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

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

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

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

Polymorphism of neuropeptide Y gene rs16147 modifies the response to a hypocaloric diet on cardiovascular risk biomarkers and adipokines.

BACKGROUND: The main genetic variant described in NPY gene is rs16147 (G-399A) and it is located within the promoter region upstream of the gene for neropeptide Y (NPY). We evaluate the effects of the rs16147 NPY gene polymorphism on metabolic changes secondary to weight loss after 3 months of a hypocaloric diet in adult obese patients. METHODS: A population of 82 obese patients was analysed in an interventional design of one arm. Before and after 3 months on a hypocaloric diet, an anthropometric evaluation, an assessment of nutritional intake and a biochemical analysis were performed. The statistical analysis was performed for combined GA and AA as a group (minor allele group) and GG as second group (major allele group) (dominant model). RESULTS: In A allele carriers, the mean (SD) decrease in weight was -2.8 (2.2) kg [decrease in non A allele carriers -2.6 (1.1) kg, P > 0.05), body mass index was -1.2 (0.6) kg m-2 [decrease in non A allele carriers -1.1 (0.8) kg m-2 , P > 0.05], fat mass was -1.7 (1.4) kg [decrease in non A allele carriers -1.9 (1.3) kg, P > 0.05], waist circumference was -5.5 (3.4) cm [decrease in non A allele carriers -3.7 (4.1) cm, P = 0.006], C-reactive protein (CRP) was -0.7 (0.6) mg dL-1 [decrease in non A allele carriers -0.1 (0.3) mg dL-1 , P = 0.02], insulin was -1.5 (0.4) mUI L-1 [decrease in non A allele carriers -0.8 (2.0) mUI L-1 , P = 0.001] and homeostasis model assessment-insulin resistance (HOMA-IR) was -0.4 (0.5) [decrease in non A allele carriers -0.2 (0.1), P = 0.005]. interleukin (IL)-6 changes were significant in A allele carriers [-0.7 (0.2) pg mL-1 ] versus non A allele carriers [-0.1 (0.3) pg mL-1 ] (P = 0.01). CONCLUSIONS: We found that the rs164147 genotype affected the reduction of waist circumference, HOMA-IR, insulin, CRP and IL-6 levels in response to weight loss diet in obese subjects.

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.

Effect of Lys656Asn Polymorphism of Leptin Receptor Gene on Cardiovascular Risk Factors and Serum Adipokine Levels after a High Polyunsaturated Fat Diet in Obese Patients.

BACKGROUND: Human obesity is characterized by high levels of leptin, and leptin levels may change with weight loss and dietary restriction. The aim of our study was to investigate the influence of Lys656Asn polymorphism in the leptin receptor gene on cardiovascular risk factors, weight loss, and serum leptin levels to a high polyunsaturated fatty acid (PUFA) hypocaloric diet in obese patients. DESIGN: A sample of 132 obese patients was analyzed in a prospective way with a dietary intervention. The enriched PUFAs hypocaloric intervention consisted in a diet of 1,459 kcal, 45.7% of carbohydrates, 34.4% of lipids, and 19.9% of proteins. RESULTS: In wild-type group, BMI (-1.9 ± 1.4 kg/m(2) ), weight (-4.4 ± 3.2 kg), fat mass (-4.2 ± 3.8 kg), waist circumference (-4.1 ± 3.1 cm), systolic blood pressure (-7.0 ± 12.1 mmHg), diastolic blood pressure (-3.9 ± 6.8 mmHg), insulin (-1.8 ± 5.6 MUI/l) and HOMA-IR (-0.5 ± 1.5 Units) decreased. In mutant genotype group, BMI (-2.0 ± 2.1 kg/m(2) ), weight (-3.6 ± 4.1 kg), waist circumference (-3.1 ± 4.1 cm), total cholesterol (-25.2 ± 19.6 mg/dl), LDL cholesterol (-16.6 ± 25.6 mg/dl), and tryglicerides (-26.6 ± 39.1 mg/dl) decreased. Only leptin levels have a significant decrease in wild genotype group (-6.6 ± 10.2 ng/ml) (25.1%). CONCLUSION: Carriers of ASn656 allele have a different response than wild-type obese, with a lack of decrease in insulin levels, leptin levels, and HOMA-IR. However, obese patients with this mutant allele have a better lipid profile after weight loss.

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

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

Lack of association between serum apelin levels and sarcopenia in elderly malnourished subjects.

OBJECTIVE: Sarcopenia is a condition characterized by muscle mass loss. Skeletal muscle is capable of producing and secreting different molecules called myokines, and apelin is one of them. The literature contains contradictory data on the relationship between apelin and sarcopenia. We decided to investigate the role of apelin in sarcopenia in subjects with disease-related malnutrition (DRM), a group of patients with a high rate of sarcopenia. PATIENTS AND METHODS: 83 elderly patients with DRM assessed according to the Global Leadership Initiative on Malnutrition (GLIM) criteria were included in the study, with a mean age of 69.9±3.8 years. Anthropometric data, muscle mass by ultrasound at the rectus femoris quadriceps (RFQ) level, bioimpedance [skeletal muscle mass (SMM), appendicular SMM (aSMM) and aSMM index (aSMMI)], dynamometry, biochemical parameters, dietary intake, circulating apelin levels were determined in all patients. RESULTS: a total of 33 patients (37.9%) were diagnosed with sarcopenia, while 54 patients did not present sarcopenia (60.1%). Body weight (-5.5±2.0 kg, p=0.01), calf circumference (-1.9±0.2 cm, p=0.02), phase angle (-0.6±0.2º, p=0.01), reactance (-6.8±2.3 Ohms, p=0.03), resistance (-38.8±12.3 Ohms, p=0.04), SMM (-2.2±0.3 kg, p=0.04), aSMM (-2.2±0.2 kg, p=0.03) and aSMMI (-0.6±0.2 kg, p=0.02), dominant muscle area (-0.6±0.2 cm2, p=0.04), dominant Y axis (-0.4±0.1 cm, p=0.03), dominant X/Y axis (1.1±0.3 cm, p=0.04), strength (-5.1±1.3 kg, p=0.01), albumin (-0.9±0.1 g/dl, p=0.02) and prealbumin (-4.6±0.7 mg/dl, p=0.02) were worse in patients with sarcopenia than non-sarcopenic patients. Circulating apelin levels were similar in both groups. No significant correlation of apelin levels was detected, either with bioimpedance data or with muscle ultrasonography data. The multivariant analysis did not detect a significant association of apelin with the presence of sarcopenia. CONCLUSIONS: Our study shows a lack of association between apelin and sarcopenia in elderly malnourished patients.

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

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

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

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

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

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

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

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

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

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

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

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

Resistin levels in morbid obese patients following the biliopancreatic diversion surgery.

Previous studies addressing the changes of resistin concentrations in morbidly obese patients after bariatric surgery have yielded conflicting results. The purpose of the present study was to investigate the changes in serum resistin levels 1 year after biliopancreatic diversion in morbidly obese patients without diabetes mellitus. A cohort of 39 morbidly obese patients without diabetes mellitus was operated. Biochemical and anthropometric evaluation were realized at basal visit and at each visit. The frequency of patients with hypertension and hyperlipidemia was recorded at each visit. Overall the mean patient age was 44.8 ± 14.1, and the mean preoperative BMI was 47.3 ± 6.5 kg/m². After one year of surgery, a significant decrease was observed in BMI, weight, waist circumference, fat mass, blood pressure, total cholesterol, LDL cholesterol, and triglyceride levels. Resistin levels did not change after surgery (5.61 ± 1.93 ng/ml vs. 6.41 ± 3.58 ng/ml; ns). Correlation analysis showed a positive association between basal resistin and weight (r = 0.68, p < 0.01) and fat mass (r = 0.65, p < 0.05). Resistin concentrations did not change after massive weight loss with biliopancreatic diversion in morbid obese patients without diabetes mellitus.

Effect of a probiotic on liver aminotransferases in nonalcoholic fatty liver disease patients: a double blind randomized clinical trial.

OBJECTIVE: The present pilot trial was carried out to evaluate the effects of an acute treatment with a mixture containing 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus per day in patients with non alcoholic fatty liver disease (NAFLD). RESEARCH METHODS: A sample of 30 patients with NAFLD (diagnosed by liver biopsy) was enrolled and 28 patients were analyzed in a double blind randomized clinical trial. Patients were randomized to one of the following treatments during 3 months: group I, treated with one tablet per day with 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus and group II, treated with one placebo tablet (120 mg of starch). RESULTS: In group I, alanine amino transferase (ALT: 67.7 +/- 25.1 vs. 60.4 +/- 30.4 UI/L; p < 0.05), aspartate aminotransferase activity (AST: 41.3 +/- 15.5 vs. 35.6 +/- 10.4 UI/L; p < 0.05) and gammaglutamine transferase levels (gammaGT: 118.2 +/- 63.1 vs. 107.7 +/- 60.8 UI/L; p < 0.05) decreased. In group II, all liver function parameters remained unchanged (ALT: 60.7 +/- 32.1 vs. 64.8 +/- 35.5 UI/L; p < 0.05), aspartate aminotransferase activity (AST: 31.7 +/- 13.1 vs. 36.4 +/- 13.8 UI/L; ns) and gammaglutamine transferase levels (gammaGT: 82.1 +/- 55.1 vs. 83.6 +/- 65.3 UI/L; ns). Anthropometric parameters and cardiovascular risk factors remained unchanged after treatment in both groups. CONCLUSION: A tablet of 500 million of Lactobacillus bulgaricus and Streptococcus thermophilus, with a randomized clinical design, improved liver aminotransferases levels in patients with NAFLD.

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

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

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

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

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

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

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

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

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

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