Abstract

Skin barrier function is often deficient in obese individuals, but the underlying molecular mechanisms remain unclear. This study investigated how skin structure and lipid metabolism, factors strongly associated with barrier function, differed among 50 Japanese women of greatly varying body mass index (BMI). Subjects receiving breast reconstruction surgery were chosen for analysis to obtain skin samples from the same site. The subjects were classified into two groups, control (BMI < 25 kg/m2) and obese (25 kg/m2 ≤ BMI < 35 kg/m2), according to standards in Japan. Hematoxylin and eosin staining was used to assess skin thickness, Ki-67 immunostaining to examine keratinocyte proliferation, and real-time polymerase chain reaction to measure skin expression levels of genes associated with lipid metabolism. Total lipids, cholesterol, and fatty acids were also measured from these same skin samples. In the obese group, structural changes included epidermal thickening and an increase in the number of Ki-67-positive (proliferating) cells. Both skin cholesterol and fatty acid levels exhibited an “inverted-U” relationship with BMI, suggesting that there is an optimal BMI for peak lipid content and barrier function. Decreased lipid levels at higher BMI were accompanied by downregulated expression of PPARδ and other genes related to lipid metabolism, including those encoding acetyl-CoA carboxylase and HMG-CoA reductase, the rate-limiting enzymes for fatty acid and cholesterol synthesis, respectively. Thus, elevated BMI may lead to deficient skin barrier function by suppressing local lipid synthesis.

Highlights

  • Obesity is a risk factor for skin disorders[1], including skin diseases characterized by barrier dysfunction such as psoriasis[2] and atopic dermatitis[3]

  • To investigate the underlying mechanisms contributing to these body mass index (BMI)-dependent changes in skin lipid concentrations, we evaluated the expression levels of genes related to lipid metabolism (Table 2)

  • Our study suggests that these skin lipid reductions are mediated by decreased expression levels of multiple genes related to lipid metabolism, including the rate-limiting enzymes for fatty acid and cholesterol synthesis

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Summary

Introduction

Obesity is a risk factor for skin disorders[1], including skin diseases characterized by barrier dysfunction such as psoriasis[2] and atopic dermatitis[3]. Transepidermal water loss (TEWL), an indicator of skin barrier function, has been reported to change in obese individuals[4, 5]. Skin structure and lipid content are critical determinants of skin barrier permeability [6]. Lipid levels affect TEWL and the risk of skin barrier disruption[7,8,9,10]. Histological changes, including epidermal thickening and keratinocyte proliferation, occur during skin barrier impairment[8, 11, 12]. The influence of obesity on these characteristics of barrier dysfunction has not been examined

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