Effects of changes in adipocyte hormones and visceral adipose tissue and the reduction of obesity-related comorbidities after laparoscopic sleeve gastrectomy in Japanese patients with severe obesity

• Published in: Endocrine Journal Vol. 61; no. 4; pp. 381 - 391
• Main Authors: Umemura, Akira, Sasaki, Akira, Nitta, Hiroyuki, Otsuka, Koki, Suto, Takayuki, Wakabayashi, Go
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2014
• Subjects: Adipokines - blood; Adipokines - metabolism; Adiponectin; Adiposity; Adult; Bariatric surgery; Body Mass Index; Cells, Cultured; Combined Modality Therapy; Diabetes Mellitus, Type 2 - complications; Diet, Reducing; Female; Follow-Up Studies; Gastroplasty; Humans; Insulin Resistance; Intra-Abdominal Fat - metabolism; Intra-Abdominal Fat - pathology; Japan; Laparoscopic sleeve gastrectomy; Laparoscopy; Leptin; Male; Middle Aged; Obesity, Morbid - complications; Obesity, Morbid - diet therapy; Obesity, Morbid - metabolism; Obesity, Morbid - surgery; Plasminogen Activator Inhibitor 1 - blood; Plasminogen Activator Inhibitor 1 - metabolism; Prospective Studies; Type 2 diabetes mellitus; Weight Loss
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ13-0524

The aim of this study was to evaluate the relative contribution of serum adipokines and adipokines from the patient’s omentum-derived adipocytes (PODAs) and visceral adipose tissue (VAT) of Japanese patients with severe obesity. Secondarily, we analyzed patients’ metabolic changes after laparoscopic sleeve gastrectomy (LSG). Twenty-three LSG patients and 23 non-obese patients undergoing elective abdominal surgery were enrolled. The levels of adipokines in the serum and the PODAs were measured. The clinical and metabolic data were evaluated at 6 months after LSG. The mean serum leptin levels and the mean serum plasminogen activator inhibitor type-1 (PAI-1) levels were significantly greater (p < 0.001) and the mean adiponectin levels were significantly lower in the LSG group (p = 0.006). In the measurements of the PODAs, the mean leptin levels (p < 0.001) were significantly greater and the mean adiponectin levels (p < 0.001) were significantly lower in the LSG group. The mean BMI (-12 kg/m², p < 0.001) and mean VAT (-135.5 cm², p = 0.001) were significantly decreased after LSG. In nine patients with type 2 diabetes mellitus, the reduction in VAT correlated with the change in high-sensitivity C-reactive protein (p = 0.006) and the homeostasis model of assessment of insulin resistance (p = 0.001). After 6 months, LSG markedly improved most obesity-related comorbidities. Our results suggest that LSG may contribute to VAT reduction, improved adipocyte hormone levels, and changes in gut physiology and endocrinology.