Relation of the rs6923761 gene variant in glucagon-like peptide 1 receptor with weight, cardiovascular risk factor, and serum adipokine levels in obese female subjects.

BACKGROUND: Studies of the glucagon-like peptide 1 (GLP-1) receptor have been directed at identifying polymorphisms in the GLP-1 receptor gene that may be a contributing factor in the pathogenesis of diabetes mellitus and cardiovascular risk factors. Nevertheless, the role of GLP-1 variants on body weight, cardiovascular risk factors, and adipokines remains unclear in obese patients. OBJECTIVE: Our aim was to analyze the effects of rs6923761 GLP-1 receptor polymorphism on body weight, cardiovascular risk factors, and serum adipokine levels in nondiabetic obese females. DESIGN: A sample of 645 obese nondiabetic Caucasian females was enrolled in a prospective way. Basal fasting glucose, c-reactive protein (CRP), insulin, insulin resistance (homeostasis model assessment (HOMA)), total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides concentration, and adipokines were measured. Weights, body mass index (BMI), waist circumference, fat mass by bioimpedance, and blood pressure measures were measured. RESULTS: Three hundred and twenty-seven participants (50.7%) had the genotype GG and 318 (49.3%) study subjects had the next genotypes; GA (270 study subjects, 41.9%) or AA (48 study subjects, 7.4%) (second group). In wild group (GG genotype), BMI (1.8 ± 2.3 kg/m(2) ; P < 0.05), weight (3.1 ± 1.3 kg; P < 0.05), fat mass (2.4 ± 1.1 kg; P < 0.05), waist circumference (2.7 ± 1.9 cm; P < 0.05), triglyceride levels (10.4 ± 5.3 mg/dl; P < 0.05), interleukin 6 (IL-6) (1.5 ± 0.9 ng/dl; P < 0.05), resistin (1.1 ± 0.3 ng/dl; P < 0.05), and leptin (30.1 ± 10.3 ng/dl; P < 0.05) levels were higher than mutant group (GA + AA). CONCLUSION: Data from our study revealed an association with decreased metabolic and cardiovascular markers in obese females. BMI weight, fat mass, waist circumference, triglycerides, leptin, resistin, and IL-6 serum levels were lower in subjects with A allele than non-A allele subjects.

Evaluation of weight loss and adipocytokine levels after two hypocaloric diets with different macronutrient distribution in obese subjects with the rs6923761 gene variant of glucagon-like peptide 1 receptor.

BACKGROUND: The role of glucagon-like peptide-1 receptor (GLP-1R) variants on body weight response after dietary intervention has not been evaluated so far. OBJECTIVE: Our aim was to evaluate weight loss and adipocytokine levels after two hypocaloric diets with different macronutrient distribution in obese subjects with rs6923761. DESIGN: A sample of 280 obese subjects was randomized to two hypocaloric diets. RESULTS: 124 patients (44.3%) had the genotype GG (wild-type) and 156 (55.7%) had another genotype (mutant), i.e. GA (n = 132, 47.1%) or AA (n = 24, 8.6%). With the type I diet (low in carbohydrates) in the wild-type and mutant groups, BMI, weight, fat mass, waist circumference, insulin levels, insulin resistance and triglycerides decreased. Anthropometric parameters were higher in non-A-allele carriers than A-allele carriers. With the type II diet (low in fats) in all genotypes, BMI, weight, fat mass, waist circumference, insulin levels, total cholesterol and LDL cholesterol decreased. CONCLUSION: Our data showed better anthropometric parameters in obese subjects with the mutant allele (A) of the rs6923761 GLP-1R polymorphism. A lack of association of this polymorphism with weight loss or biochemical parameters after two different hypocaloric diets was observed.

Relation of the rs9939609 gene variant in FTO with metabolic syndrome in obese female patients.

OBJECTIVES: Common polymorphisms of the fat mass and obesity associated gene (FTO) have been linked to obesity and diabetes mellitus type 2 in some populations. The aim of our study was to analyze the relationship of the rs9939609 FTO gene polymorphism with metabolic syndrome and its components. MATERIAL AND METHODS: A population of 457 obese Caucasian females was analyzed in a cross-sectional survey. To estimate the prevalence of Metabolic Syndrome, the definitions of the ATPIII were considered. Genotype of FTO gene polymorphism (rs9939609) was studied. RESULTS: One hundred and thirty patients (28.4%) had the genotype TT (wild group), whereas 227 patients (49.7%) had the genotype TA and 100 patients (21.9%) had the genotype AA. Prevalence of metabolic syndrome (MS) with ATP III definition was 40.7% (186 patients) and 59.3% patients had no MS (n = 271). Prevalence of mutant FTO genotypes was similar in patients with metabolic syndrome (27.4% wild genotype and 72.6% mutant genotype) and without metabolic syndrome (29.2% wild genotype and 70.8% mutant genotype).Odds ratio of metabolic syndrome in wild vs mutant genotype was 1.04 (95% CI: 0.87-1.22). Insulin levels (13.9±6.3 mUI/L vs. 12.6 ± 3.4 mUI/L; p<0.05), HOMA-R (3.3 ± 1.6 vs. 2.8 ± 1.4; p < 0.05) and triglycerides concentrations (110.8 ± 27.3 mg/dl vs. 103.1 ± 47.3 mg/dl; p < 0.05) were lower in the mutant type group than the wild type group in patients without metabolic syndrome. CONCLUSION: The FTO gene polymorphism (rs9939609) was found to be associated with increased insulin resistance, insulin and triglyceride levels in obese females with TT variant and without metabolic syndrome. MS or its components were not associated with this polymorphism in obese females.

Relation of visfatin to cardiovascular risk factors and adipocytokines in patients with impaired fasting glucose.

OBJECTIVE: The discovery of visfatin has great potential to significantly enhance our understanding of impaired fasting glucose and diabetes mellitus. The aim of the present study was to explore the relation of visfatin concentrations to cardiovascular risk factors and serum adipocytokine concentrations in patients with impaired fasting glucose. METHODS: A sample of 55 patients with impaired fasting glucose was analyzed in a prospective way. All patients with a 2-wk weight-stabilization period before recruitment were enrolled. Weight, blood pressure, basal glucose, lipoprotein(a), C-reactive protein, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols, blood, and adipocytokines (visfatin, leptin, adiponectin, resistin, tumor necrosis factor-α [TNF-α], and interleukin-6) levels were measured. Tetrapolar impedancometry, indirect calorimetry, and prospective serial assessment of nutritional intake with 3-d written food records were performed. RESULTS: Fourteen men (25.5%) and 41 women (74.5%), with a mean age of 57.3 ± 11.7 y and mean body mass index of 35.8 ± 3.6 kg/m(2), were included. Patients were divided in two groups by median visfatin value (18.2 ng/mL): group I had low values and group II had high values. Patients in group I had greater weight, body mass index, fat mass, fat-free mass, and adiponectin than patients in group II. Patients in group II had higher total cholesterol, low-density lipoprotein cholesterol, resistin, and TNF-α levels than patients in group I. In the multivariate analysis with age- and sex-adjusted basal visfatin concentration as a dependent variable, only TNF-α remained an independent predictor in the model (F = 8.4, P < 0.05), with an inverse correlation. Visfatin concentration decreased 7.33 ng/mL (95% confidence interval 2.10-12.58) for each nanogram per milligram of TNF-α increase. CONCLUSION: Only TNF-α is related in an independent way to serum visfatin levels.

Effect of fatty acid-binding protein 2 Ala54Thr genotype on weight loss and cardiovascular risk factors after a high-polyunsaturated fat diet in obese patients.

BACKGROUND: It has been found that the expression of fatty acid-binding protein 2 messenger RNA is under dietary control. The aim of our study was to investigate the influence of Thr54 polymorphism in the FABP2 gene on weight loss and secondarily in cardiovascular risk factors and serum adipokine after an enriched polyunsaturated fat hypocaloric diet in obese patients. DESIGN: A sample of 111 obese patients was analyzed. The enriched polyunsaturated fat hypocaloric diet during 3 months' intervention consisted of 1459 kcal, 45.7% carbohydrates, 34.4% lipids, and 19.9% proteins. The distribution of fats was as follows: 21.8% saturated fats, 55.5% monounsaturated fats, and 22.7% polyunsaturated fats. Level of significance was P < 0.05. RESULTS: In Ala54Ala genotype, body mass index (-1.6 ± 1.5 kg/m(2)), weight (-3.2 ± 3.3 kg), fat mass (-3.1 ± 3.5 kg), and waist circumference (-3.3 ± 2.1 cm) decreased. In carriers of the Thr54 allele, body mass index (-1.9 ± 1.6 kg/m(2)), weight (- 4.7 ± 1.4 kg), and waist circumference (-3.9 ± 3.7 cm) decreased. These changes were significantly higher in the carriers of the Thr54 allele than noncarriers. Only in the carriers of Thr54 allele, total cholesterol levels (-11.4 ± 20.6 mg/dl), low-density lipoprotein cholesterol levels (-5.4 ± 10.6 mg/dL), insulin (-2.6 ± 3.4 MUI/L), and the level of homeostasis model assessment for insulin sensitivity (-0.9 ± 1.7 U) decreased. CONCLUSION: Carriers of Thr54 allele have a better metabolic response than obese carriers with Ala54Ala genotype, with a decrease of total cholesterol, low-density lipoprotein cholesterol, insulin levels, leptin levels, and homeostasis model assessment for insulin sensitivity.

Evaluation of weight loss and adipocytokines levels after two hypocaloric diets with different macronutrient distribution in obese subjects with rs9939609 gene variant.

BACKGROUND: Common polymorphisms of the fat mass and obesity associated gene (FTO) have been linked to obesity in some populations. One of these genetic variants (rs9939609) has been related to an increased risk of obesity. OBJECTIVE: Our aim was to evaluate weight loss and adipocytokine levels after two hypocaloric diets with different macronutrient distribution in obese subjects with RS9939609 gene variant. DESIGN: 305 obese patients were enrolled in a prospective way. In the basal visit, patients were randomly allocated during 3 months to low carbohydrates and low fat. RESULTS: After treatment with both diets and in both genotypes, weight, fat mass, waist circumference and systolic blood pressures decreased. With the diet type I and in TT genotype, insulin (-6.6 ± 9.8 IU/L) and homeostasis model assessment (-2.9 ± 6.1 units) decreased. With the diet type II and in both genotypes (wild and mutant type), insulin (-5.2 ± 6.1 vs. -3.8 ± 6.1 IU/L; p < 0.05) and homeostasis model assessment (-2.4 ± 4.8 vs. -1.1 ± 3.8 kg; p < 0.05) decreased. In the A allele group, a significant decrease was detected in total cholesterol levels (-11.5 ± 20.1 mg/dL), low density lipoprotein cholesterol levels (-13.2 ± 20.9 mg/dL) and c-reactive protein levels (-1.3 ± 3.8 mg/dL) secondary to weight loss after treatment with diet II. The decrease of leptin levels was higher in mutant type group than wild type group with low fat diet (-10.3 ± 36.1 vs. -28.6 ± 53.7 ng/mL; p < 0.05). CONCLUSION: Metabolic improvement secondary to weight loss was better in A carriers with a low fat hypocaloric diet.

Insulin resistance predicts steatosis and fibrosis in morbidly obese patients undergoing bariatric surgery.

BACKGROUND: Influence of adipokines and insulin resistance on liver histology is an unclear area in morbidly obese patients. OBJECTIVE: The aim of our study was to study the influence of insulin resistance and adipokines in the grade of liver steatosis and fibrosis in morbidly obese patients undergoing bariatric surgery. SETTING: Tertiary hospital. MATERIALS AND METHODS: A sample of 36 morbidly obese patients undergoing bariatric surgery was analyzed in a cross-sectional study. A liver biopsy was performed. Weights, basal glucose, insulin, insulin resistance (homeostasis model assessment for insulin resistance [HOMA-IR]), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and adipokine blood levels were measured. RESULTS: Seventeen patients (47.2%) had low-grade steatosis, and 19 patients (52.8%) had high-grade steatosis. Sixteen patients (44.4%) did not have liver fibrosis, and 20 patients (56.6%) had liver fibrosis. Only insulin levels, HOMA-IR, and aspartate aminotransferase activity were higher in the patients with high-grade steatosis. Insulin levels and HOMA-IR were higher in patients with fibrosis. In the logistic regression analysis with a dependent dichotomous variable (grades of steatosis: low vs high), the HOMA-IR remained in the model, with an odds ratio to develop high-grade steatosis of 1.33 (95% confidence interval, 1.09-1.86). In the second logistic regression analysis with a dependent dichotomy variable (grades of fibrosis: present vs absent), the HOMA-IR remained in the model, with an odds ratio to develop fibrosis of 1.53 (95% confidence interval, 1.13-2.51). CONCLUSION: Insulin resistance determined with HOMA-IR model is associated with high-grade steatosis and liver fibrosis in obese patients before bariatric surgery.

Relationship of -55C/T polymorphism of uncoupling protein 3 (UCP3) gene with metabolic syndrome by ATP III classification.

BACKGROUND AND AIMS: The relation of -55C/T polymorphism of uncoupling protein 3 (UCP3) with metabolic syndrome (MS) has been evaluated only in one previous study with contradictory results. The aim of our study was to investigate the association of -55C/T polymorphism of UCP3 gene with MS. DESIGN: A population of 817 obese Caucasian patients was analyzed in a cross-sectional survey. Genotype of UCP3 gene -55C/T was studied. To estimate the prevalence of MS , the definitions of the ATPIII were considered. RESULTS: Five hundred and ninety-four patients (72.7%) had the genotype -55CC (wild group), whereas 223 patients (27.3%) had the genotype -55C/T. Genotype -5TT was not detected. Prevalence of mutant UCP genotypes was similar in patients with MS (75.7% wild genotype and 24.3% mutant genotype) and without MS (69.7% wild genotype and 30.3% mutant genotype). Odds ratio of MS wild vs. mutant genotype was 1.17 CI 95%: 0.99-1.38). Total cholesterol and low density lipoprotein (LDL) cholesterol concentrations were lower in mutant-type group than wild-type group in patients with MS. No differences in other parameters were detected between genotypes in the same group of MS. CONCLUSION: -55C/T UCP polymorphism is not major risk factor for the MS. However, in mutant group of -55CC UCP3 gene in patients with MS, total cholesterol and LDL cholesterol were lower than wild-type patients.

Effects of RS9939609 gene variant in FTO gene on weight loss and cardiovascular risk factors after biliopancreatic diversion surgery.

BACKGROUND: The high variation in responses to bariatric surgery might be partially explained by genetic effects. Recently, common polymorphisms of the fat mass and obesity-associated gene (FTO) have been linked to obesity in some populations. Only two studies have investigated the effect of FTO variants on weight loss of morbid obese patients undergoing bariatric surgery with contradictory results. OBJECTIVE: We decided to investigate the role of the rs9939609 FTO gene polymorphism on outcomes after a biliopancreatic diversion surgery (BPD) in morbidly obese patients. DESIGN: A sample of 119 morbidly obese patients' body mass index (BMI) > 40 kg/m(2) were operated. Weight, fat mass, blood pressure, basal glucose, triacylglycerols, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol were measured at basal visit and at each visit (basal, 3, 9 and 12 months). The frequency of metabolic comorbidities was recorded at each visit. RESULTS: Thirty-seven patients (31.1%) had genotype TT (wild type group), 58 (48.7%) patients had genotype TA and 24 patients (20.2%) had genotype AA. In the wild and mutant type groups, BMI, weight, waist circumference, systolic blood pressure and diastolic blood pressure decreased in a significant way. In the wild type groups, glucose, total cholesterol, low density lipoprotein (LDL) cholesterol and triacylglycerol concentrations decreased at 3, 9 and 12 months after surgery. In the mutant type groups, glucose, total cholesterol and triacylglycerol concentrations decreased at 3, 9 and 12 months after surgery. LDL cholesterol decreased at 9 and 12 months after surgery. Initial weight percent loss at 3 months of follow-up was higher in the wild type group (26.1% vs. 18.6%: p < 0.05). The initial weight percent loss at 9 or 12 months was similar in both genotypes. CONCLUSION: Our study showed a higher initial weight loss at 3 months after the TT variant of FTO gene (rs9939609). However, the weight loss at 9 and 12 months of BPD was similar in both genotypes with a significant improvement in biochemical parameters and cardiovascular comorbidities.

Role of G1359A polymorphism of the cannabinoid receptor gene on weight loss and adipocytokines levels after two different hypocaloric diets.

BACKGROUND: A silent intragenic polymorphism (1359 G/A) of the cannabinoid receptor 1 gene resulting in the substitution of the G to A at nucleotide position 1359 in codon 435 (Thr) was reported as a common polymorphism in Caucasian populations. Intervention studies with this polymorphism have not been realized. OBJECTIVE: We decide to investigate the role of missense polymorphism (G1359A) of cannabinoid receptor 1 gene on adipocytokines response and weight loss secondary to a low-fat versus a low-carbohydrate diet in obese patients. DESIGN: A population of 249 patients was analyzed. A nutritional evaluation was performed at the beginning and at the end of a 3-month period in which subjects received one of two diets (diet I: low fat vs. diet II: low carbohydrate). RESULTS: One hundred forty three patients (57.4%) had the genotype G1359G (wild-type group), and 106 (42.6%) patients had G1359A (92 patients, or 36.9%) or A1359A (14 patients, or 5.6%; mutant-type group). With both diets in wild-type and mutant-type groups, body mass index (BMI), weight, fat mass, waist circumference and systolic blood pressure levels decreased. With both diets and in wild-type group, glucose, total cholesterol and insulin levels and homeostasis model assessment test score decreased. No metabolic effects were observed in mutant-type group. Leptin levels decreased significantly in the wild-type group with both diets (diet I: 10.8% vs. diet II: 28.9%; P<.05). CONCLUSION: The novel finding of this study is the lack of metabolic improvement of the mutant-type groups G1359A and A1359A after weight loss with both diets. Decrease in leptin level was higher with low-carbohydrate diet than low-fat diet.

Relation of osteocalcin with insulin resistance and histopathological changes of non alcoholic fatty liver disease.

BACKGROUND: Osteocalcin is a hormone with a complex cross-talk between adipose tissue and the skeleton. The aim of the present study was to explore the relation of osteocalcin with histopathological changes of NALFD patients. SUBJECTS: A population of 69 NAFLD patients was analyzed. A liver biopsy was realized. Weight, fat mass, body mass index, basal glucose, insulin, insulin resistance (HOMA), total cholesterol, LDLcholesterol, HDL-cholesterol, triglycerides and osteocalcin levels were measured. RESULTS: Patients were divided in two groups by median osteocalcin value (11.34 ng/mL), group I (patients with the low values) and group II (patients with the high values). Only liver fibrosis frequencies were different between groups (group I: 22.9% vs group II: 9.4%; p < 0.05). Patients in group I had higher levels of glucose (115.6 ± 28.1 mg/dL vs. 103.7 ± 24.3 mg/dL; p < 0.04), HOMA (4.6 ± 3.1 units vs. 3.6 ± 1.8 units; p < 0.04), weight (102.9 ± 32.4 kg vs. 85.9 ± 16.8 kg; p = 0.002) and body mass index (38.3 ± 11.4 kg/m(2) vs. 30.1 ± 5.7 kg/m(2); p = 0.001)) than patients in group II. Osteocalcin was inverse correlated with glucose (r =-0.4; p = 0.002) and HOMA (r = -0.3:p = 0.01). CONCLUSION: Osteocalcin is associated with liver fibrosis. However, this association disappeared in a multivariate analysis, and HOMA remained as an independent factor.

[Visfatin in obese patients, relation with cardiovascular risk factors, a cross sectional study]. / Visfatina en pacientes obesos, relación con factores de riesgo cardiovascular, un estudio tranversal.

BACKGROUND AND OBJECTIVE: Obesity and insulin resistance are associated with cardiovascular risk factors. The aim of the present study was to explore the relation of visfatin with insulin resistance, cardiovascular risk factors and anthropometry in obese patients without comorbidities. PATIENTS AND METHOD: A population of 270 obese patients was analyzed in a prospective way. In all patients we performed a biochemical analysis (lipid profile, insulin, HOMA and visfatina), and a nutritional evaluation (dietary intake, conventional anthropometry and bioimpedance). RESULTS: Patients were divided in two groups by median visfatin value (8,32 ng/ml), group I (patients with the low values, average value 7,11 (0,7) ng/ml) and group II (patients with the high values, average value 13,5 (10,1) ng/ml). Patients in the group I had higher weight, body mass index, waist circumference, and waist to hip ratio than patients in group II. Patients in group I had lower LDL-cholesterol and C reactive protein than patients in group II. Correlation analysis showed a positive correlation between visfatin levels and LDL cholesterol (r=0.194; p<0.05) and C reactive protein (r=0.266; p<0.05) and a negative corelation with weight (r=-0.162; p<0.05). In the logistic analysis with age-, sex- and dietary intake- adjusted basal visfatin concentration as a dependent variable, the next variables remained in the model; weight with an odds ratio (OR) 0,97 (IC95% 0,95-0,99), LDL cholesterol 1,012(1,010-1.023) and C reactive protein 1,15 (1.03-1.3). CONCLUSION: LDL cholesterol and c reactive protein levels are positively correlated with visfatin levels. Weight is negatively correlated with visfatin levels, in an independent way and adjusted by age, sex and dietary intake.

Visfatin levels in female, morbid, nondiabetic obese patients after biliopancreatic diversion surgery.

BACKGROUND: Visfatin was recently identified as a protein preferentially expressed in visceral adipose tissue. The purpose of the present study was to investigate the changes in serum visfatin levels after biliopancreatic diversion and the association of the changes observed with other parameters in morbidly nondiabetic obese women. METHODS: A sample of 27 morbidly obese women (body mass index >40 kg/m(2)) were operated. The biochemical and anthropometric parameters were measured at the initial visit and 1 year after surgery. The frequency of patients with hypertension and hyperlipidemia was recorded at 1 year. RESULTS: The mean patient age was 46.0 ± 13.0 years, and the mean preoperative body mass index was 46.3 ± 13.1 kg/m(2). The body mass index, weight, waist circumference, fat mass, blood pressure, total cholesterol, and low-density lipoprotein cholesterol had decreased significantly. The visfatin levels did not change after surgery (5.70 ± 1.84 ng/mL versus 6.12 ± 1.68 ng/mL; P = NS). The correlation analysis showed a positive association between the baseline visfatin and total cholesterol level (r = 0.49; P <.01). CONCLUSION: The massive weight reduction 1 year after biliopancreatic diversion was not associated with a significant change in the circulating visfatin levels in morbidly obese women.

Influence of lys656asn polymorphism of leptin receptor gene on surgical results of biliopancreatic diversion.

BACKGROUND: Bariatric surgery is the most effective long-term treatment for morbid obesity, reducing obesity-associated comorbidities. The purpose of the present study was to evaluate Lys656Asn polymorphism of leptin receptor gene on outcomes 1 year after biliopancreatic diversion. METHODS: A sample of 41 morbidly obese patients (body mass index (BMI) > 40 kg/m(2)) were operated on. Biochemical and anthropometric evaluation were realized at basal visit and at each visit. The frequency of patients with diabetes mellitus, hypertension, and hyperlipidemia was recorded at each visit. RESULTS: Thirty-two patients (78%) had genotype Lys656/Lys656, eight patients (19.5%) Lys656/Asn656 genotype, and one patient (2.4%) Asn656/Asn656 genotype. In the wild-type group, body mass index, weight, glucose, total cholesterol, LDL cholesterol, triacylglycerol, and systolic blood pressure decreased. In the mutant group, the same parameters improved. Initial weight percent loss at 1 year of follow-up was higher in mutant group than in wild-type group (38.9% vs 29.9%; p < 0.05). Total weight loss was higher in mutant group than wild-type group (50.7 vs 37.2 kg; p < 0.05). Basal weight and BMI were higher in mutant group than wild type. CONCLUSION: Weight loss was higher in mutant group (Lys656Asn and Asn656Asn) than wild-type group (Lys656Lys) after bariatric surgery. Carriers of the allelic variant (Asn) had higher basal weight.

Effects of C358A missense polymorphism of the degrading enzyme fatty acid amide hydrolase on weight loss, adipocytokines, and insulin resistance after 2 hypocaloric diets.

It has been demonstrated that the polymorphism 385 C/A of fatty acid amide hydrolase was associated with obesity. We decided to investigate the role of a polymorphism (cDNA 385 C->A) on insulin resistance and weight loss secondary to a low-fat vs a low-carbohydrate diet. A population of 248 patients with obesity was analyzed. Basal measurements were performed, and values were compared to those at the end of a 3-month period in which subjects received either diet I (low fat) or diet II (low carbohydrate). One hundred seventy-eight patients (71.8%) had the genotype C358C (wild-type group), and 70 (28.2%) patients had the genotype C358A (62 patients, 25%) or A358A (8 patients, 3.2%) (mutant-type group). With diet I, body mass index, weight, fat mass, waist circumference, and systolic blood pressures decreased in the wild-type and mutant-type groups. With diet II, body mass index, weight, fat mass, waist circumference, and systolic blood pressures decreased in both genotypes. With diet I, leptin, glucose, total cholesterol, triglyceride, insulin, and homeostasis model assessment for insulin sensitivity (HOMA) decreased in the wild-type group. In the mutant-type group, only cholesterol decreased in a significant way. With diet II, leptin, interleukin-6, glucose, total cholesterol, low-density lipoprotein cholesterol, insulin, HOMA, and C-reactive protein decreased in the wild-type genotype. The allele A358 of fatty acid amide hydrolase was associated with a lack of improvement on glucose insulin, HOMA, and leptin levels in both diets after weight loss.

Circulating visfatin in obese non-diabetic patients in relation to cardiovascular risk factors, insulin resistance, and adipocytokines: a contradictory piece of the puzzle.

OBJECTIVE: Obesity and insulin resistance are associated with cardiovascular risk factors. The aim of the present study was to explore the relation of circulating visfatin to insulin resistance, cardiovascular risk factors, anthropometry, and adipocytokines in obese patients without diabetes mellitus. METHODS: A population of 228 obese non-diabetic outpatients was analyzed in a prospective way. All patients with a 2-wk weight-stabilization period before recruitment were enrolled. Biochemical analysis and nutritional evaluation were performed. RESULTS: Subjects were 62 men (27.2%) and 166 women (62.8%) with a mean age of 41.1 ± 16.4 y and a mean body mass index of 35.8 ± 3.6 kg/m(2). Patients were divided in two groups by median visfatin value (22.8 ng/mL), i.e., those with low values (group I) and those with high values (group II). Patients in group I had greater weight, body mass index, fat mass, fat-free mass, insulin, homeostasis model of assessment, triacylglycerol, leptin, and adiponectin than patients in group II. Patients in group II had higher total cholesterol, low-density lipoprotein cholesterol, resistin, and tumor necrosis factor-α levels than patients in group I. In a multivariate analysis with age- and sex-adjusted basal visfatin concentration as a dependent variable, only weight and leptin remained as an independent predictor in the model (F = 6.5, P < 0.05), with an inverse correlation. CONCLUSION: Total cholesterol, low-density lipoprotein cholesterol, tumor necrosis factor-α, and resistin levels are elevated in patients with visfatin levels above the median value. Homeostasis model of assessment, insulin, weight, fat mass, fat-free mass, triacylglycerols, leptin, and adiponectin are decreased in these patients.

Influence of G308A promoter variant of tumor necrosis factor-alpha gene on insulin resistance and weight loss secondary to two hypocaloric diets: a randomized clinical trial.

BACKGROUND AND AIMS: The aim of our study was to investigate the influence of G-308A promoter variant in the TNF-alpha gene on insulin resistance and weight loss secondary to two hypocaloric diets. METHODS: Two hundred and three obese, nondiabetic patients were analyzed. Before and after 2 months of two hypocaloric diets, a nutritional evaluation and a blood analysis were performed. Statistical analysis was performed for the combined G308A and A-308A as mutant group and type G-308G as wild-type (WT) group. RESULTS: Two hundred and three patients were enrolled; 154 patients (75.5%) had the genotype G-308G and 49 patients (24.5%) had the genotype G-308A. With diet Type I and in the WT group, body mass index (BMI), weight, fat mass (FM), systolic blood pressure (SBP), diastolic blood pressure (DBP), glucose, insulin, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) concentrations decreased. In the mutant group, BMI, weight and FM decreased. In the WT group with Type II diet, BMI, weight, FM, SBP, TC, and insulin concentrations decreased. In the mutant group, BMI, weight and FM decreased. Only leptin concentrations showed a significant decrease in the WT group with both diets (diet I: 15.6%, p <0.05 and diet II: 28.3%, p <0.05). CONCLUSIONS: Carriers of G-308G promoter variant of TNF-alpha gene have a better metabolic response than A-308 obese patients with both diets.

The effects of two different hypocaloric diets on glucagon-like peptide 1 in obese adults, relation with insulin response after weight loss.

OBJECTIVE: Few studies have investigated the effect of type of diets on GLP-1 concentrations. The aim of this study was to compare the effect of two diets on circulating GLP-1 levels and the relation with insulin response after weight loss. METHODS: A population of 118 obese patients were analyzed. Patients were randomly allocated to two groups: (a) Diet I (low carbohydrate) and (b) Diet II (low fat). Biochemical and anthropometric parameters were measured before and after 3 months of hypocaloric diet. RESULTS: Fifty-two patients (12 male/40 female) were treated with Diet I and 66 patients (21 male/45 female) with Diet II. In Group I, basal GLP-1 levels did not change after dietary treatment (9.4+/-3.3 vs. 9.9+/-3.1 ng/ml; ns). In Group II, GLP-1 levels decreased significantly (8.4%) (9.2+/-3.3 vs 8.7+/-3.1 ng/ml; P<.05). In the multivariate analysis with a dependent variable (levels of GLP-1), only insulin levels remained as an independent predictor in the model (F=5.9; P<.05), with an increase of 0.6 ng/ml (95% CI 0.1-1.1) GLP-1 concentrations with each increase of 1 mUI/ml of insulin. CONCLUSION: A hypocaloric diet with a low fat percentage decreased GLP-1 levels with a direct correlation with insulin levels. Nevertheless, patients with a hypocaloric diet with a low carbohydrate percentage treatment did not change GLP-1 levels. Diet macronutrient manipulation on GLP-1 response could be useful in an obesity nutrition therapy.

Influence of Ala54Thr polymorphism of fatty acid-binding protein-2 on clinical results of biliopancreatic diversion.

OBJECTIVE: Bariatric surgery is the most effective long-term treatment for morbid obesity, reducing obesity-associated comorbidities. The purpose of the present study was to evaluate the fatty acid-binding protein-2 Ala54Thr polymorphism outcomes 1 y after biliopancreatic diversion in morbidly obese patients. METHODS: A sample of 41 morbidly obese patients (body mass index >40 kg/m(2)) were operated upon from December 2004 to December 2006. Weight, fat mass, blood pressure, basal glucose, triacylglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured at the basal visit and at each visit. The frequency of patients with diabetes mellitus, hypertension, and hyperlipidemia was recorded at each visit. RESULTS: Twenty-three patients (56.1%) had genotype Ala54/Ala54 (wild group) and 18 patients had genotype Ala54/Thr54 (15 patients, 36.5%) or Thr54/Thr54 (3 patients, 7.4%; mutant group). In the wild group, body mass index, weight, fat mass, systolic blood pressure, glucose, total cholesterol, low-density lipoprotein cholesterol, and triacylglycerol concentrations decreased. Diastolic blood pressure remained unchanged. In the mutant group, the same parameters improved, without statistical differences from the wild group. Initial excess weight percent loss at 1 y of follow-up was similar in both genotype groups (61.8% versus 61.9%, NS). CONCLUSION: Polymorphism Ala54Thr of fatty acid-binding protein did not have an effect on weight loss or clinical outcomes after bariatric surgery.

Changes of ghrelin and leptin in response to hypocaloric diet in obese patients.

OBJECTIVE: Hypocaloric diet-induced weight loss produces a coordinated decrease in plasma leptin levels and an increase in plasma ghrelin levels. The aim of the present study was to determine whether subjects who lose significant weight experience changes in circulating ghrelin and leptin levels. METHODS: A population of 66 obese patients was analyzed. Leptin, active ghrelin blood levels, and other cardiovascular risk factors were measured before and after 3 mo of a hypocaloric diet. RESULTS: Sixty-six patients (17 male, 49 female) gave informed consent and were enrolled in the study. Forty-six patients did not lose 5% of initial weight (group I, weight loss 1.4 +/- 2.5 kg) and 20 patients lost weight (>5% of initial weight; group II, weight loss 7.1 +/- 2.6 kg). In group I, active ghrelin levels increased (7.40 +/- 8 versus 19.40 +/- 32 pg/mL, P < 0.05) and leptin levels decreased (102.6 +/- 86 versus 89.30 +/- 76 ng/mL, P < 0.05). In group II, leptin levels also decreased significantly (69.80 +/- 67 versus 53.50 +/- 59 ng/mL, P < 0.05). Active ghrelin in this group did not show differences (24.20 +/- 41 versus 10.30 +/- 12 pg/mL, NS). In the multivariate analysis with a dependent variable (change in active ghrelin levels, pg/ml) in group II adjusted by age and sex, only basal fat mass and basal intake of protein remained in the model. In the multivariate analysis with a dependent variable (change in leptin levels, pg/ml) in group II adjusted by age and sex, only basal fat mass and BMI remained in the model. CONCLUSION: Patients with weight loss secondary to a hypocaloric diet did not change active ghrelin levels and decreased leptin levels after treatment.