Adipokines in metabolic processes regulating during obesity treatment

Bariatric surgery serves as a model for the assessment of the relationship between body mass index (BMI) reduction and changes in adipokine production and for exploring the endocrine function of the pancreas in patients who do not have the proximal part of the small intestine.
Aim.
 of the study was to assess the biochemical parameters and plasma levels of adipokines [adiponectin, adipsin, leptin, plasminogen activator inhibitor (PAI-1), resistin and visfatin], insulin, C-peptide, ghrelin and incretins [glucose insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1)] in patients with morbid obesity after surgery (gastric bypass) and therapeutic correction.
Materials and methods.
A total of 75 patients (34 men and 41 women; age range: 24?67 years) diagnosed as obese were divided into two groups according to the treatment they received. Biochemical analysis was performed to estimate carbohydrate and lipid metabolism rates and plasma levels of adipokines (adiponectin, adipsin, leptin, PAI-1, resistin, visfatin), insulin, C-peptide, ghrelin and incretins (GIP and GLP-1) using the flow fluorometry.
Results.
Surgical treatment of obesity resulted in a significant decrease in BMI (from 45.67?9.87 to 32.45?5.35 kg/m², p<0.05). Carbohydrate metabolism parameters and HOMA-IR index independent of BMI were comparable to the reference values after gastric bypass (18 months later). A direct correlation of plasma PAI-1 and leptin levels with BMI in groups with conservative (r=0.800, p=0.004 and r=0.780, p=0.010) and surgical treatment (r=-0.670, p=0.001 and r=0.760, p=0.01) was observed. Elevated leptin levels in patients with morbid obesity after gastric bypass with normal glucose and insulin levels indicated an indirect effect of leptin levels on the development of insulin resistance in metabolic syndrome.
Conclusions.
Gastric bypass is a more efficient approach to reduce obesity. Adipokine (leptin and PAI-1) production and adipose tissue mass are directly correlated.

type 2 diabetes, insulin resistance, adipokines, bariatric surgery

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