Abstract
Objectives:Bariatric surgery provides most substantial and sustainable weight loss measures in individuals with obesity. Caloric restriction is not only intervention, changes in hormonal secretions are also leading contributory mechanisms to reduce body weight and improve the glycaemic control. The aim of this study was to evaluate the impact of gastric sleeve surgery on plasma retinol binding protein 4 (RBP4) and adipsin levels among Saudi male obese population.Methods:This prospective study was conducted in the Departments of Physiology and Surgery, College of Medicine, King Saud University. Thirty-three obese (BMI>38.3) male patients age ranged from 25 to 50 years were recruited. RBP4 and adipsin levels were analyzed before and 6-12 months after gastric sleeve surgery by ELISA along with plasma glucose, insulin, HOMA-IR and lipid profile.Results:Circulating RBP4 levels were not significantly changed by bariatric surgery (4382.85±40.35 ng before, and 4393.28±33.13 ng after surgery, p=0.842), neither did adipsin (2949.68±46.86 pg before, and 2917.90±41.90 pg after surgery, p=0.535). Segregation of study participants into two age groups, 25-35 and 35-50 years of age, revealed that before surgery older age group (35-50) had higher RBP4 levels compared to younger group (25-35) (p=0.016). However, after surgery RBP4 levels were decreased in older group but not to a significant level (p=0.174). In younger age group after surgery, there was a near significant increase in RBP4 levels (p=0.052). There were no significant changes in RBP4 levels in both age groups after surgery (p=0.461). For adipsin, there were no significant differences before and after surgery in both age groups. Insulin, BMI and HOMA-IR index were decreased after surgery, however there was no correlation with RBP4 and adipsin levels.Conclusions:The present study findings do not suggest a role for RBP4 and adipsin in the improvement of insulin sensitivity in Saudi male obese population after gastric sleeve surgery. However, a decrease in RBP4 levels in older individuals after surgery needs further investigations to understand its effect on weight and glycemic control.
Highlights
Obesity is a major risk factor of noncommunicable diseases such as metabolic syndrome and diabetes mellitus.[1,2] Bariatric surgeries have been introduced as the most functioning long-term management of severely obese individuals compared with diet and exercise
There was no correlation between retinol binding protein 4 (RBP4) and adipsin levels with insulin and lipid parameters
Analysis of effect of age on RBP4 and adipsin levels before and after surgery: The study subjects were divided into two age groups, 25-35 and 35-50 years of age
Summary
Obesity is a major risk factor of noncommunicable diseases such as metabolic syndrome and diabetes mellitus.[1,2] Bariatric surgeries have been introduced as the most functioning long-term management of severely obese individuals compared with diet and exercise. Decreased gut size, minimized calorie intake and hormonal alterations are important mechanisms responsible for health improvement after bariatric surgery.[3]. Plasma retinol binding protein 4 (RBP4) is a protein that belongs to the lipocalin family and acts as a transporter protein for retinol (vitamin A), expressed in liver followed by visceral adipose tissue.[4] The expression of RBP4 is higher in obese individuals compared to lean controls which is linked to increased visceral adipose tissue content.[5] RPB4 levels were reduced after gastric banding surgery and associated with weight loss, lipid parameters, reduced waist-hip ratio and visceral fat.[6,7]
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