Syndrome In Obese Individuals Research Articles

Soluble P-selectin, procalcitonin, transforming growth factor (TGF)-β and apo-proteins in association with the components of metabolic syndrome in obese individuals.

Metabolic syndrome (MetS) is a clinical disorder with widespread prevalence. In the current study, we aimed to investigate the association between serum soluble P-selectin, procalcitonin, transforming growth factor (TGF)-β and apo-proteins with the components of metabolic syndrome in obese individuals. Sixty two obese patients with MetS and sixty five obese apparently healthy controls were participated in the current case-control study. The participants' anthropometric assessments and systolic and diastolic blood pressure (SBP and DBP) were measured. Serum lipids and the concentrations of ox-LDL, P-selectin, procalcitonin, TGF-β and apo-proteins were measured with commercial ELIZA kits. Serum TG and TC were significantly higher in obese subjects with MetS; while TGF-β, procalcitonin, apoprotein B and insulin concentrations were higher in obese non- MetS group. In obese subjects with MetS, procalcitonin was in positive association with ox-LDL and apoprotein-B was in positive association with HDL. In obese subjects without MetS, apoprotein -B was in positive association with WC and HDL and WC. The current study found several associations between serum lipids and PCT and serum apo-proteins in obese individuals either with or without MetS. Further studies with large sample size are warranted to better elucidate the observed relationships and underlying mechanism. Not Applicable.

A Study on Prevalence of Carpal Tunnel Syndrome in Obese Individuals and Electrophysiological Assessment in Symptomatic and Asymptomatic Cases

A Study on Prevalence of Carpal Tunnel Syndrome in Obese Individuals and Electrophysiological Assessment in Symptomatic and Asymptomatic Cases

Copeptin as a Novel Biomarker of Obesity-Induced Insulin Resistance and Metabolic Syndrome

The objective of the study was to evaluate whether circulating Copeptin could be used as a novel biomarker associated with measures of insulin resistance and presence of metabolic syndrome in obese individuals. The study was carried out on three groups: G1: Twenty obese individuals with metabolic syndrome, G2: Twenty age-matched obese adults without metabolic syndrome, and G3: control group: Twenty age-matched non obese healthy adult voluntrrers. Both group (1) and (2) were selected to be obese with Body Mass Index (BMI) is greater than 30kg/m2. All groups were subjected to: complete physical examination, assessment of metabolic syndrome criteria according to the National Heart, Lung and Blood Institute (NHLBI) and the American Heart Association (AHA), fasting plasma glucose (FPG), fasting insulin, lipid profile, assessment of insulin resistance by HOMA-IR and measurement of plasma Copeptin level using ELISA technique. The results of Plasma Copeptin levels were significantly increased in G1 than the other two groups (median 38.30 ng/ml for G1 vs. 25.and 23.00 in G2 and G3 respectively, P < 0.001). Evident Positive correlation were found between plasma Copeptin level and HOMA-IR, FBG, TG, WC and BMI, and Negative correlation with HDL level (P <0.for HOMA-IR and FPG; P < 0.01 for TG, WC, BMI, and HDL). The area under the receiver-operating characteristic curve (AUC) for Copeptin was 0.79 (95% confidence interval, CI:0.67 to 0.89). Conclusion: Our results suggest that circulating Copeptin could be used as a possible biomarker of obesity-induced insulin resistance that provide diagnostic advantage to measures of metabolic syndrome. Further prospective multi center studies on a large scale of cases are needed. Disclosure S.M.M. Eltabakh: None. M. Zeidan: None. H. Maged: None. M. Zikry: None. M. Khedr: None.

The relationship between vitamin D deficiency and metabolic syndrome in obese individuals

Introduction: Decreased vitamin D levels may have a role in the development of metabolic syndrome due to its effect on the metabolic syndrome components or because of insulin resistance. Objectives: The aim of this study was to investigate the prevalence of vitamin D deficiency in obese individuals and to determine the relationship between deficiency of vitamin D with metabolic syndrome in obese people with metabolic syndrome and healthy individuals. Patients and Methods: In this descriptive-analytical study, samples were selected among obese individuals admitted to Hajar and Kashani hospitals in Shahrekord. Metabolic indices of the samples were measured and recorded along with information such as demographic characteristics. According to the indices, the subjects (n= 192) were divided into two equal groups of healthy obese and obese people with metabolic syndrome. Vitamin D levels were measured in both groups followed by determination of relationships between the vitamin D levels with metabolic syndrome and its indices. Results: The mean ages of the patients and healthy groups were 50.09±1.95 years and 52.57±2.05 years, respectively. The average serum vitamin D levels in the two groups showed a significant difference with significantly lower vitamin D levels in the metabolic syndrome group than those in the obese subjects (P<0.001). The relationship between each of the metabolic syndrome indices at different levels of vitamin D showed that levels of triglyceride (TG) and fasting blood sugar (FBS) decreased with increasing serum vitamin D. However, the level of vitamin D was not significantly related to the waist size and body mass index (BMI) (P>0.05). Conclusion: The results of this study indicated that vitamin D determination can be used for the prognosis and early detection of people at risk for metabolic syndrome.

Serum concentration of hs-CRP in obese individuals with and without metabolic syndrome and its association with parameters of metabolic syndrome

Introduction: Serum level of high sensitivity C-reactive protein (hs-CRP), as an inflammatory marker, can play a role in development of metabolic syndrome in obese individuals. Objectives: This study aimed to determine serum concentration of hs-CRP in obese patients with metabolic syndrome and determine the association of this factor with factors involved in the progression of metabolic syndrome. Patients and Methods: In this study, samples were selected by convenient method from obese patients, admitted to Kashani and Hajar hospitals (Shahrekord, Iran). First, based on NCEP-ATPIIIdefined metabolic syndrome, parameters of metabolic syndrome and serum levels of vitamin D were measured and a questionnaire containing demographics was completed for each participant. Accordingly, the samples (n=192) were divided into two identical groups; obese individuals without metabolic syndrome (controls) and obese individuals with metabolic syndrome (case group). HsCRP levels were measured in both groups. Results: Serum level of hs-CRP in the case group was 17.58±1.40 µg/mL and in the control group was 9.04±1.26 µg/mL, which was significantly higher in the case group than the control group (P 0.05). Conclusion: Hs-CRP can be used for prognosis and early detection of patients at risk of metabolic syndrome.

Prevalence of Irritable Bowel Syndrome in Morbidly Obese Individuals Seeking Bariatric Surgery

AIM: An increased prevalence of irritable bowel syndrome has been reported in obese individuals. Factors important in weight loss after bariatric surgery are incompletely understood, and small intestinal bacterial overgrowth in individuals with type 2 diabetes mellitus is a potential risk factor. Our aims are to examine whether the increased prevalence of irritable bowel syndrome in obese individuals seeking bariatric surgery is associated with diabetes mellitus and whether weight loss after bariatric surgery is altered by irritable bowel syndrome. METHODS: This is a single-center, retrospective study performed in a large, urban community teaching hospital. Individuals seen in gastrointestinal bariatric clinic prior to bariatric surgery from 2010 to 2013 completed a Manning symptom criteria questionnaire prior to their medical evaluation; ≥3 Manning criteria is accepted as diagnostic of irritable bowel syndrome. Percent excess weight loss at 6-, 12-, and 24-months after bariatric surgery is recorded. RESULTS: Thirty percent of 278 individuals seeking bariatric surgery have ≥3 Manning criteria. There is no relationship between type 2 diabetes mellitus and the presence of ≥3 Manning criteria (p>.05), nor is body mass index a significant risk factor for irritable bowel syndrome (p>.05). At 6-, 12-, and 24-months after Roux-en-Y gastric bypass or vertical sleeve gastrectomy, there is no difference in percent excess weight loss in individuals with ≥3 Manning criteria compared to individuals with ≤2 Manning criteria (for both surgical procedures: p>.05). CONCLUSION: A diagnosis of diabetes mellitus or body mass index do not explain the high prevalence of irritable bowel syndrome identified in individuals with obesity seeking bariatric surgery, and irritable bowel syndrome does not alter weight loss after bariatric surgery.

Obesity-Induced Endoplasmic Reticulum Stress Causes Lung Endothelial Dysfunction and Promotes Acute Lung Injury.

RETRACTED: Obesity is a significant risk factor for acute respiratory distress syndrome. The mechanisms underlying this association are unknown. We recently showed that diet-induced obese mice exhibit pulmonary vascular endothelial dysfunction, which is associated with enhanced susceptibility to LPS-induced acute lung injury. Here, we demonstrate that lung endothelial dysfunction in diet-induced obese mice coincides with increased endoplasmic reticulum (ER) stress. Specifically, we observed enhanced expression of the major sensors of misfolded proteins, including protein kinase R-like ER kinase, inositol-requiring enzyme α, and activating transcription factor 6, in whole lung and in primary lung endothelial cells isolated from diet-induced obese mice. Furthermore, we found that primary lung endothelial cells exposed to serum from obese mice, or to saturated fatty acids that mimic obese serum, resulted in enhanced expression of markers of ER stress and the induction of other biological responses that typify the lung endothelium of diet-induced obese mice, including an increase in expression of endothelial adhesion molecules and a decrease in expression of endothelial cell-cell junctional proteins. Similar changes were observed in lung endothelial cells and in whole-lung tissue after exposure to tunicamycin, a compound that causes ER stress by blocking N-linked glycosylation, indicating that ER stress causes endothelial dysfunction in the lung. Treatment with 4-phenylbutyric acid, a chemical protein chaperone that reduces ER stress, restored vascular endothelial cell expression of adhesion molecules and protected against LPS-induced acute lung injury in diet-induced obese mice. Our work indicates that fatty acids in obese serum induce ER stress in the pulmonary endothelium, leading to pulmonary endothelial cell dysfunction. Our work suggests that reducing protein load in the ER of pulmonary endothelial cells might protect against acute respiratory distress syndrome in obese individuals.

МАРКЕРЫ ВОСПАЛЕНИЯ, ПОКАЗАТЕЛИ ГЕМОСТАЗА И СОСТОЯНИЕ ОРГАНОВ-МИШЕНЕЙ У МОЛОДЫХ ПАЦИЕНТОВ С РАЗЛИЧНЫМИ КОМПОНЕНТАМИ МЕТАБОЛИЧЕСКОГО СИНДРОМА

Введение. Согласно современным представлениям, инициирующим фактором для запуска каскада метаболических нарушений при артериальной гипертензии (АГ) и абдоминальном ожирении (АО) является инсулинорезистентность. Активация локального и системного воспалительного ответа, а также протромботические изменения при АГ и АО являются основой для органных поражений, прогрессирования атеросклеротического процесса и развития осложнений. Цель исследования. Изучение взаимосвязи между маркерами воспалительного ответа, показателями гемостаза и состоянием органов-мишеней у молодых пациентов с различными компонентами метаболического синдрома. Материалы и методы. Проведена комплексная оценка взаимосвязи уровней адипокинов, цитокинов и показателей гемостаза с состоянием органов-мишеней у 251 пациента в возрасте 18–44 лет: 1 группа — 35 пациентов с изолированной АГ; 2 группа — 76 пациентов с изолированным АО; 3 группа — 60 пациентов с сочетанием АГ и АО; 4 группа — 80 практически здоровых волонтеров. Результаты. У больных с комбинацией АГ и АО выявлено повышение лептина и интерлейкина-6, снижение адипонектина и протромботические изменения гемостаза по сравнению с пациентами с изолированными АГ, АО и практически здоровыми. В группе больных с комбинацией АГ и АО с бóльшей частотой обнаруживались гипертрофия левого желудочка и увеличение комплекса интима-медиа сонных артерий по сравнению с пациентами, имевшими только АГ и только АО. Обнаружены положительные линейные корреляции индекса массы миокарда левого желудочка с концентрацией интерлейкина-6 и толщины комплекса интима-медиа с уровнем интерлейкина-1β, отрицательная связь этих показателей с уровнями адипонектина и ингибитора активатора плазминогена 1 типа. Заключение. При сочетании АГ с АО в молодом возрасте чаще выявляется субклиническое поражение органов-мишеней; установлено более высокое содержание глюкозы, общего холестерина, холестерина липопротеинов низкой плотности, триглицеридов, лептина, интерлейкина-6, фибриногена, ингибитора активатора плазминогена 1 типа и ингибитора пути тканевого фактора по сравнению с пациентами с изолированной АГ и изолированным АО. Introduction. According to modern concepts insulin resistance is the initiating factor for triggering a cascade of metabolic disorders in hypertension (AH) and abdominal obesity (AO). Activation of local and systemic infl ammatory response as well as prothrombotic changes at AH and AO are the basis for organ’s lesions, progression of atherosclerotic process and complications development. The aim: to study the relationship between the markers of infl ammatory response, hemostatic parameters and target organs in young patients with diff erent components of metabolic syndrome. Materials and methods. Complex assessment of relationships between adipokines, cytokines, hemostatic parameters and status of target organs was done in 251 patients (18–44 years old): group 1–35 patients with isolated AH; group 2–76 patients with isolated AO; group 3–60 patients with combination of AH and AO; group 4–80 practically healthy volunteers. Results. In patients with combination of AH and AO we revealed increased values of leptin and interleukin-6, decreased values of adipokine and prothrombotic changes as compared to patients with isolated AH, isolated AO and with healthy people. Left ventricular hypertrophy and thickening of intima-media of carotid arteries were revealed more frequently in patients with combination of AH and AO. We found positive correlations between the left ventricular mass index and interleukin-6 content, thickening of intima-media complex and interleukin-1β concentration, negative correlation of these parameters with adiponectin level and plasminogen activator inhibitor type 1 content. Conclusion. The subclinical lesion of target organs is more often detected in young people with AH in combination with AO; higher levels of glucose, total cholesterol, low-density lipoprotein cholesterol, triglycerides, leptin, interleukin-6, fibrinogen, inhibitor of plasminogen activator type 1 and inhibitor of tissue factor were revealed as compared to patients with isolated AH and with isolated AO.

Oral AGE restriction ameliorates insulin resistance in obese individuals with the metabolic syndrome: a randomised controlled trial.

We previously reported that obese individuals with the metabolic syndrome (at risk), compared with obese individuals without the metabolic syndrome (healthy obese), have elevated serum AGEs that strongly correlate with insulin resistance, oxidative stress and inflammation. We hypothesised that a diet low in AGEs (L-AGE) would improve components of the metabolic syndrome in obese individuals, confirming high AGEs as a new risk factor for the metabolic syndrome. A randomised 1year trial was conducted in obese individuals with the metabolic syndrome in two parallel groups: L-AGE diet vs a regular diet, habitually high in AGEs (Reg-AGE). Participants were allocated to each group by randomisation using random permuted blocks. At baseline and at the end of the trial, we obtained anthropometric variables, blood and urine samples, and performed OGTTs and MRI measurements of visceral and subcutaneous abdominal tissue and carotid artery. Only investigators involved in laboratory determinations were blinded to dietary assignment. Effects on insulin resistance (HOMA-IR) were the primary outcome. Sixty-one individuals were randomised to a Reg-AGE diet and 77 to an L-AGE diet; the data of 49 and 51, respectively, were analysed at the study end in 2014. The L-AGE diet markedly improved insulin resistance; modestly decreased body weight; lowered AGEs, oxidative stress and inflammation; and enhanced the protective factors sirtuin 1, AGE receptor 1 and glyoxalase I. The Reg-AGE diet raised AGEs and markers of insulin resistance, oxidative stress and inflammation. There were no effects on MRI-assessed measurements. No side effects from the intervention were identified. HOMA-IR came down from 3.1 ± 1.8 to 1.9 ± 1.3 (p < 0.001) in the L-AGE group, while it increased from 2.9 ± 1.2 to 3.6 ± 1.7 (p < 0.002) in the Reg-AGE group. L-AGE ameliorates insulin resistance in obese people with the metabolic syndrome, and may reduce the risk of type 2 diabetes, without necessitating a major reduction in adiposity. Elevated serum AGEs may be used to diagnose and treat 'at-risk' obesity. ClinicalTrials.gov NCT01363141 FUNDING: The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (DK091231).

Lifestyle of metabolically healthy obese individuals

AimsThe aim of this study is to find factors associated with metabolic syndrome in obese individuals and thus offer guidance to stay metabolically healthy if obese. MethodsA cardiovascular screening programme performed in Finland during the years 2005–2007, identified 901 obese white individuals. Of them, 269 (30%) were metabolically healthy according to the Harmonization criteria of metabolic syndrome. ResultsIn multivariate logistic regression analysis, male sex [odds ratio (OR) 1.44 (95% CI 1.01–2.07)], living alone [OR 1.77 (95% CI 1.18–2.65)], physical inactivity [OR 3.73 (95% CI 1.24–11.24)], and use of betablockers [OR 2.63 (95% CI 1.75–3.95)] were associated with metabolic syndrome. ConclusionsEven mild or occasional physical exercise is beneficial to health in obese individuals. Betablockers may not be the antihypertensive agents of choice when treating obese hypertensive individuals.

Menopause and metabolic syndrome in obese individuals with binge eating disorder

Menopausal transition has been associated with the emergence of metabolic abnormalities, which may increase risk for chronic medical conditions in women. This study compared metabolic function between premenopausal women (n=152), postmenopausal women (n=88), and men (n=98) recruited for treatment studies for obesity co-occurring with binge eating disorder (BED), a high-risk population for developing metabolic syndrome (MetS). Postmenopausal women were more likely than premenopausal women to show elevated total cholesterol (OR=2.75; 95% CI=1.56–4.80) and poor glycemic control (OR=2.92; 95% CI=1.32–6.33) but were more likely to have lower HDL levels (OR=0.36; 95% CI=0.19–0.68). These became non-significant after adjusting for age. Both pre- and postmenopausal women were less likely than age-matched men to show elevated levels of triglycerides (OR=0.27; 95% CI=0.13–0.53 [postmenopausal], OR=0.29; 95% CI=0.16–0.53 [premenopausal]), blood pressure (OR=0.48; 95% CI=0.25–0.91 [postmenopausal], OR=0.40; 95% CI=0.23–0.69 [premenopausal]), and less likely to have MetS (OR=0.41; 95% CI=0.21–0.78 [postmenopausal], OR=0.46; 95% CI=0.27–0.79 [premenopausal]). Premenopausal women were also less likely to have elevated fasting glucose level (OR=0.50; 95% CI=0.26–0.97) than age-matched men. Among obese women with BED, aging may have a more profound impact on metabolic abnormalities than menopause, suggesting the importance of early intervention of obesity and symptoms of BED. The active monitoring of metabolic function in obese men with BED may also be critical.

The factor structure of the metabolic syndrome in obese individuals with binge eating disorder

ObjectiveMetabolic syndrome (MetS) is strongly linked with cardiovascular disease and type-II diabetes, but there has been debate over which metabolic measures constitute MetS. Obese individuals with binge eating disorder (BED) are one of the high risk populations for developing MetS due to their excess weight and maladaptive eating patterns, yet, the clustering patterns of metabolic measures have not been examined in this patient group. Methods347 adults (71.8% women) were recruited for treatment studies for obese individuals with BED. We used the VARCLUS procedure in the Statistical Analysis System (SAS) to investigate the clustering pattern of metabolic risk measures. ResultsThe analysis yielded four factors: obesity (body-mass-index [BMI] and waist circumference), lipids (HDL and triglycerides), blood pressure (systolic and diastolic blood pressure), and glucose regulation (fasting serum glucose and Hb1Ac). The four factors accounted for 84% of the total variances, and variances explained by each factor were not substantially different. There was no inter-correlation between the four factors. Subgroup analyses by sex and by race (Caucasian vs. African American) yielded the same four-factor structure. ConclusionThe factor structure of MetS in obese individuals with BED is not different from those found in normative population studies. This factor structure may be applicable to the diverse population.

The Impact of Rapid Weight Loss on Oxidative Stress Markers and the Expression of the Metabolic Syndrome in Obese Individuals

Objective. Obesity is linked with a state of increased oxidative stress, which plays an important role in the etiology of atherosclerosis and type 2 diabetes mellitus. The aim of our study was to evaluate the effect of rapid weight loss on oxidative stress markers in obese individuals with metabolic syndrome (MetS). Design and Methods. We measured oxidative stress markers in 40 obese subjects with metabolic syndrome (MetS+), 40 obese subjects without metabolic syndrome (MetS−), and 20 lean controls (LC) at baseline and after three months of very low caloric diet. Results. Oxidized low density lipoprotein (ox-LDL) levels decreased by 12% in MetS+ subjects, associated with a reduction in total cholesterol (TC), even after adjustment for age and sex. Lipoprotein associated phospholipase A2 (Lp-PLA2) activity decreased by 4.7% in MetS+ subjects, associated with a drop in LDL-cholesterol (LDL-C), TC, and insulin levels. Multivariate logistic regression analysis showed that a model including ox-LDL, LpPLA2 activity, and myeloperoxidase (MPO) improved prediction of MetS status among obese individuals compared to each oxidative stress marker alone. Conclusions. Oxidative stress markers were predictive of MetS in obese subjects, suggesting a higher oxidative stress. Rapid weight loss resulted in a decline in oxidative stress markers, especially in MetS+ patients.

The relationship between mean platelet volume with metabolic syndrome in obese individuals

The metabolic syndrome is closely associated with atherosclerotic risk factors and increased mortality. Mean platelet volume (MPV) is an indicator of platelet activation which also shows a close relationship with cardiovascular risk factors, such as diabetes mellitus, hypertension, hypercholesterolemia, obesity, metabolic syndrome. The aim of this study was to investigate the correlates of metabolic syndrome, its components and MPV adjusted for obesity in a large population study. A total of 2298 individuals with a mean age of 50 (age range 18-92) were interviewed. Nine hundred and twenty obese participants, who had BMI 30 kg/m² or more, further evaluated for the presence of metabolic syndrome. Five hundred and thirteen [396 women (70.2%)] had metabolic syndrome and the rest 407 individuals [324 women (79.6%)] served as the control group. The BMI, SBP, DBP, waist circumference, fasting plasma glucose, visceral fat, total cholesterol, high-density lipoprotein-cholesterol, and triglyceride was higher significantly in metabolic syndrome group (P = 0.002 for BMI and P < 0.001 for the others). No significant difference was observed between groups regarding low-density lipoprotein cholesterol, white blood cells, platelet counts, MPV, hematocrit and hemoglobin (P > 0.05 for all). The presence of metabolic syndrome and its components do not constitute a difference in MPV values in obese patients with a BMI 30 kg/m² or more.

Great discoveries of milk for a healthy diet and a healthy life

Extensive research in recent years has shown that consumption of milk and dairy products, promotes cardiovascular health, reduces symptoms of the metabolic syndrome in obese individuals, promotes weight loss while maintaining body muscle mass and reduces incidence of some cancers. Detailed analysis of prospective studies in large Western populations over long periods of time demonstrates that higher consumption of dairy products provides an overall survival advantage.

Butyrylcholinesterase activity and metabolic syndrome in obese patients

Total butyrylcholinesterase activity (EC 3.1.1.8) was previously suggested as a marker for metabolic syndrome. The present study examined total butyrylcholinesterase activity and the relative and absolute activities of two butyrylcholinesterase electrophoretic bands (C(4/5) and C(OF) in 99 obese individuals (body mass index > or = 30 kg/m2) presenting the CHE2 C5- phenotype of the CHE2 gene. Anthropometric, hormonal and biochemical variables already associated with metabolic syndrome were also examined. The data from these obese individuals of the CHE2 C5- phenotype show that total butyrylcholinesterase activity and the absolute activities of the C(4/5) and C(OF) electrophoretic bands are associated with metabolic syndrome and with variables related to it. These butyrylcholinesterase activities do not behave as independent risk factors for metabolic syndrome, but can be considered as secondary markers for this syndrome in obese individuals with the CHE2 C5- phenotype.

Adiponectin, inflammation, and the expression of the metabolic syndrome in obese individuals: the impact of rapid weight loss through caloric restriction.

Severe obesity increases the prevalence of the metabolic syndrome, and moderate acute weight loss with a very low-calorie diet in obese subjects with the metabolic syndrome leads to significant metabolic benefits. Adiponectin has been implicated in both the pathogenesis of obesity-related insulin resistance and increased inflammation. We analyzed the relationship of the adipocyte-derived hormone adiponectin with indices of inflammation, adiposity, and insulin resistance in obese subjects with (MS+, n = 40) and without (MS-, n = 40) the metabolic syndrome and examined the acute effects of rapid weight loss. MS+ subjects had significantly lower adiponectin (7.6 +/- 0.6 vs. 10.4 +/- 0.6 microg/ml; P = 0.003) and significantly higher TNF-alpha (3.3 +/- 0.2 vs. 2.8 +/- 0.3 pg/ml; P = 0.004) levels compared with MS- subjects matched for age and body mass index. Plasma adiponectin and TNF-alpha levels were inversely related to the number of metabolic syndrome factors in a stepwise manner. After 4-6 wk of weight loss, there was marked improvement in glucose, insulin, leptin, and triglycerides, whereas adiponectin and TNF-alpha concentrations did not change. Thus, increases in plasma levels of adiponectin or reductions in TNF-alpha are not required for marked improvements in glucose/insulin and lipid metabolism with acute weight loss.

Relationships of serum leptin to clinical and anthropometric findings in obese patients.

The authors evaluated the relationship between leptin and the clinical, anthropometric and metabolic variables connected to the metabolic syndrome in obese individuals. A large group of patients with different degrees of obesity was investigated: body mass index (BMI) values, serum leptin, fasting glucose and insulin, triglycerides and HDL-cholesterol concentrations, insulin resistance index and blood pressure were measured. On multiple regression analysis, serum leptin levels appeared to be positively correlated to the BMI and to the serum HDL-cholesterol concentration. Principal component factor analysis revealed three factors, explaining 61.3% of the total variance of the sample. General features of these factors were: factor 1--BMI values and serum leptin and fasting glucose concentration; factor 2--systolic and diastolic blood pressure and serum triglycerides and HDL-cholesterol concentration; factor 3--fasting serum insulin concentration and insulin resistance index. In obese subjects multiple factors underlie the metabolic syndrome and therefore more than one mechanism may account for the clustering characteristics. In obese patients leptin loads only one factor, and therefore leptin does not appear to be a key feature in the metabolic syndrome. On the contrary, multiple correlation and factor analysis data give rise to the hypothesis that in obese patients, leptin may play a protective role against cardiovascular risk.