Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass.

Xabier Unamuno,Javier Gómez-Ambrosi,Gema Frühbeck,Victoria Catalán,Víctor Valentí,Beatriz Ramírez,Amaia Rodríguez,Sara Becerril,Piero Portincasa,Maitane Izaguirre,Javier Salvador,Camilo Silva,Rafael Moncada

doi:10.3390/nu11092069

Abstract

Bariatric surgery remains the most effective option for achieving important and sustained weight loss. We explored the effects of Roux-en-Y gastric bypass (RYGB) on the circulating levels of adiponectin, leptin, and the adiponectin/leptin (Adpn/Lep) ratio in patients with obesity and type 2 diabetes (T2D). Twenty-five T2D volunteers undergoing RYGB were included in the study, and further subclassified as patients that responded or not to RYBG, regarding remission of T2D. Anthropometric and biochemical variables were evaluated before and after RYGB. Obese patients with T2D exhibited an increase (p < 0.0001) in the Adpn/Lep ratio after RYGB. Changes in the Adpn/Lep ratio correlated better with changes in anthropometric data (p < 0.001) than with the variations of adiponectin or leptin alone. Multiple regression analysis revealed that the change in the Adpn/Lep ratio in patients with T2D was an independent predictor of the changes in body mass index (p < 0.001) and body fat percentage (p = 0.022). However, the Adpn/Lep ratio did not differ between individuals with or without T2D remission after RYGB. In summary, the current study demonstrated that after weight and body fat loss following RYGB, the Adpn/Lep ratio increased in patients with obesity and T2D.

Highlights

The prevalence of overweight and obesity is increasing worldwide, reaching epidemic proportions and emerging as a major public health challenge [1,2]
Together with an increase of adiponectin concentrations and a reduction in leptin levels, we aim to investigate the Adpn/Lep ratio in patients with type 2 diabetes (T2D) before and after weight loss achieved by bariatric surgery
We addressed whether the Adpn/Lep ratio differed between patients with T2D that responded or not to Roux-en-Y gastric bypass (RYGB) regarding remission of T2D

Summary

Introduction

The prevalence of overweight and obesity is increasing worldwide, reaching epidemic proportions and emerging as a major public health challenge [1,2]. Treatment options involve lifestyle interventions (caloric restriction, reduction of sedentary behaviors, and increased physical activity), pharmacotherapy as well as surgical procedures [5,6]. Conventional treatments have little effect on weight loss and are relatively inefficient in treating obesity in the long-term [7,8,9]. Bariatric surgery has rapidly expanded, due to its capacity to induce sustained long-term weight loss, ameliorate obesity-related comorbidities, and reduce mortality, constituting an effective option for individuals with severe obesity [6,10]

Objectives

Methods

Results

Discussion

Conclusion