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Insulin resistance, leptin and TNF-alpha system in morbidly obese women after gastric bypass.
Obes Surg 2003; 13(4):615-21OS

Abstract

Obesity is a complex disease associated with insulin resistance. Leptin and the TNF-alpha system could be involved in the pathogenesis of obesity and insulin resistance. Gastric bypass (GBP) is a surgical treatment for morbidly obese patients. We conducted a study after GBP to analyze the pattern of variation of anthropometric and body composition variables, leptin and sTNFR1 and 2.

METHODS

29 morbidly obese women were studied, at baseline and throughout 6 months after gastric bypass.

RESULTS

At baseline, the BMI was 49 +/- 6 kg/m(2) and patients showed a higher fasting insulin resistance index (FIRI), leptin, leptin/fat mass and sTNFR1 and 2 than did controls. 6 months after GBP, BMI was 35+/-4, and FIRI, leptin and leptin/fat mass decreased significantly in the first months and throughout the follow-up. sTNFR1 and 2 showed an initial increase, but at 6 months their concentrations were similar to baseline (2.6+/-0.8 vs 3.1+/-0.95 ng/ml, P < 0.05; 4.6+/-1.4 vs 7+/-2.5 ng/ml, P < 0.05). At baseline, there was no correlation between leptin and BMI and body composition variables but there was a correlation with fat mass (r=0.42, P=0.004) and sTNFR1 (r=0.58, P=0.001). At 6 months, there was a correlation between leptin and BMI (r=0.53, P=0.004) and sTNFR1 (r=0.46, P=0.013).

CONCLUSIONS

Morbidly obese women after GBP became less insulin resistant with lower leptin concentrations, but showed an initial increase of sTNFR1 and 2. This pattern of variation of the leptin TNF-alpha axis suggests a disregulation of the system after dramatic weight loss and also that insulin and leptin up-regulate TNF-alpha production irrespective of insulin resistance status.

Authors+Show Affiliations

Department of Endocrinology, Prínceps d'Espanya Hospital, Barcelona, Spain. 30903xrc@comb.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12935365

Citation

Molina, Ana, et al. "Insulin Resistance, Leptin and TNF-alpha System in Morbidly Obese Women After Gastric Bypass." Obesity Surgery, vol. 13, no. 4, 2003, pp. 615-21.
Molina A, Vendrell J, Gutiérrez C, et al. Insulin resistance, leptin and TNF-alpha system in morbidly obese women after gastric bypass. Obes Surg. 2003;13(4):615-21.
Molina, A., Vendrell, J., Gutiérrez, C., Simón, I., Masdevall, C., Soler, J., & Gómez, J. M. (2003). Insulin resistance, leptin and TNF-alpha system in morbidly obese women after gastric bypass. Obesity Surgery, 13(4), pp. 615-21.
Molina A, et al. Insulin Resistance, Leptin and TNF-alpha System in Morbidly Obese Women After Gastric Bypass. Obes Surg. 2003;13(4):615-21. PubMed PMID: 12935365.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance, leptin and TNF-alpha system in morbidly obese women after gastric bypass. AU - Molina,Ana, AU - Vendrell,Joan, AU - Gutiérrez,Cristina, AU - Simón,Inmaculada, AU - Masdevall,C, AU - Soler,Juan, AU - Gómez,José Manuel, PY - 2003/8/26/pubmed PY - 2003/12/3/medline PY - 2003/8/26/entrez SP - 615 EP - 21 JF - Obesity surgery JO - Obes Surg VL - 13 IS - 4 N2 - UNLABELLED: Obesity is a complex disease associated with insulin resistance. Leptin and the TNF-alpha system could be involved in the pathogenesis of obesity and insulin resistance. Gastric bypass (GBP) is a surgical treatment for morbidly obese patients. We conducted a study after GBP to analyze the pattern of variation of anthropometric and body composition variables, leptin and sTNFR1 and 2. METHODS: 29 morbidly obese women were studied, at baseline and throughout 6 months after gastric bypass. RESULTS: At baseline, the BMI was 49 +/- 6 kg/m(2) and patients showed a higher fasting insulin resistance index (FIRI), leptin, leptin/fat mass and sTNFR1 and 2 than did controls. 6 months after GBP, BMI was 35+/-4, and FIRI, leptin and leptin/fat mass decreased significantly in the first months and throughout the follow-up. sTNFR1 and 2 showed an initial increase, but at 6 months their concentrations were similar to baseline (2.6+/-0.8 vs 3.1+/-0.95 ng/ml, P < 0.05; 4.6+/-1.4 vs 7+/-2.5 ng/ml, P < 0.05). At baseline, there was no correlation between leptin and BMI and body composition variables but there was a correlation with fat mass (r=0.42, P=0.004) and sTNFR1 (r=0.58, P=0.001). At 6 months, there was a correlation between leptin and BMI (r=0.53, P=0.004) and sTNFR1 (r=0.46, P=0.013). CONCLUSIONS: Morbidly obese women after GBP became less insulin resistant with lower leptin concentrations, but showed an initial increase of sTNFR1 and 2. This pattern of variation of the leptin TNF-alpha axis suggests a disregulation of the system after dramatic weight loss and also that insulin and leptin up-regulate TNF-alpha production irrespective of insulin resistance status. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/12935365/Insulin_resistance_leptin_and_TNF_alpha_system_in_morbidly_obese_women_after_gastric_bypass_ L2 - https://dx.doi.org/10.1381/096089203322190844 DB - PRIME DP - Unbound Medicine ER -