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Bariatric Surgery

Visceral adipose tissue adiponectin predicts excess weight loss after bariatric surgery in females with severe obesity

International Journal of Obesity volume 48, pages 247–253 (2024)Cite this article

Subjects

Abstract

Objective

Bariatric surgery not always results in satisfactory excess weight loss (EWL) in severe obesity. Given the economic and clinical costs of bariatric surgery failure, defining predictors of successful EWL represents a relevant clinical issue for the health system to select patients benefiting from operation.

Methods

By ELISA and Western blot analyses, we assessed the predicting value of pre-operative adiponectin (APN) locally produced in abdominal visceral (VAT) and subcutaneous (SAT) adipose tissue versus plasma levels as a novel sex-linked biomarker of EWL at different time points of follow up (6–24 months) after bariatric surgery in 43 patients (56% females) affected by severe obesity undergoing a small pilot observational study.

Results

VAT-APN was lower in females and represented the only marker significantly correlated with EWL. In females, VAT-APN in the distribution upper quartile but not baseline BMI retained a statistically significant correlation with EWL at any time points (6–24 months) at multivariate analysis. The best VAT-APN cut-off value to predict 95% EWL at 12 months from surgery (98% accuracy, 100% sensitivity, 94% specificity, p = 0.010) was 5.1 µg/mg.

Conclusions

In this very preliminary study, APN in VAT rather than its circulating or subcutaneous levels predicts EWL after bariatric surgery as an independent factor in the female sex only, thus contributing to identify those patients who could much benefit from surgery.

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Fig. 1: APN protein expression in abdominal AT of patients with severe obesity: sex and depot differences.
Fig. 2: EWL association with AT (SAT and VAT) or circulating APN as well as with BMI or W/H in female patients with severe obesity.
Fig. 3: High VAT adiponectin levels are associated with EWL prediction in female severe obesity.

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Data availability

The data of this study are available from the corresponding author, ML, upon reasonable request.

References

  1. Pinhas-Hamiel O, Hamiel U, Bendor CD, Bardugo A, Twig G, Cukierman-Yaffe T. The global spread of severe obesity in toddlers, children, and adolescents: a systematic review and meta-analysis. Obes Facts. 2022;15:118–34.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Di Lorenzo N, Antoniou SA, Batterham RL, Busetto L, Godoroja D, Iossa A, et al. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP. Surg Endosc. 2020;34:2332–58.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N. Engl J Med. 2007;357:753–61.

    Article  CAS  PubMed  Google Scholar 

  4. Adams TD, Davidson LE, Litwin SE, Kim J, Kolotkin RL, Nanjee MN, et al. Weight and metabolic outcomes 12 years after gastric bypass. N. Engl J Med. 2018;378:93–96.

    Article  PubMed  Google Scholar 

  5. Kauppila JH, Markar S, Santoni G, Holmberg D, Lagergren J. Temporal changes in obesity-related medication after bariatric surgery vs no surgery for obesity. JAMA Surg. 2023;158:817–23.

  6. Yarigholi F, Bahardoust M, Mosavari H, Tehrani FM, Gholizadeh H, Shahmiri SS, et al. Predictors of weight regain and insufficient weight loss according to different definitions after sleeve gastrectomy: a retrospective analytical study. Obes Surg. 2022;32:4040–6.

    Article  PubMed  Google Scholar 

  7. El Ansari W, Elhag W. Weight regain and insufficient weight loss after bariatric surgery: definitions, prevalence, mechanisms, predictors, prevention and management strategies, and knowledge gaps-a scoping review. Obes Surg. 2021;31:1755–66.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pokala B, Hernandez E, Giannopoulos S, Athanasiadis DI, Timsina L, Sorg N, et al. Early postoperative weight loss predicts nadir weight and weight regain after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Surg Endosc. 2023;37:4934–41.

    Article  PubMed  Google Scholar 

  9. Athanasiadis DI, Martin A, Kapsampelis P, Monfared S, Stefanidis D. Factors associated with weight regain post-bariatric surgery: a systematic review. Surg Endosc. 2021;35:4069–84.

    Article  PubMed  Google Scholar 

  10. Faraj M, Havel PJ, Phélis S, Blank D, Sniderman AD, Cianflone K. Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab. 2003;88:1594–602.

    Article  CAS  PubMed  Google Scholar 

  11. Williams RL, Wood LG, Collins CE, Morgan PJ, Callister R. Energy homeostasis and appetite regulating hormones as predictors of weight loss in men and women. Appetite. 2016;101:1–7.

    Article  PubMed  Google Scholar 

  12. Di Franco A, Guasti D, Mazzanti B, Ercolino T, Francalanci M, Nesi G, et al. Dissecting the origin of inducible brown fat in adult humans through a novel adipose stem cell model from adipose tissue surrounding pheochromocytoma. J Clin Endocrinol Metab. 2014;99:E1903–12.

    Article  PubMed  Google Scholar 

  13. Di Franco A, Guasti D, Squecco R, Mazzanti B, Rossi F, Idrizaj E, et al. Searching for classical brown fat in humans: development of a novel human fetal brown stem cell model. Stem Cells. 2016;34:1679–91.

    Article  PubMed  Google Scholar 

  14. Lee JM, Okumura MJ, Davis MM, Herman WH, Gurney JG. Prevalence and determinants of insulin resistance among U.S. adolescents: a population-based study. Diabetes Care. 2006;29:2427–32.

    Article  PubMed  Google Scholar 

  15. Lee S, Bacha F, Gungor N, Arslanian S. Racial differences in adiponectin in youth: relationship to visceral fat and insulin sensitivity. Diabetes Care. 2006;29:51–56.

    Article  CAS  PubMed  Google Scholar 

  16. Alser M, Elrayess MA. From an apple to a pear: moving fat around for reversing insulin resistance. Int J Environ Res Public Health. 2022;19:14251.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Smith SR, Lovejoy JC, Greenway F, Ryan D, deJonge L, de la Bretonne J, et al. Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity. Metabolism. 2001;50:425–35.

    Article  CAS  PubMed  Google Scholar 

  18. Delaney KZ, Santosa S. Sex differences in regional adipose tissue depots pose different threats for the development of Type 2 diabetes in males and females. Obes Rev. 2022;23:e13393.

    Article  CAS  PubMed  Google Scholar 

  19. Lihn AS, Bruun JM, He G, Pedersen SB, Jensen PF, Richelsen B. Lower expression of adiponectin mRNA in visceral adipose tissue in lean and obese subjects. Mol Cell Endocrinol. 2004;219:9–15.

    Article  CAS  PubMed  Google Scholar 

  20. Reneau J, Goldblatt M, Gould J, Kindel T, Kastenmeier A, Higgins R. et al. Effect of adiposity on tissue-specific adiponectin secretion. PLoS One. 2018;13:e0198889.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Drolet R, Richard C, Sniderman AD, Mailloux J, Fortier M, Huot C, et al. Hypertrophy and hyperplasia of abdominal adipose tissues in women. Int J Obes. 2008;32:283–91.

    Article  CAS  Google Scholar 

  22. Sarafidis PA, McFarlane SI, Bakris GL. Gender disparity in outcomes of care and management for diabetes and the metabolic syndrome. Curr Diab Rep. 2006;6:219–24.

    Article  PubMed  Google Scholar 

  23. Drolet R, Bélanger C, Fortier M, Huot C, Mailloux J, Légaré D, et al. Fat depot-specific impact of visceral obesity on adipocyte adiponectin release in women. Obesity (Silver Spring). 2009;17:424–30.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors thank Dr. Enrico Facchiano (General and Bariatric Surgery Unit, Santa Maria Nuova Hospital) for his valuable collaboration.

Funding

This publication was produced with the co-funding European Union—Next Generation EU, in the context of The National Recovery and Resilience Plan, Investment 1.5 Ecosystems of Innovation, Project Tuscany Health Ecosystem (THE), CUP: B83C22003920001.

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Authors and Affiliations

  1. Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Endocrinology Unit, University of Florence, 50139, Florence, Italy

    Giulia Cantini, Diego Assis Gonçalves, Laura Fei, Arianna Pia Propato, Luca Galtarossa, Mario Maggi & Michaela Luconi

  2. Department of Surgery, General and Bariatric Surgery Unit, Santa Maria Nuova Hospital, Piazza Santa Maria Nuova, 50122, Florence, Italy

    Giovanni Quartararo, Niccolò Ghezzi & Marcello Lucchese

  3. Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, Juiz de Fora, Brazil

    Diego Assis Gonçalves

Authors
  1. Giulia Cantini
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  2. Giovanni Quartararo
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  3. Niccolò Ghezzi
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  4. Diego Assis Gonçalves
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  5. Laura Fei
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  8. Marcello Lucchese
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  9. Mario Maggi
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  10. Michaela Luconi
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Contributions

GC, GQ, ML designed and conceive the study; GQ, NG, MaLu were responsible for patient selection and surgery and obtained patient samples; DAG, LF, AP, LG conducted experiments; GC, GQ, NG, collected patient data; GC, ML analysed data and wrote the manuscript; MM, ML interpreted results, revised the draft manuscript critically for important intellectual content. All authors were involved in writing the paper and had final approval of the submitted version.

Corresponding author

Correspondence to Michaela Luconi.

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Cantini, G., Quartararo, G., Ghezzi, N. et al. Visceral adipose tissue adiponectin predicts excess weight loss after bariatric surgery in females with severe obesity. Int J Obes 48, 247–253 (2024). https://doi.org/10.1038/s41366-023-01406-1

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