scholarly journals Reduced Levels of Circulating 7α-Hydroxy-Dehydroepiandrosterone in Treated Adolescent Obese Patients

2014 ◽  
pp. 95-101
Author(s):  
L. MÁČOVÁ ◽  
M. BIČÍKOVÁ ◽  
H. ZAMRAZILOVÁ ◽  
M. HILL ◽  
H. KAZIHNITKOVÁ ◽  
...  

Elevated levels of glucocorticoids lead to the development of obesity and metabolic syndrome. Local glucocorticoid levels are regulated through the enzyme 11β-hydroxysteroid dehydrogenase 1 (11β-HSD 1), an enzyme that regenerates active cortisol from inert cortisone. Increased expression of 11β-HSD 1 in adipose tissue promotes higher body mass index (BMI), insulin resistance, hypertension, and dyslipidemia. Human 11β-HSD 1 is also responsible for inter-conversion of 7-hydroxylate metabolites of dehydroepiandrosterone (7-OH-DHEA) to their 7-oxo-form. To better understanding the mechanism of the action, we focused on 7-OH- and 7-oxo-DHEA, and their circulating levels during the reductive treatment in adolescent obese patients. We determined plasma levels of 7α-OH-DHEA, 7β-OH-DHEA, and 7-oxo-DHEA in 55 adolescent patients aged 13.04-15.67 years, BMI greater than 90th percentile. Samples were collected before and after one month of reductive therapy. Circulating levels of 7α-OH-DHEA decreased during the reductive therapy from 1.727 (1.614; 1.854, transformed mean with 95 % confidence interval) to 1.530 nmol/l (1.435; 1.637, p<0.05) in girls and from 1.704 (1.583; 1.842) to 1.540 nmol/l (1.435; 1.659, p<0.05) in boys. With regard to the level of 7-oxo-DHEA, a significant reduction from 1.132 (1.044; 1.231) to 0.918 nmol/l (0.844; 1.000, p<0.05) was found after the treatment, but only in boys. No significant difference in 7β-OH-DHEA levels was observed. In conclusions, diminished levels of 7α-OH-DHEA indicate its possible effect on activity of 11β-HSD 1. Further studies are necessary to clarify whether competitive substrates for 11β-HSD 1 such as 7α-OH-DHEA could inhibit production of glucocorticoids and may be involved in metabolic processes leading to reduction of obesity.

2021 ◽  
Vol 14 (1) ◽  
pp. 1-6
Author(s):  
Shakeela Ishrat ◽  
Marufa Hossain ◽  
Subrata Kumar Biswas

The objective of this study is to explore how hyperinsulinemia and insulin resistance relate to the clinical, endocrine and metabolic factors in the infertile women with polycystic ovary syndrome. This study was conducted on 121 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit from January 2017 to December 2017. They were divided into two groups: insulin resistant and insulin sensitive. There was significant difference in body mass index and waist circumference between the two groups. Serum lipids were not associated with insulin resistance. Hyperinsulinemia was significantly associated with metabolic syndrome. Reducing body mass index and waist circumference may improve insulin resistance in infertile women with polycystic ovary syndrome. Screening the infertile women with polycystic ovary syndrome for hyperinsulinemia and insulin resistance and subsequent counseling is recommended to address the long-term risks of metabolic syndrome.


2020 ◽  
Vol 21 (14) ◽  
pp. 4860 ◽  
Author(s):  
Michele Mannelli ◽  
Tania Gamberi ◽  
Francesca Magherini ◽  
Tania Fiaschi

Cachexia is a devastating pathology induced by several kinds of diseases, including cancer. The hallmark of cancer cachexia is an extended weight loss mainly due to skeletal muscle wasting and fat storage depletion from adipose tissue. The latter exerts key functions for the health of the whole organism, also through the secretion of several adipokines. These hormones induce a plethora of effects in target tissues, ranging from metabolic to differentiating ones. Conversely, the decrease of the circulating level of several adipokines positively correlates with insulin resistance, metabolic syndrome, diabetes, and cardiovascular disease. A lot of findings suggest that cancer cachexia is associated with changed secretion of adipokines by adipose tissue. In agreement, cachectic patients show often altered circulating levels of adipokines. This review reported the findings of adipokines (leptin, adiponectin, resistin, apelin, and visfatin) in cancer cachexia, highlighting that to study in-depth the involvement of these hormones in this pathology could lead to the development of new therapeutic strategies.


2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
Saeid Golbidi ◽  
Ismail Laher

The lack of adequate physical activity and obesity created a worldwide pandemic. Obesity is characterized by the deposition of adipose tissue in various parts of the body; it is now evident that adipose tissue also acts as an endocrine organ capable of secreting many cytokines that are though to be involved in the pathophysiology of obesity, insulin resistance, and metabolic syndrome. Adipokines, or adipose tissue-derived proteins, play a pivotal role in this scenario. Increased secretion of proinflammatory adipokines leads to a chronic inflammatory state that is accompanied by insulin resistance and glucose intolerance. Lifestyle change in terms of increased physical activity and exercise is the best nonpharmacological treatment for obesity since these can reduce insulin resistance, counteract the inflammatory state, and improve the lipid profile. There is growing evidence that exercise exerts its beneficial effects partly through alterations in the adipokine profile; that is, exercise increases secretion of anti-inflammatory adipokines and reduces proinflammatory cytokines. In this paper we briefly describe the pathophysiologic role of four important adipokines (adiponectin, leptin, TNF-α, and IL-6) in the metabolic syndrome and review some of the clinical trials that monitored these adipokines as a clinical outcome before and after exercise.


2013 ◽  
Vol 0 (4(45)) ◽  
pp. 22-26
Author(s):  
О. С. Ларін ◽  
М. Л. Кирилюк ◽  
О. Е. Третяк ◽  
М. С. Черенько ◽  
Л. В. Щекатурова ◽  
...  

2009 ◽  
Vol 94 (11) ◽  
pp. 4499-4507 ◽  
Author(s):  
David M. Selva ◽  
Albert Lecube ◽  
Cristina Hernández ◽  
Juan A. Baena ◽  
José M. Fort ◽  
...  

Context: Zinc-α2 glycoprotein (ZAG) has been proposed as a new candidate in the pathogenesis of obesity, but most of the information stems from studies performed in rodents and in vitro assays. Objective: The main aim of the study was to compare serum levels of ZAG and its expression (mRNA levels and protein) in adipose tissue and the liver between obese and nonobese subjects. The relationship between ZAG and insulin resistance was also explored. Design: This was a case-control study. Setting: The study was conducted at a university referral center. Patients and Methods: Samples of serum, sc adipose tissue (SAT), visceral adipose tissue (VAT), and liver were obtained from 20 obese subjects during bariatric surgery. Samples from 10 nonobese patients matched by age and gender were used as a control group. Serum ZAG levels were determined by ELISA. ZAG mRNA levels were measured by real-time PCR and protein content by Western blot. The effect of insulin on liver production of ZAG was assessed using HepG2 cultures. Results: Serum concentration of ZAG (micrograms per milliliter) was significantly lower in obese subjects (40.87 ± 10.45 vs. 63.26 ± 16.40; P = 0.002). ZAG expression was significantly lower in the adipose tissue (SAT and VAT) and liver of obese patients than in control subjects. Significant negative correlations between body mass index and circulating ZAG (r = −0.65, P &lt; 0.001) as well as between body mass index and mRNA ZAG levels in SAT (r = −0.68, P &lt; 0.001) and VAT were detected (r = −0.64, P &lt; 0.001). No relationship was found between ZAG and homeostasis model assessment for insulin resistance and insulin had no effect on ZAG production in vitro. Conclusion: A down-regulation of ZAG in SAT, VAT, and liver exists in obese patients but seems unrelated to insulin resistance. A downregulation of zinc-α2 glycoprotein in adipose tissue and liver exists in obese patients, and it is unrelated to insulin resistance.


Author(s):  
Dharma Lindarto ◽  
Brama Ihsan Sazli

Chemerin is adipokine that plays an important role in macrophage infiltration into adipose tissue and may contribute to inflammation development and insulin resistance. This study aimed to determine the effect of lifestyle modification with and without metformin on chemerin in metabolic syndrome. Forty-five metabolic syndrome subjects (IDF-2005) were randomly assigned to one of the two groups: placebo group (n=22) and metformin group (n=23). Both groups underwent a 12-week lifestyle modification (diet and moderate aerobic-exercise). Only 40 participants (placebo group n=20 and metformin group n=20) completed the survey whereas 5 participants dropped out of the study. After their lifestyle was modified, body weight, BMI, WC, and chemerin decreased significantly (p<0.001) in both groups. Moreover, there was a significant difference between both groups in body weight, BMI, and WC (p<0.05) but not for chemerin. Thus, lifestyle modification with metformin improved BW, BMI, WC on metabolic syndrome, and there was no decrease significantly of chemerin between placebo and metformin groups. Further investigations should be done to confirm the effect of lifestyle modification and metformin on chemerin after an extended follow-up period.


2020 ◽  
Author(s):  
Nianrong Zhang ◽  
Yumeng Liu ◽  
Guoshan Yang ◽  
Biao Zhou ◽  
Guanming Qi ◽  
...  

Abstract Background: Obesity is associated with an increased risk of all-cause mortality. Mortality related to excess body weight occurs mostly due to coronary artery disease(CAD). This study is to observe the prevalence of coronary atherosclerotic stenosis in obese young-middle adults and outcomes of coronary stenosis in patients with obesity after metabolic surgery. Methods: Patients with obesity undergoing metabolic surgery were included from December 2015 to June 2017.Coronary computed tomography angiography(CTA) was examined preoperatively. Patients were divided into the stenosis group and the non-stenosis group and differences in clinical indicators and Homeostasis model assessment insulin resistance(HOMA-IR)were compared between the two groups. After metabolic surgery, the clinical indicators and severity of coronary stenosis were compared with those before metabolic surgery. Results: Among 217 consecutive obese patients with a mean body mass index(BMI) of 37.92±6.14kg/m2, 58(26.72%) patients were diagnosed with coronary atherosclerotic stenosis. Compared with the non-stenosis group, patients in the stenosis group had a more elder age, higher rates of male, smoking, hypertension and type 2 diabetes mellitus(T2DM), and higher levels of glycated haemoglobin(HbA1C),fasting blood glucose(FBG),fasting C-peptide and HOMA-IR(P<0.05). While there was no significant difference in BMI, waist circumstance(WC), serum lipid levels (P>0.05). The multivariate binomial logistic regression analysis showed that the age(β=0.070, OR=1.073, 95% CI 1.028-1.120, P<0.001),smoking(β=1.371, OR=3.941, 95% CI 1.257-12.357, P=0.019), and HOMA-IR(β=0.040, OR=1.041, 95% CI 1.000-1.083, P=0.047) were independent risk factors of coronary stenosis. After metabolic surgery, coronary stenosis relieved in 11/19 cases (57.89%), in which 9 cases got complete remission; coronary stenosis was aggravated in one case and remained the same in another one case.Conclusions: HOMA-IR, as well as age and smoking, is an independent risk factor for CAD in obese patients. Metabolic surgery is possibly helpful to reverse mild to moderate coronary atherosclerotic stenosis in patients with obesity.


2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Christine G. Schnackenberg ◽  
Melissa H. Costell ◽  
Daniel J. Krosky ◽  
Jianqi Cui ◽  
Charlene W. Wu ◽  
...  

Metabolic syndrome is a constellation of risk factors including hypertension, dyslipidemia, insulin resistance, and obesity that promote the development of cardiovascular disease. Metabolic syndrome has been associated with changes in the secretion or metabolism of glucocorticoids, which have important functions in adipose, liver, kidney, and vasculature. Tissue concentrations of the active glucocorticoid cortisol are controlled by the conversion of cortisone to cortisol by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Because of the various cardiovascular and metabolic activities of glucocorticoids, we tested the hypothesis that 11β-HSD1 is a common mechanism in the hypertension, dyslipidemia, and insulin resistance in metabolic syndrome. In obese and lean SHR/NDmcr-cp (SHR-cp), cardiovascular, metabolic, and renal functions were measured before and during four weeks of administration of vehicle or compound 11 (10 mg/kg/d), a selective inhibitor of 11β-HSD1. Compound 11 significantly decreased 11β-HSD1 activity in adipose tissue and liver of SHR-cp. In obese SHR-cp, compound 11 significantly decreased mean arterial pressure, glucose intolerance, insulin resistance, hypertriglyceridemia, and plasma renin activity with no effect on heart rate, body weight gain, or microalbuminuria. These results suggest that 11β-HSD1 activity in liver and adipose tissue is a common mediator of hypertension, hypertriglyceridemia, glucose intolerance, and insulin resistance in metabolic syndrome.


2019 ◽  
Vol 49 (1/2019) ◽  

Background and aims: Overweight and obese patients who undergo bariatric surgery require a rigorous clinical and paraclinical assessment both before and after the surgery at 3, 6, and 12 months.The present study aims the assessment of serum leptin levels and insulin resistance status in compliant bariatric patients to scheduled medical laboratory assessment at 6 months after surgery. Material and Method: The study included 109 eligible patients selected for bariatric surgery, 48 of whom attended the scheduled visit at 6 months after the surgery. Laboratory assessing regarded the insulin resistance by determining before meal the serum levels of leptin, glucose and insulin, as well as HOMA 1 and HOMA 2 indexes. Results: Patients who underwent bariatric treatment experienced a significant decrease in insulin resistance status. A higher percentage in the preoperative group was recorded in women, feature which was also recorded in the postoperative group that attended the scheduled visit at 6 months after surgery. Age is also an important factor that significantly influences the behavioral adherence to postoperative visits. Conclusions: Insulin resistance status improved significantly in 6 months after bariatric surgery among the fully compliant patients. The percentage of attendance at scheduled visits is higher among women, and decreases with age. Keywords: obesity surgery, leptin resistance, insulin resistance, HOMA index, compliance


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Ishikawa ◽  
Y Izumiya ◽  
A Shibata ◽  
T Yoshida ◽  
H Hayashi ◽  
...  

Abstract Background Epicardial adipose tissue (EAT) has been recognized to contribute inflammatory activity and atherosclerosis. On the other hand, it has been reported that the volume of EAT is lower in non-ischemic heart failure (HF) patients than healthy individuals. However, the difference in regional muscle-adipose distribution including EAT between HF with preserved ejection fraction (HFpEF) and HF reduced ejection fraction (HFrEF) has not been investigated. In addition, we investigated whether distribution of body composition contributed to exercise capacity. Methods The study included 105 non-ischemic HF patients diagnosed by cardiac catheterization between September 2017 and November 2019. Epicardial, abdominal and thigh muscle and adipose tissue volume were measured by computed tomography (CT), and exercise tolerance was evaluated by symptom-limited cardiopulmonary exercise test. Results Patients were divided into 2 groups according to the left ventricular ejection fraction, ≥40% as HFpEF (n=28) or &lt;40% as HFrEF (n=77). There was no significant difference comorbidity, including hypertension, dyslipidemia, chronic kidney disease, and body mass index. Plasma B-type natriuretic peptide level was significantly higher in HFrEF than HFpEF group (146.2 vs 393.2 pg/ml, p&lt;0.01), whereas, high-sensitive troponin T level was not different between two groups. Although there was no significant difference in BMI between two groups, the volume of EAT was significantly higher in HFpEF than HFrEF group (81.8 vs 136.4 ml, p=0.01). On the other hand, HFpEF had more thigh adipose tissue compared with HFrEF group (54.6 vs 42.1 ml, p=0.03). There were negative correlations between EAT volume and parameters of exercise capacity such as anaerobic threshold (r=−0.42, p&lt;0.01) and peak VO2 (r=−0.32, p&lt;0.01). Muscle volume itself does not corelate with these parameters. Conclusion In patient with nonischemic HF, the pattern of regional adipose distribution may have important role in pathologically. HFpEF and HFrEF has different pattern despite similar body mass index. These differences may be related to impaired exercise tolerance in these 2 different types of HF. Correlation between EAT and AT, peak VO2 Funding Acknowledgement Type of funding source: None


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