low adherence. FM (-3.2 ± 1.1 kg; p = 0.03) was lower in subjects with good adherence to MD. MD score (Beta 1.71, CI 95% 1.06-2.16), FFM (Beta 3.99, CI 95% 1.87-7.16), and SMM (Beta 4.21, CI 95% 1.76-8.19) remained in the multivariate model. CONCLUSION: We concluded that a high adherence to a MD in subjects with obesity and metabolic syndrome is associated with values of PhA.

Role of beta-2 adrenergic receptor polymorphism (rs1042714) on body weight and glucose metabolism response to a meal-replacement hypocaloric diet.

OBJECTIVES: The beta-2 adrenergic receptor (ADRB2) is involved in energy balance regulation. The objective of our study was to evaluate the role of the rs1042714 genetic variant of ADRB2 gene on weight loss, body composition, and metabolic changes secondary to partial meal replacement (pMR) hypocaloric diet in women with obesity. METHODS: We conducted an interventional study in 95 premenopausal women with body mass index ≥ 35 kg/m2. The subjects received two intakes per day of a normocaloric hyperproteic formula during 12 wk of a pMR diet. Body weight, body mass index, fat mass, waist circumference, lipid profile, fasting insulin levels, and homeostasis model assessment for insulin resistance were determined. All patients were genotyped rs1042714 and evaluated in a dominant model (CC versus CG + GG). RESULTS: Genotype frequencies were 31 (37.3%), 38 (45.8%), and 14 (16.9%) for the CC, CG, and GG genotypes, respectively. We found significant interaction effects between ADRB2 variant and pMR-induced changes (CC versus CG + GG) on body weight (-7.1 ± 0.3 versus -13.5 ± 0.5 kg; P = 0.03), body mass index (-0.9 ± 0.1 versus -1.2 ± 0.2 kg/m2; P = 0.03), fat mass (-4.9 ± 0.5 versus -10.2 ±1.2 kg; P = 0.01), waist circumference (-5.1 ± 0.2 versus -10.1 ± 1.9 cm; P = 0.03), glucose (-5.1 ± 1.3 versus -12.5 ± 2.5 mg/dL; P = 0.03), total cholesterol (-18.1 ± 9.3 versus -33.5 ± 4.5 mg/dL; P = 0.03), low-density lipoprotein cholesterol (-9.1 ± 5.3 versus -24.5 ± 4.1 mg/dL; P = 0.04), triacylglycerol levels (-6.1 ± 5.3 versus -31.5 ± 9.5 mg/dL; P = 0.04), fasting insulin levels (-1.8 ± 0.3 versus -6.3 ± 0.5 IU/L; P = 0.03), and homeostasis model assessment for insulin resistance (-0.6 ± 0.3 versus -1.9 ± 0.5 U; P = 0.03). The odds ratio to improve alteration in glucose metabolism adjusted by age and weight loss throughout the study was 0.26 (95% CI, 0.07-0.95; P = 0.02) in G allele carriers. CONCLUSIONS: The G allele of rs1042714 predicts the magnitude of weight loss resulting from a pMR diet. These adiposity improvements produce a better improvement of insulin resistance and percentage of impaired glucose metabolism in G allele carriers.

Anthropometric, muscle and serum myokine levels effects of physical exercise with an online platform in female patients with obesity.

INTRODUCTION: Under physical exercise conditions, muscles can synthetise and release myokines and these molecules can exert paracrine and endocrine actions. Females with obesity have a sedentary lifestyle with alterations in myokine levels. OBJECTIVE: The aim of our study was to evaluate the effect of physical exercise on myokine levels, anthropometric parameters, clinical data, impedance parameters, and muscle ultrasound data in sedentary females with obesity. MATERIAL AND METHODS: Anthropometric data, muscle mass by ultrasound at the quadriceps level, myokine determination, and blood pressure were collected at baseline and after 12 weeks in 25 females with obesity. For 12 weeks, the physical exercise programme was prescribed through an online platform. RESULTS: After the physical exercise programme, there was a significant improvement in body mass index (-1.49±0.1kg/m2; p=0.02), weight (-3.9±0.7kg; p=0.01), waist circumference (-7.2±0.2cm; p=0.01), skeletal muscle mass (5.4±1.2kg; p=0.01), appendicular skeletal muscle mass index (0.5±0.1kg; p=0.02) and appendicular skeletal muscle mass (1.4±0.1kg; p=0.03), and a decrease in fat mass (-4.1±0.2kg; p=0.01) and blood pressure. The ultrasound parameters of the anterior rectus quadriceps muscle improved significantly. The following biochemical parameters decreased; insulin levels (-66.3±10.2pg/ml; p=0.04), HOMA-IR (-0.4±0.1 units; p=0.03), apelin (-3.5±0.2IU/l; p=0.04), FABP3 (-143.6±38.1pg/ml; p=0.03), IL6 (-4.1±0.02pg/ml; p=0.02), myostatin (-81.6±18.1pg/ml; p=0.04), and FGF21 (-9.5±1.1pg/ml; p=0.03). CONCLUSION: The prescription of physical exercise with an online platform for females with obesity decreases weight, body fat mass and increases muscle mass, producing a decrease in insulin resistance and some myokine levels.

Relationship of circulating resistin levels with muscle mass determined by bioelectrical impedance in females with obesity.

INTRODUCTION: Serum resistin levels have been associated with obesity, visceral fat, and insulin resistance. Its relationship with muscle mass has been less evaluated. OBJECTIVES: to evaluate the relationship between muscle mass determined by electrical bioimpedance and circulating resistin levels in obese women over 60 years of age. METHODS: We conducted a cross-sectional study in 313 obese women. Anthropometric data (weight, height, body mass index (BMI) and waist circumference), BIA parameters (total fat mass (TFM), fat-free mass (FFM), fat-free mass index (FFMI)), skeletal muscle mass (SMM) and skeletal muscle mass index (SMI)), blood pressure and laboratory tests were recorded. RESULTS: Patients were divided into two different groups according to the mean value of SMI (11.93 kg/m2): low SMI versus high SMI. In the low SMI group, the resistin levels were higher than the resistin levels in the high SMI group (delta value: 2.8 + 0.3 ng/dl:p = 0.01). Serum resistin levels are inversely correlated with FFM, FFMI, SMM, and SMI. This adipokine shows a positive correlation with insulin, HOMA-IR and PCR levels. In the model with SMI as the dependent variable, resistin levels explained 12% of the variability in muscle mass (Beta -0.38, 95% CI -0.91 to -0.11). CONCLUSIONS: Serum resistin levels are associated with low skeletal muscle mass in obese women over 60 years of age.

Resistin/uric acid index as a marker of metabolic syndrome in females with obesity.

BACKGROUND: The resistin/uric index has been considered a prognostic factor for identifying young people with obesity. Obesity and Metabolic Syndrome (MS) are an important health problem in females. AIMS: The objective of this work was to evaluate the relationship of resistin/acid uric index with Metabolic Syndrome on Caucasian females with obesity. METHODS: We conducted a cross sectional study in 571 females with obesity. Measurements of anthropometric parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C reactive protein, uric acid, resistin and prevalence of Metabolic Syndrome were determined. The resistin/uric acid index was calculated. RESULTS: In total, 249 subjects had MS (43.6%). We detected higher levels in the following parameters (Delta; p values); waist circumference (3.1 ± 0.5 cm; p = 0.04), systolic blood pressure (5.3 ± 3.6 mmHg; p = 0.01), diastolic blood pressure (2.3 ± 0.4 mmHg; p = 0.02), glucose levels (7.5 ± 0.9 mg/dL; p = 0.01), insulin levels (2.5 ± 0.3 UI/L; p = 0.02), HOMA-IR (0.7 ± 0.2 units; p = 0.03), uric acid levels (0.9 ± 0.2 mg/dl; p = 0.01), resistin levels (4.1 ± 0.4 ng/dl; p = 0.01) and resistin/uric acid index (0.61 ± 0.01 mg/dl; p = 0.02) in subjects of the high resistin/uric acid index group than low index group. Logistic regression analysis reported a high percentage of hyperglycemia (OR = 1.77, 95% CI = 1.10-2.92; p = 0.02), hypertension (OR = 1.91, 95% CI = 1.36-3.01; p = 0.01), central obesity (OR = 1.48, 95% CI = 1.15-1.84; p = 0.03) and metabolic syndrome percentage (OR = 1.71, 95% CI = 1.22-2.69; p = 0.02) in high resistin/uric acid index group. CONCLUSIONS: Resistin/uric acid index is related with Metabolic syndrome (MS) risk and criteria of it in a population of Caucasian females with obesity and this index is a correlated with glucose levels, insulin levels and insulin resistance (HOMA-IR).

Role of resistin (rs7139228) gene polymorphism with metabolic response after a hypocaloric mediterranean diet.

BACKGROUND: The SNP (rs7139228) of the RETN gene is a polymorphism that has been associated with metabolic disorder in subjects with obesity, and its effect on metabolic response after dietary intervention has not been evaluated. OBJECTIVE: Our objective was to analyse the effects of the polymorphism of the RETN gene rs7139228 on metabolic changes secondary to weight loss with a hypocaloric Mediterranean diet. DESIGN: 1000 obese Caucasian patients were evaluated. An anthropometric evaluation and a biochemical analysis were performed before and after 12 weeks of a hypocaloric Mediterranean diet. The statistical analysis was performed as a dominant model (GG vs GA+AA). RESULTS: Improvements in anthropometric parameters, leptin levels and systolic blood pressure were similar in both genotype groups. In non- A allele carriers, levels of resistin, insulin, HOMA-IR, triglycerides and C-reactive protein decreased. The improvements were statistically significant in this group; resistin (-1.3+0.1ng/dL: p=0.02), triglycerides (-22.9+4.9mg/dl: p=0.02), CRP (-2.7+0 0.4mg/dl: p=0.02), insulin -6.5+1.8 mIU/L: p=0.02) and HOMA-IR (-2.2+0.8: p=0, 03). In addition, insulin, HOMA-IR and resistin levels were higher in A allele carriers than in non-carriers. Finally, the prevalence of metabolic syndrome and hyperglycaemia were higher in A allele carriers, and these percentages only decreased after intervention in non-A allele carriers. CONCLUSION: The A rs7139228 allele is associated with a worse metabolic response (insulin, HOMA-IR, triglycerides and CRP) after weight loss with a hypocaloric Mediterranean diet. A non-significant decrease in the prevalence of metabolic syndrome and hyperglycaemia were detected in A allele carriers.

A single FTO gene variant rs9939609 is associated with weight change and insulin resistance improvement in response to a robotic sleeve gastrectomy in individuals with severe obesity.

BACKGROUND: Genetic mechanisms have been involved in the weight response secondary to bariatric surgery. OBJECTIVE: The aim of our study was to evaluate the effects of the rs9939609 genetic variant on weight loss and metabolic parameters after sleeve gastrectomy. SETTING: Tertiary hospital. METHODS: A total of 95 participants were enrolled. Co-morbidities, biochemical evaluation, and anthropometric parameters were registered before and after 3-, 6-, and 12-month follow-up. Genotype of the rs9939609 fat mass and obesity-associated (FTO) gene was evaluated. RESULTS: We grouped the participants into 2 groups: carriers of A allele (TA+AA, 69.5%) and noncarriers of A allele (TT, 30.5%). We detected a statistically significant reduction of blood pressure, biochemical, and anthropometric parameters at 3 times during follow-up. After 6 months, changes of some parameters were greater in non-A allele carriers: weight (-39.6 + 4.0 kg versus -24.6 + 2.8 kg; P = .02), waist circumference (-21.1 + 2.1 cm versus -16.2 + 1.8 cm; P = .04), insulin (-12.3 + .9 mUI/L versus -8.9.1 + .2 mUI/L; P = .02), and homeostasis model assessment of insulin resistance (-3.1 + .1 units versus -2.3 + .1 units; P = .02 ). After 12 months, changes of the aforementioned parameters remained greater in non-A allele carriers. The percentage of participants with diabetes diminished earlier in the non-A allele carriers than A allele carriers at 6-month follow-up. The percentage of participants with diabetes at the end of the study was lower in non-A allele carriers (3.4% versus 12.1%; P = .02). CONCLUSIONS: Our data suggest that non-A allele carriers of the genetic variant (rs9939609) of the FTO gene showed a better improvement of anthropometric and insulin levels in non-A allele carriers after a robotic sleeve gastrectomy. Both improvements are associated with a lower percentage of participants with diabetes at 12 months.

Triglyceride-Glucose Index Cutoff Point Is an Accurate Marker for Predicting the Prevalence of Metabolic Syndrome in Obese Caucasian Subjects.

BACKGROUND: Recently, the triglyceride-glucose (TyG) index has been suggested as a surrogate insulin resistance marker. This index could act as an early screening marker in individuals with a high risk of metabolic syndrome (MS) such as obese subjects. AIMS: The objective of this work was to detect the cutoff point of the TyG index for the diagnosis of MS according to ATPIII criteria on obese subjects and to compare with HOMA-IR. METHODS: We conducted a cross-sectional study in 1,494 obese subjects. Measurements of adiposity parameters, blood pressure, fasting blood glucose, insulin concentration, insulin resistance (HOMA-IR), lipid profile, C-reactive protein, adipokines, and the prevalence of MS were determined. The TyG index was calculated from the next equation: Ln (fasting triglycerides (mg/dL) × fasting glucose (mg/dL))/2. RESULTS: A total of 1,494 subjects were recruited, 421 males (28.1%) and 1,073 females (71.8%), with an average age of 45.8 ± 15.3 years (range: 29-62). A total of 677 subjects had MS (45.5%) and 817 did not show MS (54.6%). The averages of HOMA-IR and TyG index values increased as the components of MS were aggregated, and both indexes were higher in subjects with MS. The area under the curve (AUC) of the TyG index according to ATPIII criteria showed values of 0.746 (0.721-0.771; p = 0.001). The cutoff point according to the Youden index was 4.72, with sensitivity and specificity of 87% and 88.2%, respectively. For the HOMA-IR, AUC showed values of 0.682 (0.654-0.710; p = 0.01). The cutoff point was 3.23, with sensitivity and specificity of 78% and 70.1%, respectively. CONCLUSIONS: The TyG index is more powerful for predicting MS than HOMA-IR in Caucasian obese subjects.

Effects of a Short-Term Meal Replacement Hypocaloric Diet in Subjects with Obesity and High Fatty Liver Index.

INTRODUCTION: Dietary changes play a role in metabolic response of patients with metabolic-associated fatty liver disease, and there is little evidence on the use of partial meal replacement (pMR) diets in this pathology. AIM: We decided to evaluate the modifications in transaminases levels after a pMR hypocaloric diet in subjects with obesity and elevated fatty liver index (FLI). MATERIAL AND METHODS: A sample of 606 patients with obesity and FLI ≥ 60 were enrolled and treated during 3 months with a pMR diet. Patients were divided as group I (Alanine amino transferase (ALT) normal) or group II (ALT ≥ 43 UI/L). RESULTS: Body mass index, body weight, total fat mass, waist circumference, blood pressure, fasting glucose, total cholesterol, Low-density lipoprotein (LDL) cholesterol, triglycerides, insulin, Homeostasis Model assessment (HOMA-IR), and FLI index improved significantly in the total group with pMR diet, without differences between group I and II. ALT, aspartate aminotransferase activity (AST), Gama glutamine transferase (GGT), and ratios of AST/ALT improved in both groups, too. This improvement was higher in group II (deltas group I vs. deltas group II); ALT (-4.2 ± 0.9 UI/L vs. -32.1 ± 5.7 UI/L: p = 0.01), AST (-4.8 ± 1.8 UI/L vs. -14.1 ± 1.9 UI/L: p = 0.02), GGT (-4.8 ± 1.4 UI/L vs. -37.1 ± 4.2 UI/L: p = 0.01), and AST/ALT ratio (-0.04 ± 0.002 units vs. -0.19 ± 0.04 units: p = 0.01). CONCLUSIONS: We reported that a pMR diet is an effective method to lose weight and to improve metabolic parameters in patients with obesity and high FLI. The decrease in liver parameters was greater in patients with ALT ≥ 43 UI/L.

Correlation of the Phase Angle with Muscle Ultrasound and Quality of Life in Obese Females.

Introduction: Phase angle (PhA) has been suggested to be an indicator of body cell mass and nutritional status. Clinically, the phase angle supposedly reflects body cell mass and cell membrane function, and the higher the phase angle, the better is the cell function. Muscle ultrasound (US) is an emerging nutritional assessment technique. Objective: The aim of this study was to investigate the usefulness and correlation of PhA with muscle US of quadriceps rectus femoris (QRF) in obese female subjects and the relationship with quality of life and physical performance. Material and Methods. In a total of healthy 50 obese female patients, anthropometric data by BIA, muscle mass by ultrasound at the QRF level, analytical determination, blood pressure, and quality of life were measured. Physical performance was assessed, too. Results: In total, 50 female obese patients were included with a mean age of 45.9 ± 2.4 years. The mean body mass index was 32.1 ± 1.6 kg/m2 with a mean weight of 83.5 ± 14.6 kg. Correlation analysis showed a positive correlation of PhA with all US parameters corrected by squared height (anteroposterior muscle thickness, circumference, cross-sectional area, and Echo-intensity). The correlation analysis of biochemical parameters with PhA showed a positive correlation with serum albumin and total protein levels. Physical activity and vitality scores of SF36 were correlated with PhA. Finally, PhA was positive correlated with physical performance, doing push-ups in 30 seconds (r =0.42; p =0.03) and doing squats in 30 seconds (r =0.54; p =0.02), without correlation with the time of 1.5 km walk. Conclusion: PhA was correlated with muscle area, muscle circumference, muscle echo intensity, serum protein, quality of life SF-36, and strength physical performance.

Association of the APOA-5 Genetic Variant rs662799 with Metabolic Changes after an Intervention for 9 Months with a Low-Calorie Diet with a Mediterranean Profile.

In cross-sectional studies, the genetic variant rs662799 of the APOA5 gene is associated with high serum triglyceride concentrations, and in some studies, the effect of short-term dietary interventions has been evaluated. The aim of the present investigation was to evaluate the role of this genetic variant in metabolic changes after the consumption of a low-calorie diet with a Mediterranean pattern for 9 months. A population of 269 Caucasian obese patients was recruited. Adiposity and biochemical parameters were measured at the beginning (basal level) and after 3 and 9 months of the dietary intervention. The rs662799 genotype was assessed with a dominant analysis (TT vs. CT + CC). The APOA5 variant distribution was: 88.1% (n = 237) (TT), 11.5% (n = 31) (TC) and 0.4% (n = 1) (CC). There were significant differences only in triglyceride levels at all times of the study between the genotype groups. After 3 and 9 months of dietary intervention, the following parameters improved in both genotype groups: adiposity parameters, systolic pressure, total cholesterol, LDL cholesterol, leptin, adiponectin and the leptin/adiponectin ratio. The intervention significantly decreased insulin levels, HOMA-IR and triglyceride levels in non-C allele carriers (Delta 9 months TT vs. TC + CC). i.e., insulin levels (delta: -3.8 + 0.3 UI/L vs. -1.2 + 0.2 UI/L; p = 0.02), HOMA-IR levels (delta: -1.2 + 0.2 units vs. -0.3 + 0.1 units; p = 0.02), triglyceride levels (delta: -19.3 + 4.2 mg/dL vs. -4.2 + 3.0 mg/dL; p = 0.02). In conclusion, non-C allele carriers of rs662799 of the APOA5 gene showed a decrease of triglyceride, insulin and HOMA-IR levels after consuming a low-calorie diet with a Mediterranean pattern; we did not observe this effect in C allele carriers, despite a significant weight loss.

A Randomized Trial with Two Hypocaloric Diets with Different Lipid Profiles and Effects on Serum Omentin-1 Levels in Obese Subjects.

Background: The effects of weight loss therapies on omentin-1 levels have been unclear, showing both elevations and decreases in circulating levels. The role of dietary fat might have an important role. The aim of our investigation was to evaluate the influence of weight decrease on omentin-1 levels after two different high-fat hypocaloric diets. Methods: 319 Caucasian obese subjects were randomly allocated during 12 weeks (Diet M (high monounsaturated fat diet) vs. Diet P (high polyunsaturated fat diet)). The mean age was 47.2 ± 5.0 years (range: 26-64), and the mean body mass index (BMI) was 37.9 ± 4.1 kg/m2 (range: 30.6-39.8). Sex distribution was 237 females (74.7%) and 72 males (25.3%). Anthropometric and biochemical parameters were evaluated at basal and after both diets. SPSS 23.0 has been used to realize univariant and multivariant statistical analysis. Results: After both diets, BMI, weight, fat mass, waist circumference, systolic blood, LDL-cholesterol, insulin levels, and HOMA-IR decreased in a statistical way from basal values. These improvements were similar in both diets. After Diet P, omentin-1 levels increase (21.2 ± 9.1 ng/ml: P = 0.02), and after Diet M, this adipokine increases (47.1 ± 11.2 ng/ml: P = 0.02), too. The increase of omentin-1 with Diet M was statistically significantly higher than that after Diet P (P = 0.01). A multiple regression analyses adjusted by age and sex reported a statistical relation between BMI (kg/m2) and insulin (UI/L) with omentin-1 levels. Conclusions: Our study demonstrated a significant improvement on serum omentin-1 levels after weight loss secondary to both diets; in contrast, omentin-1 improvement was higher with Diet M than with Diet P.

Dietary Intervention during 9 Months with a Hypocaloric Diet, Interaction of the Genetic Variant of Adiponectin Gene rs822393 with Metabolic Parameters.

BACKGROUND AND AIMS: rs822393 (-4522C/T) genetic variant is associated with hypoadiponectinemia and other metabolic parameters. The aim of our investigation was to analyze the effects of a hypocaloric diet with Mediterranean dietary pattern during 9 months according to genetic variant rs822393 of ADIPOQ gene. METHODS AND RESULTS: A sample of 269 obese patients was enrolled. Anthropometric and serum parameters (lipid profile, insulin, homeostasis model assessment (HOMA-IR), glucose, C reactive protein, and adipokines) were determined, at basal time and after 3 and 9 months. All patients were genotyped in the rs822393. The genotype distribution was as follow; 176 patients (65.4%) CC, 83 patients CT (30.9%), and 10 patients TT (3.7%). After dietary intervention, the following parameters improved in non-T allele carriers; BMI, weight, fat mass, waist circumference, systolic blood pressure, insulin levels, HOMA-IR, leptin, total cholesterol, and LDL-cholesterol improved significantly. HDL-cholesterol (delta: 5.7 ± 1.1 mg/dl vs. 1.0 ± 0.8 mg/dl; p = 0.01), serum adiponectin (delta: 14.4 ± 2.0 ng/dl vs. 7.1 ± 3.1 ng/dl; p = 0.02), and adiponectin/leptin ratio (delta: 0.54 ± 0.1 vs. 0.22 ± 0.09 ng/dl; p = 0.03). Basal and postintervention HDL cholesterol, adiponectin levels, and adiponectin/leptin levels were lower in T-allele carriers than non-T Allele carriers. CONCLUSION: T allele carriers showed lower levels of HDL-cholesterol, adiponectin, and adiponectin/leptin ratio than non-T allele carriers. A medium-term hypocaloric diet with a Mediterranean partner increased adiponectin levels, ratio adiponectin/leptin, and HDL-cholesterol in non-T allele carriers.

[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]. / Estudio en vida real de una plataforma «online¼ para la prescripción de ejercicio físico a pacientes obesos: efecto sobre los parámetros antropométricos y bioquímicos, y sobre la calidad de vida.

Introduction: 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. Results: 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.

Introducción: 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, con disminución de la resistencia a la insulina y mejora de la calidad de vida.

A Pilot Study of Gene Expression Analysis in Peripheral Blood Mononuclear Cells in Response to a Hypocaloric Mediterranean Diet.

BACKGROUND: Few studies have examined gene expression in peripheral blood mononuclear cells (PBMCs) after a dietary intervention. OBJECTIVE: Our study is aimed at evaluating in a pilot study the peripheral blood gene expression in obese patients after weight loss secondary to a hypocaloric Mediterranean diet. DESIGN: A sample of 11 obese subjects without metabolic syndrome was enrolled. Biochemical, anthropometric parameters and microarray analysis were performed at baseline and after 6 months of dietary intervention. RESULTS: The mean age was 43.1 ± 6.3 years, and the mean body mass index (BMI) was 38.6 ± 8.1 kg/m2. All the next improvements were statistically significant: body weight -7.4 ± 1.9 kg, BMI -2.5 ± 0.2 kg, fat mass -5.7 ± 1.2 kg, waist circumference -5.8 ± 1.2 cm, triglycerides -17.4 ± 6.5 mg/dl, C-reactive protein -3.1 ± 1.5 mg/dL, insulin -2.1 ± 1.0 mUI/L, and HOMA-IR -0.7 ± 0.2 units. We identified 634 differentially expressed genes: 262 genes with relative higher expression levels and 372 with lower expression levels. Cluster analysis showed 35 genes in nutritional disease and 17 genes in endocrine system. The most relevant gene was thyroid peroxidase (TPO), and this gene was overexpressed, and the next genes carbonic anhydrase VI (CA6), caveolin protein 1 (CAV1) and solute carrier family type 12 (SLLC12A3), soluble carrier family type 12 (SLLC12A3), beta 3 receptor (ADRB3), and glutamate receptor ionotropic N methyl D aspartate 2 A (GRIN2A) were all underexpressed. CONCLUSION: In PBMC from obese patients after a diet with a Mediterranean pattern, the expression of 634 genes, of the endocrine system and of nutritional disease, is modified.

Role of the rs10401670 variant in the resistin gene on the metabolic response after weight loss secondary to a high-fat hypocaloric diet with a Mediterranean pattern.

BACKGROUND: The single nucleotide polymorphism (SNP) (rs10401670) of the RETN gene has been associated with metabolic disorder in obese subjects and has scarcely been evaluated after dietary interventions. The present study aimed to analyse the effects of the rs10401670 RETN gene polymorphism on metabolic changes secondary to weight loss and secondary to a high-fat hypocaloric diet with a Mediterranean dietary pattern. METHODS: A Caucasian population comprising 284 obese patients without diabetes mellitus was analysed. Before and after 3 months of a high-fat hypocaloric diet with a Mediterranean pattern, an anthropometric evaluation, an assessment of nutritional intake and a biochemical analysis were performed. A statistical analysis was conducted for the combined CT and TT as a group and for wild-type CC as a second group. RESULTS: Decreases in weight, body mass index (BMI), fat mass, systolic blood pressure and waist circumference were similar in both genotypes groups. In T allele carriers, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), triglycerides and C-reactive protein levels were decreased. The decrease in these parameters was statistically significant for triglycerides (-22.3 ± 9.3 mg dl-1 : p = 0.03), C-reactive protein (-2.8 ± 0.5 mg dl-1 : p = 0.03), insulin (-7.4 ± 2.9 mUI L-1 : p = 0.03) and HOMA-IR (-2.4 ± 1.0: p = 0.02). Leptin levels were decreased in both genotypes groups after the hypocaloric diet, as well as the anthropometric parameters BMI, weight, waist circumference and fat mass. Resistin and adiponectin levels remained unchanged in both groups. CONCLUSIONS: In the present study, we have detected a significant association between the T allele of this SNP and a better response of insulin resistance, triglycerides and C-reactive protein compared to non T allele carriers after weight loss with a high-fat hypocaloric diet and a Mediterranean diet.