Kopp H-P, Krzyzanowska K, Möhlig M, Spranger J, Pfeiffer A F H, Schernthaner G
Department of Medicine 1, Rudolfstiftung Hospital Vienna, Austria.
Int J Obes (Lond). 2005 Jul;29(7):766-71. doi: 10.1038/sj.ijo.0802983.
Obesity is linked to the insulin resistance syndrome (IRS), type 2 diabetes (T2D) and cardiovascular disease. Markers of chronic subclinical inflammation such as high-sensitive C-reactive protein (hs-CRP) and interleukin 6 (IL-6) are closely related to insulin resistance and obesity. Recent evidence suggests that adiponectin, a protein whose circulating levels are decreased in obesity, has anti-inflammatory properties, and also appears to enhance potently insulin action and therefore appears to function as a signal produced by adipose tissue that influences whole-body glucose metabolism.
We investigated the cross-sectional and longitudinal association of adiponectin with CRP and IL-6 in 41 morbidly obese women with different stages of glucose tolerance before and 17 months after significant weight loss induced by gastric surgery. Adiponectin was measured by RIA. CRP and IL-6 were determined by commercially available ELISA systems.
Weight loss induced a significant shift from T2D (preoperatively 34% vs postoperatively 2%) to impaired glucose tolerance (IGT) (37% preoperatively vs 30% postoperatively) and normal glucose tolerance (NGT) (29% preoperatively vs 68% postoperatively). Preoperatively adiponectin levels were negatively correlated with CRP (r=-0.59, P<0.0006), IL-6 (r=-0.42, P<0.02) and leukocytes (r=-0.41, P<0.007). After gastroplasty, adiponectin concentrations increased significantly (15.4+/-8.2 vs 19.8+/-6.2 microg/ml, P<0.005) associated with changes of weight and body mass index (r=-0.45, P<0.007; r=-0.35, P<0.04). Furthermore, preoperative CRP was significantly associated with changes in adiponectin even after adjustment for sex, age, preoperative body mass index (BMI) impaired glucose metabolism and changes in BMI and changes in BMI (standardized beta 0.61, P=0.005).
Levels of adiponectin, which are associated with markers of chronic subclinical inflammation, could be significantly increased after weight loss in morbidly obese patients. This increase was more pronounced in patients with NGT compared to those with T2D and IGT. Preoperative levels of CRP are predictive for changes of adiponectin after weight loss.
肥胖与胰岛素抵抗综合征（IRS）、2型糖尿病（T2D）及心血管疾病相关。高敏C反应蛋白（hs-CRP）和白细胞介素6（IL-6）等慢性亚临床炎症标志物与胰岛素抵抗和肥胖密切相关。最近有证据表明，脂联素是一种在肥胖时循环水平降低的蛋白质，具有抗炎特性，且似乎能有效增强胰岛素作用，因此似乎作为一种由脂肪组织产生的信号，影响全身葡萄糖代谢。
我们调查了41例患有不同糖耐量阶段的病态肥胖女性在胃手术诱导显著体重减轻之前及之后17个月时脂联素与CRP和IL-6的横断面及纵向关联。采用放射免疫分析法测定脂联素。通过市售酶联免疫吸附测定（ELISA）系统测定CRP和IL-6。
体重减轻导致从T2D（术前34% vs术后2%）显著转变为糖耐量受损（IGT）（术前37% vs术后30%）和正常糖耐量（NGT）（术前29% vs术后68%）。术前脂联素水平与CRP（r=-0.59，P<0.0006）、IL-6（r=-0.42，P<0.02）及白细胞（r=-0.41，P<0.007）呈负相关。胃成形术后，脂联素浓度显著升高（15.4±8.2 vs 19.8±6.2微克/毫升，P<0.005），与体重及体重指数变化相关（r=-0.45，P<0.007；r=-0.35，P<0.04）。此外，即使在调整性别、年龄、术前体重指数（BMI）、糖代谢受损情况以及BMI变化后，术前CRP仍与脂联素变化显著相关（标准化β 0.61，P=0.005）。
与慢性亚临床炎症标志物相关的脂联素水平在病态肥胖患者体重减轻后可显著升高。与T2D和IGT患者相比，这种升高在NGT患者中更为明显。术前CRP水平可预测体重减轻后脂联素的变化。
