Levels In Obese Patients Research Articles

The association between serum levels of TNF-α and IL-6 in schizophrenic patients and their metabolic status – A case control study

Introduction and objectivesAccording to immunological theory of schizophrenia, dysfunctions of the immune system are linked with the pathology of schizophrenia. Among cytokines, tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) seem to be correlated with psychopathology of schizophrenia. Both IL-6 and TNF-α are produced in the fat tissue by adipocytes. Thus, cytokine levels in obese patients are increased compared with healthy subjects. These metabolic underlying mechanisms may be an important confounding factor in the studies on cytokines levels in schizophrenia. The aim of this study was to evaluate how metabolic alterations affect peripheral IL-6 and TNF-α levels in schizophrenia patients. Materials and methodsThis was a case-control study, 30 schizophrenia patients were recruited in the study group and 30 healthy subjects were matched by sex and age. Serum levels of TNF-α and Il-6 were measured using ELISA test, together with detailed anthropometric, laboratory and body composition parameters (determined using bioelectric impedance analysis). Results and conclusionsSerum TNF-α concentration in the schizophrenia group was 6.05 ± 1.61 ng/mL and 5.94 ± 1.26 ng/mL in the control group. The difference between these two groups was not significant (p = .79). Serum IL-6 concentration in the schizophrenia group was 1.54 ± 1.46 ng/mL and in the control group 1.39 ± 1.39 ng/mL. Again, the difference was not significant (p = .51). We have analysed the relationship between anthropometric and metabolic variables and serum IL-6 and TNF-α concentrations. In conclusion, TNF-α was more sensitive to metabolic alterations compared with IL-6. This observation may be beneficial for further research on immune system in schizophrenia, indicating that studies of IL-6 and TNF-α should be controlled at least for major metabolic parameters (BMI, WHR).

Effects of Hypnotherapy on Weight Loss and thus on Serum Leptin, Adiponectin, and Irisin Levels in Obese Patients.

Objective: This study aimed to investigate effects of hypnotherapy on weight loss and thus on leptin, adiponectin (ADP), and irisin levels in obese patients who presented to the psychiatry outpatient clinic to participate in hypnotherapy sessions to develop a healthy and balanced diet. Methods: The study sample included 32 individuals with a body mass index (BMI) of ≥30 and who completed the 10-week hypnotherapy. First, the Personal Information Form was handed out to the participants and then each participant's weight (in the morning on an empty stomach) and height were measured and BMI was determined. Five-milliliter blood samples were drawn before the first session, and then irisin, leptin, and ADP levels were measured using the enzyme-linked immunosorbent assay method. Then, they participated in hypnotherapy sessions once a week for 10 weeks. At the end of the 10-week hypnotherapy, 5 mL of blood was taken again and the aforementioned biochemical analyses were performed. BMIs were measured again. Results: The mean BMI values of the patients were 33.43 ± 5.28 and 31.45 ± 4.98 at the beginning and end of the hypnotherapy sessions, respectively. Serum leptin, ADP, and irisin levels, which were 9.48 ± 5.48, 6.73 ± 3.27, and 1.43 ± 1.14, respectively, at the beginning of the hypnotherapy sessions, were 6.47 ± 2.69, 7.68 ± 3.34, and 1.53 ± 1.21, respectively, at the end of the hypnotherapy sessions. The results showed that BMI and serum leptin levels decreased significantly after the hypnotherapy sessions, whereas serum ADP and irisin levels increased significantly. Conclusions: This study indicates that hypnotherapy in obesity treatment leads to weight loss in obese patients and thus to considerable changes in leptin, ADP, and irisin levels. Hypnotherapy is easy to apply, cheap, and effective; has no potential for side effects; and can be applied both alone and in combination with other treatments. However, to confirm its effects, further studies should be conducted on this issue.

Plasma progranulin levels in obese patients before and after Roux-en-Y gastric bariatric surgery: a longitudinal study.

Bariatric surgery stands out as the most effective long-term intervention for sustainable weight loss and metabolic improvement in patients with severe obesity. Progranulin was recently identified as an adipokine related to obesity and inflammation, revealing a metabolic function and proinflammatory properties. To evaluate plasma progranulin levels before and after 6 months of bariatric surgery in Roux-en-Y gastric bypass (RYGB). Tertiary referral hospital, southern Brazil. This was a prospective longitudinal study, including 23 obese patients who underwent RYGB. Demographic and clinical characteristics, body composition, and resting energy expenditure were evaluated. Plasma progranulin was determined with enzyme-linked immunosorbent assays in a peripheral blood sample collected before and 6 months after the surgical procedure. The participants were mostly women (78.3%), with a mean age of 42.3 ± 10.8 years and baseline body mass index of 48.8 ± 10.4 kg/m2. Regarding the anthropometric parameters, there were differences in the pre- and post-RYGB values, with reduction of weight, body mass index, body fat percentage, and cervical and abdominal circumferences. All laboratory parameters improved, such as lipid profile and fasting glycemia, and resting energy expenditure values decreased significantly. Plasma progranulin levels decreased from 47.6 ± 13.5 ng/mL before RYGB to 40.4 ± 9.9 ng/mL after 6 months of surgery (P = .005). The reduction of progranulin did not correlate with body composition or laboratory data. Plasma progranulin levels significantly reduced 6 months after RYGB, but it could not be explained by changes in anthropometry, body composition, or glycemic or lipid profile.

The effect of nutrition and exercise training on irisin and semaphorin-3E levels in obese patients

We aimed to firstly examine the effects of nutrition and exercise training on irisin, Sema-3E, biochemical and inflammatory parameters in obese patients. This study was conducted using 37 individuals were divided into three groups according to body mass index (BMI) as non-obese, 1nd degree and 2nd degree obese individuals. Nutrition and exercise training were applied to groups for eight weeks. Insulin resistance decreased in non-obese and 1st degree obese subjects. HsCRP values decreased only in the second degree obese individuals. Adiponectin values were significantly decreased in all three groups. There was a negative correlation between serum adiponectin and plasma irisin levels both before and after treatment. Sema-3E levels increased significantly in only the first degree obese individuals, whereas plexin-D1 values did not change significantly in any group. Our findings indicate that nutrition and exercise training we apply improved both anthropometric measurements and biochemical parameters in obese and non-obese individuals.

2314-PUB: The Uric Acid Is Differentiated by Thyroid Hormones Levels in Obese Patients with Acanthosis Nigricans

Purpose: To investigate the serum levels of uric acid (UA) in obese acanthosis nigricans (AN) patients with different thyroid hormones (THs) levels within the normal range. Methods: We investigated 834 obese patients (385 females and 449 males) with euthyroid function in the department of endocrinology of shanghai 10th people’s hospital from 2011 to 2019 with the median age of 29 years (interquartile range 22-36 years) for this study. 343 patients were diagnosed of AN. The cut-offs for thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were 2mIU/L, 16mIU/L and 5mIU/L, respectively. Results: In male obese patients, AN patients with high TSH and FT4 had higher levels of UA compared to those with high TSH and low FT4 (523.20±120.98 vs. 477.56±86.92umol/L, P=0.036) and showed a correlation with fasting C-peptide (FCP) (r=0.330, P=0.029). The TSH, FT3, and FT4 alone did not showed any predictive value in male patients. In female patients, high FT3 was associated with higher levels of UA (388.47±100.95 vs. 366.33±82.40umol/L, P=0.019). However, the predictive value of FT3 in female was obtained only in low TSH subgroup (low TSH+ high FT3 vs. low TSH+ low FT3, P=0.033) not in high TSH patients. The levels of fasting insulin, 2h-insulin, FCP, 2h C-peptide, total cholesterol, triglyceride and testosterone were in correlation with higher UA levels in female obese patients with low TSH and high FT3(all P<0.05). Conclusion: The metabolic characteristics of UA are found to differ in obese patients with euthyroid function, in which AN plays an important role for male obese patients with high TSH and high FT4. But in the case of female, a combination of THs instead of AN showed it’s unique in UA metabolism. Disclosure J. Zhang: None. G. Li: None. X. Cheng: None. X. Wang: None. M. Jayachandran: None. Y. Huang: None. S. Qu: None. Funding National Key Research and Development Program of China (2018YFC1314100); National Natural Science Foundation of China (81970677); Shanghai Pujiang Program (2019PJD040); Effect of ApoC3 High Expression on Islet Cells and Related Molecular Mechanism (03.05.18.002)

Overweight-obesity is associated with decreased vitamin K2 levels in hemodialysis patients

Obesity is an important risk factor for morbidity and mortality. Vitamin K2 is involved in the production of bone and matrix amino acid g-carboxy-glutamic acid (Gla) proteins (vitamin K-dependent proteins [VKDPs]), regulating bone and vascular calcification (VC). Bone Gla protein (BGP) is involved both in bone mineralization and VCs. We assessed the relationships between vitamin K levels and body mass index (BMI) according to the hypothesis that the impact of BMI on mortality is partly driven by low vitamin K levels. The Vitamin K Italian (VIKI) study included 387 hemodialysis patients from 18 dialysis centers in Italy. We determined plasma levels of bone markers: vitamin K levels, VKDPs, vitamin 25(OH)D, alkaline phosphatase (ALP), parathyroid hormone (PTH), calcium (Ca), phosphorus (P) and routine biochemistry. BMI was classified into the following categories: underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 25 kg/m2), overweight (25 ≤ BMI < 30 kg/m2) and obese (BMI ≥ 30 kg/m2). 45.2% of patients were overweight or obese. Stratification by BMI demonstrated lower median menaquinone-7 (MK7)/triglycerides levels in obese patients (0.42 ng/mg [0.19, 0.87], p = 0.005). BGP levels were lower in overweight and obese patients (152 mcg/L [83.2, 251] and 104 mcg/L [62.7, 230], p = <0.001). Furthermore, there was an inverse correlation between MK7/triglycerides levels and BMI (regression coefficient β = -0.159; p = 0.003). In multiple linear regression, there was an inverse relationship between BGP levels and BMI (β = - 0.119; p = 0.012). These data are the first to report an inverse relationship between Vitamin K2 levels and BMI in hemodialysis patients. Further studies are needed to confirm these findings and to determine if lower levels of Vitamin K are related to greater morbidity and mortality in this at-risk population.

MON-605 Serum CD163, but Not Gal-3, Predicts Response to Liraglutide Therapy in Obese Patients

Liraglutide is a GLP-1 Receptor Agonist licensed to treat T2DM and obesity. Soluble CD163 (sCD163) is a marker of macrophage activation, the integral immunological component in inflammation associated with obesity. Gal-3 is a β-galactoside-binding lectin that has been implicated in the development of cardiovascular diseases and insulin resistance. Recent studies have suggested that Gal-3 is raised in obesity with levels correlating with markers of inflammation.In this study, we aim to elucidate if the levels of sCD163 and Gal-3 can be used to predict treatment outcomes of Liraglutide in obese patients.Thirty-four obese patients (58.8% female; 44.1% diabetic) were enrolled for 12-week Liraglutide therapy. Anthropometric parameters were assessed before and after. Serum levels for sCD163 and Gal-3 were measured using ELISA.Pre-treatment age (mean ± SD) was 52.41 ± 10.74y, BMI was 44.97±7.71 kg/m2, HbA1c was 47.18±15.96 mmol/mol, sCD163 was 284059.20 ± 71859.88 pg/ml and Gal-3 was 6584.83 ± 3477.59 pg/ml. Post-treatment, BMI reduced to 43.19±7.92 kg/m2 (p < 0.001), HbA1c to 43.59±16.00 mmol/mol (p<0.001), sCD163 to 249130.45 ± 57972.85 pg/ml (p<0.001) and Gal-3 to to 6254.23 ± 3282.66 pg/ml (p<0.03). We found that pre-treatment sCD163 levels correlate weakly with BMI and HbA1c (r=0.3 & 0.4) while Gal-3 correlates moderately with age only (r=0.36). Percentage of changes in HbA1c (∆HbA1c) correlates strongly with ∆sCD163 (r=0.6). Levels of pre-treatment sCD163 correlates strongly with higher ∆sCD163 (r=0.7). Changes in BMI post-treatment (∆BMI) is negatively correlated with initial sCD163 levels (r=-0.3) and is not correlated with ∆sCD163.Liraglutide treatment leads to significant improvement in sCD163 and Gal-3 levels in obese patients. Patients with high HbA1c have high levels of sCD163. Reduction in sCD163 predicts reduction in HbA1c. Higher initial sCD163 levels predicts poor weight improvement. Patients most likely to have reduction in sCD163 are the ones with higher initial sCD163 levels. We conclude that sCD163 but not Gal-3 levels can predict response to liraglutide in obese patients.

Modulation of Epidermal γδ T Cell Functionality by Obesity due to Acute versus Chronic TNF-α Reception

Abstract Epidermal γδ T cells exhibit functional plasticity with roles varying from wound healing to tumor cell lysis. Activation of epidermal γδ T cells occurs via the γδ TCR along with costimulation, suggesting that costimulatory ligand expression regulates functional outcome. Data from our lab indicates that the cytokine milieu adds an additional pressure on epidermal γδ T cells to mediate or inhibit a particular functionality. Previous work from our lab shows that obesity impairs epidermal γδ T cell wound repair function in a TNF-α dependent manner. Here we identify TNF-α as a modulator of epidermal γδ T cell function in wound repair or cellular lysis depending on reception of acute or chronic signals. TNF-α signals through two receptors, tumor necrosis factor receptor 1 and 2 (TNFR1 and TNFR2), thus the signaling dynamics are complex and induce varied responses including apoptosis, survival and inflammation. We show that epidermal γδ T cells exhibit low TNFR1 and TNFR2 expression prior to TCR activation. Even with low TNFR expression epidermal γδ T cells produce cytokines and chemokines involved in inflammation and macrophage recruitment in response to acute TNF-α signals without TCR activation. During TCR activation or IL-2 stimulation epidermal γδ T cells to upregulate TNFR2 indicating a reliance on TNFR2 signaling during activation. Alternatively, chronic TNF-α stimulation, similar to levels in obese patients, induces a reduction in epidermal γδ T cell cytotoxicity, proliferation and viability. Normal function is restored with IL-2 addition suggesting the inhibition is not permanent, but instead can be modulated. These studies provide potential targets for regulating epidermal γδ T cell functions such as wound repair and tumor lysis.

Alexithymia and obesity: controversial findings from a multimethod assessment.

The aim of the study is to assess alexithymia levels in obese patients using a multimethod measurement (TAS-20 and TSIA) to evaluate both possible differences between the two instruments and their relationship with body weight. 54 obese patients, seeking surgical treatment, were enrolled. They completed a socio-demographic questionnaire, 20-items Toronto Alexithymia Scale and the Toronto Structured Interview for Alexithymia. Data analysis showed a significant positive association between TAS-20 and TSIA total scores (r=.28, p<.05), but only the TSIA score was positively related to body weight (r=.39; p<.001). Multivariable linear regression models showed the predictive effects of TSIA total score (beta=.41; p<.001) and difficulty in identifying feelings (DIF) (beta=.56; p<.001) respectively on weight. The findings showed a different association between body weight and alexithymia according to the instrument employed to evaluate alexithymia, supporting the importance of a multimethod assessment in some clinical conditions.

The Effect of Laparoscopic Sleeve Gastrectomy on Serum Thyroid-Stimulating Hormone Levels in Obese Patients with Overt and Subclinical Hypothyroidism: a 7-Year Retrospective Study.

Inconsistent results were reported by several studies that evaluated the effect of weight loss induced by bariatric surgery on thyroid function panel. This study is aimed at evaluating this effect on thyroid-stimulating hormone (TSH) and thyroid hormone replacement dosages in obese population with overt and subclinical hypothyroidism (SH). A retrospective study was performed on all morbidly obese patients with previous diagnosis of overt and subclinical hypothyroidism who underwent laparoscopic sleeve gastrectomy from October 2009 to January 2017. The correlation between TSH and body mass index (BMI) and the effect of weight loss induced by bariatric surgery on TSH were investigated. The prevalence of overt and SH in morbidly obese patients was 10.8% and 7.2%, respectively. Thirty-six hypothyroid patients and 67 subclinically hypothyroid patients were included in the study. Hypothyroidism improved in 44.5% of patients and completely resolved in 22.2%, and 33.3% experienced no change. Ninety-one percent of SH patients completely resolved, 6% improved, but 3% worsened, with one patient developed hypothyroidism. Both groups achieved a significant decrease in postoperative BMI. A positively statistically significant association was found between BMI and TSH (p < 0.005). Our results favor the effect of laparoscopic sleeve gastrectomy in the obese population with overt and SH as shown by the majority of SH resolution and overt hypothyroidism improvement.

Bariatric surgery results in restoration of physiological plasma levels of pentraxine-3.

Pentraxine-3 (PTX3) is a member of the humoral innate immune system and serves a role in protection against infections, inflammation control and matrix deposition. The aim of the present study was to measure the PTX3 levels in obese patients and its association with glycemic and lipid profiles, and to analyze the effects of weight loss provided by bariatric surgery in serum PTX3 levels. PTX3 was measured in 84 obese patients whom underwent bariatric surgery and 94 healthy controls. Lipid and glycemic profiles were determined using a clinical chemistry analyzer, and PTX3 levels were measured in patients prior to and following bariatric surgery using ELISA. PTX3 levels prior to surgery were significantly lower compared with the normal controls (median of 0.10 vs. 0.80 ng/ml; P<0.0001). Following surgery, the median weight loss was 33.1 kg, and the median PTX3 levels were significantly increased to 1.45 ng/ml compared with pre-surgery levels (P<0.001) and did not differ significantly from the control group levels (P=0.10). There were no correlations between PTX3 levels and total cholesterol, HDL and LDL, fasting glycemia, HbA1c and basal insulin levels. A significant positive correlation was observed between PTX3 levels and triglycerides levels in the post-operative period (ρ=0.26, P=0.01). In conclusion, obese patients had lower levels of PTX3 compared with the control patients, and the levels were restored to physiological levels following bariatric surgery which may be associated with the weight loss.

Impacts of Different Modes of Bariatric Surgery on Plasma Levels of Hepassocin in Patients with Diabetes Mellitus

Background: Hepassocin is a liver-derived protein and its serum concentrations significantly increase in diabetes and fatty liver patients. Hepassocin is also a biomarker for diabetes and fatty liver; therefore, we aimed to investigate the impacts of different types of bariatric surgery on hepassocin plasma levels in obese patients with diabetes, and to determine if hepassocin could be a potential new marker for monitoring the effects of bariatric surgery and a treatment target. Methods: Overall, 12 patients undergoing gastric bypass (GB), 10 patients undergoing sleeve gastrectomy (SG) and 11 patients undergoing duodeno-jejunal bypass with sleeve gastrectomy (DJB-SG) were enrolled. Fasting hepassocin levels were measured at baseline, three, 12, and 24 months after surgery. Results: All the three groups significantly decreased their body mass index, waist-to-hip ratio, a body shape index (ABSI), triglycerides, fasting blood sugar, hemoglobin A1c, C-peptide levels and homeostasis model assessment of insulin resistance 24 months after surgery. There were no significant changes in hepassocin levels, even 24 months after the three surgeries. Hepassocin had a significant negative relationship with the ABSI (p&lt; 0.001) 24 months after the SG. Conclusions: Neither GB, SG, nor DJB-SG altered plasma hepassocin levels in diabetic patients up to 24 months after surgery. The use of hepassocin in clinical settings requires more investigation.

Uric acid level changes after bariatric surgery in obese subjects with type 2 diabetes mellitus.

The purpose of the study was to investigate the incidence of hyperuricemia (HU) in obese subjects with type 2 diabetes mellitus (T2DM) before and after Roux-en-Y gastric bypass (RYGB), to describe the impact of this therapy in reducing uric acid levels, and its possible mechanism. This study was performed by cooperation with the First affiliated hospital of Soochow University and the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, department of general surgery. A retrospective study was performed. From February 2015 to December 2017, we evaluated 147 obese patients with T2DM. Blood samples and other clinical data were drawn before and postoperative (1, 3, 6, 12 months after RYGB). All obese patients with T2DM underwent laparoscopic Roux-en-Y gastric bypass surgery (LRYGB). Different gender with HU were compared before and after surgery. A total of 147 patients received LRYGB (75 were female, 72 were male), and 48 patients with HU (22 were female, 26 were male). Four women and 2 men were lost to follow-up, they were excepted from this study. No patients with HU lost to follow-up. There's an intuitive downward trend about uric acid levels both in men and women, with men from 497.9 µmol/L before surgery to 371.5 µmol/L 1 year after surgery, P=0.000; women from 432.3 to 354.1 µmol/L, P=0.002. The proportion of HU changed with men from 37.1% (26/70) before surgery to 12.9% (9/70) one year after surgery, women from 31.0% (22/71) to 14.1% (10/71). The results of binary logistic regression analysis confirmed that triglycerides were clinical predictors for HU remission (P=0.004). No major late surgical complications were reported. Our data showed that, bariatric surgery was effective to decrease the levels of serum uric acid (SUA) in obese patients with T2DM. Compared with traditional drug treatment, this shows a possible treatment of HU by RYGB. The remission of HU was associated with the decreased triglyceride levels in obese patients with T2DM, independent of BMI. The potential role of triglycerides in the remission of HU merits further study.

Magnesium and vitamin B2 status of children with bronchial asthma and obesity

Insufficiency or deficiency of some micronutrients may be additional modifying factors that influence the pathogenesis of the disease and the effectiveness of standard pharmacotherapy. The aim of the study - to evaluate the level of magnesium and vitamin B2 in blood serum of patients with bronchial asthma and obesity in order to develop methods for individual correction of deficiency. Material and methods. The study included 51 children aged 12-17 years. The first group included 23 patients (12 girls and 11 boys) with asthma with comorbidities (obesity), and the second group consisted of 28 children (10 girls and 18 boys) with obesity. The concentration of magnesium in blood serum was determined by a colorimetric method without deproteinization, and vitamin B2 - by an immunological microbiological method. Results and discussion. When analyzing the concentration of magnesium in blood serum of the examined children, it was found that in patients with bronchial asthma and obesity, a reduced content of this mineral was observed in 15 (65.2%) patients. The average magnesium concentration was 0.66±0.02 mmol/l at a rate of 0.7-1.2 mmol/l. A statistically significant decrease in the magnesium level in children suffering from asthma and obesity was noted, compared with the level in children with obesity (0.66 [0.57; 0.73] vs 0.71 [0.67; 0.73] mmol/l, р<0.05). Low serum magnesium levels in obese patients were detected more rarely (р<0.05) - only in 6 (21.4%) children, mostly in patients with grade III obesity. The remaining 22 (78.6%) children had magnesium level within the normal range. Patients with low serum magnesium levels showed increased irritability, sleep disturbance, loss of memory and concentration. Vitamin B2 levels in all examined children were within the normal range (137-370 ng/ml). Conclusion. The results indicate a decrease in the concentration of magnesium and normal levels of vitamin B2 in serum in patients with bronchial asthma and obesity. Low serum magnesium levels were observed in children with low bronchial asthma control. To increase the effectiveness of therapy and control the symptoms of bronchial asthma, especially when combined with obesity, correction of the accompanying magnesium deficiency is necessary.

The Role of Visceral Adiposity Index Levels in Predicting the Presence of Metabolic Syndrome and Insulin Resistance in Overweight and Obese Patients.

Background: To investigate visceral adiposity index (VAI) levels in obese patients with and without metabolic syndrome (MetS) and its relationship with insulin resistance (IR), and define cutoff value of VAI in the determination of patients with MetS and IR. Methods: Aged between 18 and 65, 92 patients with obesity were included. Levels of homeostasis model assessment of IR (HOMA-IR) and VAI were calculated. Results: Of 92 patients, HOMA-IR and VAI levels (P < 0.001 and P < 0.001, respectively) were found to be higher in 41 (44.6%) with MetS. The cutoff value of VAI in predicting MetS was found to be 2.205. The frequency of MetS was seen as 22.2% when VAI was below this value, but if over, was found to be 66%. There was a positive correlation between VAI and HOMA-IR levels. In 36 cases (39.1%) with HOMA-IR (≥2.5), VAI was detected to be higher than those without IR, and high-density lipoprotein-cholesterol levels were lower. The cutoff value of VAI in predicting IR was found to be 2.31. While the prevalence of IR was 23.4% in those with VAI of 2.31, IR frequency in patients with equal to or greater than 2.31 was determined as 55%. Conclusion: We found that MetS was present in almost half of overweight and obese individuals, and the cutoff values of VAI in predicting the presence of MetS and IR were 2.205 and 2.31, respectively. Our study was carried out in overweight and obese Turkish individuals, and we consider that further studies including normal weight individuals and larger population are required.

HUBUNGAN LINGKAR PINGGANG DENGAN KEJADIAN DIABETES MELLITUS PADA PASIEN USIA 30 SAMPAI 50 TAHUN DI PUSKESMAS KOTA MATSUM MEDAN

The purpose of this study was to identify blood sugar levels in obese patients in the Matsum City Public Health Center Medan and to analyze the relationship between waist circumference and the incidence of type 2 diabetes mellitus in patients at the Matsum City Public Health Center in Medan. This research was conducted by analytic survey with a Cross Sectional design where all data concerning research variables were collected by approaching, observing or collecting data at a time. The sample used was 69 people. The results in this study found that there was a relationship between waist circumference and the incidence of diabetes mellitus in patients in the Work Area of Kota Matsum Health Center, Medan, North Sumatra.

HUBUNGAN LINGKAR PINGGANG DENGAN KEJADIAN DIABETES MELLITUS PADA PASIEN USIA 30 SAMPAI 50 TAHUN DI PUSKESMAS KOTA MATSUM MEDAN

The purpose of this study was to identify blood sugar levels in obese patients in the Matsum City Public Health Center Medan and to analyze the relationship between waist circumference and the incidence of type 2 diabetes mellitus in patients at the Matsum City Public Health Center in Medan. This research was conducted by analytic survey with a Cross Sectional design where all data concerning research variables were collected by approaching, observing or collecting data at a time. The sample used was 69 people. The results in this study found that there was a relationship between waist circumference and the incidence of diabetes mellitus in patients in the Work Area of ​​Kota Matsum Health Center, Medan, North Sumatra.

Mechanisms of Adiponectin Action: Implication of Adiponectin Receptor Agonism in Diabetic Kidney Disease.

Adiponectin, an adipokine secreted by adipocytes, exerts favorable effects in the milieu of diabetes and metabolic syndrome through its anti-inflammatory, antifibrotic, and antioxidant effects. It mediates fatty acid metabolism by inducing AMP-activated protein kinase (AMPK) phosphorylation and increasing peroxisome proliferative-activated receptor (PPAR)-α expression through adiponectin receptor (AdipoR)1 and AdipoR2, respectively, which in turn activate PPAR gamma coactivator 1 alpha (PGC-1α), increase the phosphorylation of acyl CoA oxidase, and upregulate the uncoupling proteins involved in energy consumption. Moreover, adiponectin potently stimulates ceramidase activity associated with its two receptors and enhances ceramide catabolism and the formation of its anti-apoptotic metabolite, sphingosine 1 phosphate (S1P), independently of AMPK. Low circulating adiponectin levels in obese patients with a risk of insulin resistance, type 2 diabetes, and cardiovascular diseases, and increased adiponectin expression in the state of albuminuria suggest a protective and compensatory role for adiponectin in mitigating further renal injury during the development of overt diabetic kidney disease (DKD). We propose AdipoRon, an orally active synthetic adiponectin receptor agonist as a promising drug for restoration of DKD without inducing systemic adverse effects. Its renoprotective role against lipotoxicity and oxidative stress by enhancing the AMPK/PPARα pathway and ceramidase activity through AdipoRs is revealed here.

EVALUATION OF GALECTIN-3 LEVELS IN OBESE ADOLESCENTS

Background: Galectin-3 is a member of the family of soluble beta-galactoside binding lectins, which is involved in inflammation, cell differentiation, adhesion, proliferation, angiogenesis and cancer cell invasion. Increased galectin-3 levels in obese patients have been shown in previous studies. In our study; we aimed to investigate the galectin-3 levels in obese adolescents for the first time in the literature.&#x0D; Materials and methods: A total of 85 adolescent patients who were admitted to our pediatrics outpatient clinic between December 19th of 2018 and January 31st of 2019 were included in our study. Among those patients 52 were obese and 33 were normal-weighted. Adolescents having body mass index (BMI) 95% percentile and above according to their age and sex were defined as obese. Enzyme-Linked Immunosorbent Assay kit was used for the measurement of galectin-3 in serum. Laboratory tests (Galectin-3, HbA1c, glucose, insulin, HOMA-IR), sex, age and BMI were statistically compared between groups.&#x0D; Results: We found no statistically significant difference in terms of gender distribution rates, age, glucose or galectin-3 levels among obese adolescent and healthy control groups (p&gt; 0.05). The BMI, HbA1c, HOMA-IR and insulin levels of the obese adolescent group were found to be significantly higher than the healthy control group (p &lt;0.05). We found no statistically significant correlation between galectin-3 levels and other parameters in obese adolescent group (p&gt; 0.05).&#x0D; Conclusion: In our study, we did not find any relationship between serum galectin-3 levels and obesity in adolescents. We believe that the effects of galectin-3 levels on obesity in adolescents should be more clearly explained by further investigations, which also measures other biomarkers of the mechanism of action.&#x0D; Keywords: Galectin-3, obesity, adolescent&#x0D; List of abbreviations: BMI: Body-Mass Index, CV: Variation coefficient, ELISA: Enzyme linked immunoassay, HOMA-IR: Homeostatic model of assessment-insulin resistance, IL: Interleukin, r: Correlation coefficient, SD: Standard deviation.

ARE THE FACTORS AFFECTING ADVERSE PREGNANCY OUTCOMES DIFFERENT IN OBESE GESTATIONAL DIABETES PREGNANT WOMEN RECEIVING DIET OR INSULIN TREATMENT?

We aimed to examine the factors affecting adverse gestational outcome in gestational diabetes (GDM) patients, who were grouped as obese and normal- weight, having only-diet, or insulin treatments. The study included 373 patients, treated with diet or insulin. These patients were sub-grouped as obese and non-obese, and examined retrospectively. The variables affecting adverse gestational outcome in obese GDM patients having dietary and/ or insulin treatments were detected with multiple regression analysis. The weight gained during pregnancy in the GDM group having insulin treatment was more than the one in only-diet treated GDM group (p=0.004). Pre-pregnancy body mass index, the weight gained during pregnancy, hemoglobin A1C levels in the second and third trimesters, caesarian rates were higher in the insulin-treated obese patients than in the other groups (p<0.001). The odds ratio for fasting blood glucose level in insulin-treated obese GDM group was 1.081 (95% CI =1.004 - 1.163) (p=0.039); and it was 0.982 (95% CI =0.924 - 1.002) (p=0.048) for the weight gained during pregnancy, in only-diet treated obese GDM patients. The control of weight gained during pregnancy, and of fasting blood glucose levels in obese patients having GDM, is important to decrease adverse gestational outcome.