Weight Loss Induced by Bariatric Surgery Restricts Hepatic GDF15 Expression

Introduction. Obesity and related nonalcoholic fatty liver disease (NAFLD) are an emerging health care issue that imposes substantial morbidity to individuals. Growth and differentiation factor 15 (GDF15) limits food uptake, body weight, and energy balance by modulation of GDNF-family receptor α-like (GFRAL) signalling in the hindbrain. However, the regulation of GDF15 expression in obesity and NAFLD is incompletely understood. We sought to define the impact of weight loss achieved by laparoscopic adjustable gastric banding (LAGB) on hepatic and adipose GDF15 expression in a cohort of severely obese patients. Methods. We analysed GDF15 expression of liver and subcutaneous adipose tissue before and 6 months after LAGB in severely obese patients undergoing LAGB by quantitative real-time PCR. To assess the role of inflammation on GDF15 expression, we analysed Hep G2 hepatocytes stimulated with cytokines such as IL-1β, TNFα, IL-6, LPS, or cellular stressors such as tunicamycin. Results. GDF15 expression was mostly confined to the liver compared to adipose tissue in severely obese patients. Weight loss induced by LAGB was associated with reduced hepatic (but not adipose tissue) expression of GDF15. Stimulation with IL-1β or tunicamycin induced hepatic GDF15 expression in hepatocytes. In line with this, hepatic GDF15 expression directly correlated with IL-1β expression and steatosis severity in NAFLD. These data demonstrated that amelioration of metabolic inflammation and weight loss reduced hepatic GDF15 expression. Conclusion. Based on recent mechanistic findings, our data suggest that hepatic GDF15 may serve as a negative feedback mechanism to control energy balance in NAFLD.

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Decreased TLR3 in Hyperplastic Adipose Tissue, Blood and Inflamed Adipocytes is Related to Metabolic Inflammation

Cellular Physiology and Biochemistry ◽

10.1159/000495487 ◽

2018 ◽

Vol 51 (3) ◽

pp. 1051-1068 ◽

Cited By ~ 7

Author(s):

Jèssica Latorre ◽

José M. Moreno-Navarrete ◽

Mónica Sabater ◽

Maria Buxo ◽

José I. Rodriguez-Hermosa ◽

...

Keyword(s):

Weight Loss ◽

Adipose Tissue ◽

Low Grade ◽

Metabolic Inflammation ◽

Fat Depots ◽

Acute Surgery ◽

Obese Subjects ◽

Anti Inflammatory ◽

The Impact

Background/Aims: Obesity is characterized by the immune activation that eventually dampens insulin sensitivity and changes metabolism. This study explores the impact of different inflammatory/ anti-inflammatory paradigms on the expression of toll-like receptors (TLR) found in adipocyte cultures, adipose tissue, and blood. Methods: We evaluated by real time PCR the impact of acute surgery stress in vivo (adipose tissue) and macrophages (MCM) in vitro (adipocytes). Weight loss was chosen as an anti-inflammatory model, so TLR were analyzed in fat samples collected before and after bariatric surgery-induced weight loss. Associations with inflammatory and metabolic parameters were analyzed in non-obese and obese subjects, in parallel with gene expression measures taken in blood and isolated adipocytes/ stromal-vascular cells (SVC). Treatments with an agonist of TLR3 were conducted in human adipocyte cultures under normal conditions and upon conditions that simulated the chronic low-grade inflammatory state of obesity. Results: Surgery stress raised TLR1 and TLR8 in subcutaneous (SAT), and TLR2 in SAT and visceral (VAT) adipose tissue, while decreasing VAT TLR3 and TLR4. MCM led to increased TLR2 and diminished TLR3, TLR4, and TLR5 expressions in human adipocytes. The anti-inflammatory impact of weight loss was concomitant with decreased TLR1, TLR3, and TLR8 in SAT. Cross-sectional associations confirmed increased V/ SAT TLR1 and TLR8, and decreased TLR3 in obese patients, as compared with non-obese subjects. As expected, TLR were predominant in SVC and adipocyte precursor cells, even though expression of all of them but TLR8 (very low levels) was also found in ex vivo isolated and in vitro differentiated adipocytes. Among SVC, CD14+ macrophages showed increased TLR1, TLR2, and TLR7, but decreased TLR3 mRNA. The opposite patterns shown for TLR2 and TLR3 in V/ SAT, SVC, and inflamed adipocytes were observed in blood as well, being TLR3 more likely linked to lymphocyte instead of neutrophil counts. On the other hand, decreased TLR3 in adipocytes challenged with MCM dampened lipogenesis and the inflammatory response to Poly(I:C). Conclusion: Functional variations in the expression of TLR found in blood and hypertrophied fat depots, namely decreased TLR3 in lymphocytes and inflamed adipocytes, are linked to metabolic inflammation.

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Sleeve Gastrectomy Pre-Liver Transplant compared to Medical Weight Loss

@Gijournal ◽

10.52697/gijournal.v1i1.21 ◽

2021 ◽

Vol 1 ◽

Author(s):

Elizabeth Aby ◽

Suzanne Sharpton ◽

Julie Heimbach ◽

Anjana Pillai

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Liver Transplant ◽

Patient Outcomes ◽

De Novo ◽

Obese Patients ◽

Metabolic Complications ◽

Nonalcoholic Fatty Liver ◽

Medical Weight Loss ◽

The Impact

Methods to optimize obesity-related metabolic complications post liver transplant (LT) are needed given their impact on patient outcomes. Some transplant centers also have concerns about offering transplantation for obese patients due to concern for complications. In this study, selected patients with cirrhosis and medically complicated obesity either underwent sleeve gastrectomy (SG) or medical weight loss (MWL) and then were subsequently listed for LT. The impact of pre–LT SG and MWL on post-LT diabetes, post-LT hypertension, and recurrent and de novo nonalcoholic fatty liver disease (NAFLD) were evaluated.1 We summarize the @GIJournal discussion held on May 26, 2021, during which the article by Sharpton et al. “Sleeve gastrectomy prior to liver transplantation is superior to medical weight loss in reducing posttransplant metabolic complications” was critically discussed by our experts, Dr. Suzanne Sharpton (@SharptonSuzanne) and Dr. Julie Heimbach (@JulieHeimbach), and moderated by Dr. Anjana Pillai (@AnjanaPillaiMD).

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Neuroendocrine regulation of energy balance: Implications on the development and surgical treatment of obesity

Nutrition and Health ◽

10.1177/0260106017719369 ◽

2017 ◽

Vol 23 (3) ◽

pp. 131-146 ◽

Cited By ~ 5

Author(s):

Gisele Farias ◽

Bárbara Dal Molin Netto ◽

Solange Cravo Bettini ◽

Ana Raimunda Dâmaso ◽

Alexandre Coutinho Teixeira de Freitas

Keyword(s):

Weight Loss ◽

Adipose Tissue ◽

Gastrointestinal Tract ◽

Energy Balance ◽

Public Health Problem ◽

Neuroendocrine Regulation ◽

Calorie Intake ◽

Hormone Signaling ◽

Sustained Weight Loss

Introduction: Obesity, a serious public health problem, occurs mainly when food consumption exceeds energy expenditure. Therefore, energy balance depends on the regulation of the hunger–satiety mechanism, which involves interconnection of the central nervous system and peripheral signals from the adipose tissue, pancreas and gastrointestinal tract, generating responses in short-term food intake and long-term energy balance. Increased body fat alters the gut- and adipose-tissue-derived hormone signaling, which promotes modifications in appetite-regulating hormones, decreasing satiety and increasing hunger senses. With the failure of conventional weight loss interventions (dietary treatment, exercise, drugs and lifestyle modifications), bariatric surgeries are well-accepted tools for the treatment of severe obesity, with long-term and sustained weight loss. Bariatric surgeries may cause weight loss due to restriction/malabsorption of nutrients from the anatomical alteration of the gastrointestinal tract that decreases energy intake, but also by other physiological factors associated with better results of the surgical procedure. Objective: This review discusses the neuroendocrine regulation of energy balance, with description of the predominant hormones and peptides involved in the control of energy balance in obesity and all currently available bariatric surgeries. Conclusions: According to the findings of our review, bariatric surgeries promote effective and sustained weight loss not only by reducing calorie intake, but also by precipitating changes in appetite control, satiation and satiety, and physiological changes in gut-, neuro- and adipose-tissue-derived hormone signaling.

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Differential impact of bariatric surgery-induced weight loss on upper leg tissue composition in severely obese patients

Canadian Journal of Diabetes ◽

10.1016/s1499-2671(11)52183-5 ◽

2011 ◽

Vol 35 (2) ◽

pp. 188

Author(s):

A. Auclair ◽

J. Martin ◽

M. Bastien ◽

N. Bonneville ◽

S. Marceau ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Obese Patients ◽

Tissue Composition ◽

Differential Impact ◽

Severely Obese

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Dynamics of adipose tissue changes measured by MRI in obese patients during Reduxin treatment

Obesity and metabolism ◽

10.14341/2071-8713-5128 ◽

2012 ◽

Vol 9 (4) ◽

pp. 39-43 ◽

Cited By ~ 2

Author(s):

T I Romantsova ◽

I V Poluboyarinova ◽

O V Roik

Keyword(s):

Weight Loss ◽

Adipose Tissue ◽

Waist Circumference ◽

Dynamic Assessment ◽

Randomized Study ◽

Subcutaneous Fat ◽

Obese Patients ◽

Anthropometric Parameters ◽

Imaging Results ◽

Clinically Significant

Objective. To study the influence of the drug Reduxine in obese patients on the distribution of adipose tissue measured by MRI. Methods. In an open, prospective, non-randomized study duration of 20 weeks included 31 obese patients aged 20 to 65 years. During the study, the anthropometric parameters and the dynamics of the area of adipose tissue by means of MR imaging. Results. Weight loss in patients averaged 9.0 kg. Clinically significant weight loss reached 23 people (79%). Median reduction in waist circumference was 10 cm. Dynamic assessment of adipose tissue by MRI was performed in 17 patients. Reduxine treatment induced statistically significant decrease of both visceral and subcutaneous fat. Conclusions. According to the results of MRI, the reduction in waist circumference in patients receiving Reduxine occurred by reducing the number of both subcutaneous and visceral fat in the abdominal area.

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Towards Precision Health in Weight Reduction: Thematic Content Analysis of an Open-Ended Survey on Reasons Why Morbidly Obese Patients Want to Lose Weight.

10.21203/rs.3.rs-42745/v1 ◽

2020 ◽

Author(s):

Mazapuspavina Md-Ya ◽

Ilham Ameera Ismail ◽

Khasnur Abd Malek ◽

Khalid Yusoff ◽

Awang Bulgiba

Keyword(s):

Morbid Obesity ◽

Weight Loss ◽

Content Analysis ◽

Weight Reduction ◽

Extensive Study ◽

Morbidly Obese ◽

Obese Patients ◽

Thematic Content Analysis ◽

Thematic Content ◽

The Impact

Abstract Background: Addressing individuals’ motivation to lose weight among patients with morbid obesity is an essential entity in weight reduction. Failures to shift motivation into weight loss actions are common. These could be contributed by the inadequacy to identify and subsequently address the key reasons, that are of particular concern to the patient' individual needs. We aimed to understand the motivations better and identify the reasons why morbidly obese patients attending hospital-based weight management programmes (WMP) wanted to lose weight. Methods: The study used a qualitative approach to analyze part of a quantitative questionnaire of a more extensive study to understand factors influencing weight loss among morbidly obese patients. We used thematic content analysis to analyze responses from a self-administered open-ended question "What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics in two tertiary hospitals responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2. Four themes emerged for the reasons why morbidly obese patients wanted to lose weight. Health was the most commonly inferred theme (84%). Patients were concerned about the impact obesity had on their health. Overcoming obesity was seen as a reward not just for physical health, but also for their psychological wellbeing. Patients regard being functional to care for themselves, their family members, as well as their religious and career needs as the next most crucial theme (25.8%). Patients raised the theme appearance (12.9%), especially with regards to wanting to look and feel beautiful. The last theme was perceived stigmatization for being morbidly obese as they were mocked and laughed at for their appearance (3.1%).Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Concerns about the impact of morbid obesity on health, physical, social and obligatory function, appearance and perceived stigma warrant detailed exploration by the managing health professionals. Identifying and addressing these unique personal motivations in a focused approach is vital at the beginning and throughout a weight reduction program in this unique group.

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