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The role of liver fatty acid-binding protein (FABP1) in obesity is presently unclear. We investigated the association of FABP1 with obesity and the changes noted after laparoscopic sleeve gastrectomy (LSG) in a Chinese population. The cross-sectional analysis included 187 individuals: 65 had normal weight (18.5 ≤ body mass index (BMI)

Bariatric surgery is an effective method for severe obesity and its related comorbidities. This study was performed to explore the alterations of sex hormones and inflammatory markers following laparoscopic sleeve gastrectomy (LSG) among obese Chinese men with acanthosis nigricans (AN). Sixty-five obese men who underwent LSG were enrolled, comprising simple obesity without AN (OB group, n = 20) and obesity with AN (AN group, n = 45). There were 31 healthy male controls with normal body mass index (BMI) included. Anthropometry data, inflammatory markers, sex hormones and metabolic parameters were compared preoperatively and 12 months post-operatively. At baseline, patients in the AN group were associated with more severe metabolic abnormalities than the OB and control groups. Twelve months after surgery, AN patients obtained significant improvement in skin condition and reduction in AN score. BMI, fasting insulin (FINS), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), tumor necrosis factor-α (TNF-α) and total testosterone (TT) were significantly changed in both groups, while interleukin (IL)-6, IL-8 and C-reactive protein were changed significantly only in the AN group. Moreover, FINS, HOMA-IR, TT and IL-6 levels were changed more in the AN group than those in the OB group. Multivariate regression analysis revealed that TT increase correlated significantly with reduction in FINS and HOMA-IR in both groups, but correlated with changes in IL-6 only in the AN group. In conclusion, LSG is effective in improving the skin condition of obese men with AN. The increased TT in AN patients correlated with amelioration of inflammatory state in addition to insulin resistance after LSG.

To examine changes in sex hormones after laparoscopic sleeve gastrectomy (LSG) in Chinese obese male patients and their correlation with metabolic parameters including serum uric acid (SUA) A total of 56 obese men with body mass index (BMI) 41.9 ± 5.8 kg/m2 undergoing LSG were selected. Thirty-one healthy men with normal BMI were included as controls. Levels of total testosterone (TT), estradiol (E2), sex hormone-binding globulin (SHBG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), SUA, and other metabolic indices were compared pre- and 12 months post-LSG. Calculated free testosterone (cFT) was calculated from TT and SHBG using an empirical equation. At baseline, low TT and hyperuricemia (HUA) were common in obese men. Twelve months after LSG, statistically significant reduction in weight, BMI, and glucolipid metabolism indices was noted. SUA levels declined remarkably from 474.9 ± 94.6 to 338.8 ± 81.9 μmol/L and the percentage of HUA decreased from 76.8 to 54.1% (all P

Background and objective The stomach plays an important role in obesity and obesity-related diabetes; yet, little is known about key pathways in the gastric mucosa associated with obesity and diabetes. Methods We performed gene microarray and real time-polymerase chain reaction (RT-PCR) on gut mucosa samples from control subjects (CON), patients with simple obesity (OB), and patients with obesity and comorbid diabetes (OD) (n = 3 per group). Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were used to predict the functional significance of differentially expressed genes. Results In total, 262 genes were upregulated and 265 genes were downregulated in the OB group whereas 1756 genes were upregulated and 1053 genes were downregulated in the OD group compared with the CON group. Of these, 23 were co-regulated in both comparisons. Seven differentially expressed genes were validated by RT-PCR (NRIP3, L1CAM, TPO, P2RY1, OR8A1, ADAMTS19, and ASIC3). A functional analysis revealed that genes differentially expressed between the OB or OD and CON groups played crucial roles in metabolic, T cell, and G-protein coupled receptor biological processes, and primarily participated in the PI3K-Akt and AGE-RAGE signaling pathways. Conclusions Obesity and obesity-related diabetes are associated with important gene expression and pathway alterations in the stomach.

Laparoscopic sleeve gastrectomy (LSG) has proven to be successful in weight reduction but with potential loss of bone mass. Previous studies indicated that bone morphogenetic protein 4 (BMP4) plays an important role in both bone formation and glucose-lipid metabolism. This study aimed to investigate the changes in bone mineral density (BMD), bone metabolic parameters, and serum BMP4 levels in obese Chinese subjects after LSG.Seventy-one obese patients (34 males, age 31.70 ± 9.61 years and 37 females, age 32.80 ± 11.45 years) were enrolled. BMD (at the right hip, femoral neck, and lumbar spine 1-4 (L1-L4)) was measured by dual-energy X-ray absorptiometry, bone metabolic markers, and routine anthropometric/laboratory biochemical parameters at baseline, 3, 6, and 12 months after LSG (abbreviated as 3, 6, and 12 M post-LSG, respectively) were recorded. Serum BMP4 levels were measured by enzyme-linked immunosorbent assay.LSG led to dramatic weight loss with improved glucose-lipid metabolism in all patients. In females, BMD was significantly decreased at the right hip at all time points studied and at the femoral neck at 6 and 12 M post-LSG (P 0.05 or P 0.01). In males, BMD was not significantly changed (all P 0.05). Intriguingly, serum BMP4 levels were reduced slightly at 3 M post-LSG (P = 0.463) and were significantly at 6 M post-LSG (from 75.51 ± 16.54 to 65.40 ± 10.51 pg/mL, P = 0.048) in females, but unchanged in males (all P 0.05). Vitamin D and 25-hydroxy vitamin D were increased in males at 12 M post-LSG (all P 0.05). Osteocalcin was increased in males at all time points studied and in females at 3 and 6 M post-LSG (all P 0.05). Type I collagen was increased in males at 3 and 6 M post-LSG and in females at all the time points studied (all P 0.05).The effect of LSG on BMD differs between genders, decreasing significantly in females while remaining unchanged in males. Moreover, decreased BMP4 levels may partly account for the diminished BMD in obese Chinese female patients after LSG.

The study was designed to examine changes of body fat distribution after laparoscopic sleeve gastrectomy (LSG) in obese male patients and to confirm whether these changes are correlated with increased testosterone. A total of 30 obese male patients with body mass index (BMI) 30–45 kg/m2 were enrolled in this study. Data on demographic characteristics, anthropometry, metabolic parameters, and body fat distribution were collected at baseline and 6 months after LSG. Body fat distribution was assessed by dual-energy X-ray absorptiometry (DXA). Six months after surgery, the BMI of participants (age 33.0 ± 9.5) decreased from 40.2 ± 5.2 to 30.8 ± 4.4 kg/m2, total testosterone increased from 2.4 ± 1.2 to 4.5 ± 1.8 ng/mL, and the percentage of testosterone deficiency in these patients decreased from 82.7 to 23.1%. Fat mass was significantly decreased in all regions, but the loss of fat mass in the android region was more than that in any other body region. After adjusting age and the BMI, the changes in android FM% and gynoid FM% were significantly correlated with an increase in total testosterone concentration (R2 = 0.187, R2 = 0.282, respectively). In obese male patients with BMI 30–45 kg/m2, an increase of total testosterone correlated to the changes in android FM% and gynoid FM% at the sixth month after LSG surgery.

OBJECTIVE To investigate the gut microbiota in healthy volunteers (HVs), patients with overweight (OW), and patients with obesity (OB), including those with acanthosis nigricans (AN) or without AN (N-AN). METHODS Microbial 16S rRNA genes were examined by using pyrosequencing technology and analyzed by using bioinformatics methods. RESULTS Subjects in the OW and OB groups showed severe disturbances in glycemic control, lipid profile, and inflammatory markers (all P

Bariatric surgery has a significant impact on levels of thyroid hormones and various inflammatory markers in obesity. The relationship between changes in thyroid hormones and inflammatory markers after bariatric surgery is unknown. We aimed to investigate the changes in thyroid hormones and their relations to inflammatory changes after laparoscopic sleeve gastrectomy (LSG) in Chinese patients with morbid obesity. Eighty-eight patients with morbid obesity (56.8% female; age 30.9 ± 9.5 years; BMI 39.9 ± 5.7 kg/m2) submitted to LSG were selected. Patients were subdivided into euthyroid group and subclinical hypothyroidism (SH) group. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), inflammatory markers, and related metabolic indexes were analyzed pre- and 12 months post-LSG. SH patients presented significantly higher interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) than euthyroid patients. Twelve-month post-surgery, the SH incidence decreased from 31.8 to 2.3% (P

Liver fatty acid-binding protein (FABP1) is associated with intracellular transportation of fatty acids. However, only few studies indicated the relationship between serum FABP1 and metabolism. This study aimed to investigate the association of FABP1 levels and metabolism factors, and its change with laparoscopic sleeve gastrectomy (LSG) in Chinese. The cross-sectional analysis included a total of 187 subjects, of which 65 were with normal weight (BMI 18-24 kg/m2), 59 with over weight (BMI25-27 kg/m2), and 64 with obesity (BMI≥28 kg/m2). We found FABP1 levels in obese (303±235pg/ml, p In conclusion, serum FABP1 were correlated with obesity and NAFLD, and it might be an important mediator participating in metabolism disorders. Disclosure H. You: None. Z. Lin: None. C. Zhu: None. X. Wen: None. M. Zhang: None. S. Qu: None. Funding National Key Research and Development Program of China (2018YFC1314101); National Natural Science Foundation of China (81700752, 81500687)

Objective: This study was designed to examine changes in body fat distribution after laparoscopic sleeve gastrectomy (LSG) and to confirm whether these changes are correlated with increased testosterone. Methods: A retrospective study was performed in 51 obese female patients with BMI 30-45 kg/m2 who underwent LSG from Shanghai Tenth People’s Hospital, 38 of whom were PCOS patients. The anthropometric indexes, sex hormone and ovarian volume of ultrasound examinations include both sides ovarian volume, mean ovarian volume (MOV) and maximal ovarian volume (MaxOV) were observed preoperative and follow-up at 3 and 6 months after LSG. The metabolic indexes and ovarian volume were compared before and after surgery. Results: Compared with preoperative, PCOS patients' weight, BMI, waist circumference and hip circumference were significantly lower at 3 and 6 months after operation (P Conclusions: TT and cFT decreased and SHBG increased significantly after LSG. MOV shrinked at 6 months after LSG and was no longer different from non-PCOS patients. LSG is not only an important treatment for weight loss, but also improve PCOS and its clinical symptoms effectively in severe obese women. Disclosure J. Gao: None. M. Zhang: None. C. Zhu: None. X. Wang: None. F. Mei: None. S. Qu: None. Funding National Natural Science Foundation of China (81601269)

Background Hyperuricemia is related to obesity and fat accumulation. This study aimed to observe the effects of laparoscopic sleeve gastrectomy (LSG) on serum uric acid (sUA) level and body fat distribution in obese patients. The relationships between post-LSG improvement in sUA levels and body fat distribution changes, as well as their sex-related differences, were also explored. Methods In total, 128 obese patients (48 men; 80 women) who underwent LSG were enrolled. Anthropometric indicators, glucose and lipid metabolic indicators, and sUA levels were measured pre-LSG and 6 months post-LSG. The body compositions were measured via dual-energy X-ray absorptiometry. The patients were divided into normal-sUA (NUA) and high-sUA (HUA) groups based on preoperative sUA levels. Results Compared with the NUA group, the reduction of sUA levels 6 months post-LSG was more significant in the HUA group. In addition, sUA reduction in the female HUA group was more significant than that of the male HUA group (P

Objective: Obesity, a state of chronic low grade inflammation, has been reported to be associated with significant alterations of thyroid function. The purpose of this study is to evaluate the effect of laparoscopic sleeve gastrectomy (LSG) on thyroid function and its relation with inflammatory changes in severely obese patients. Methods: We performed a retrospective observational study of 128 severely obese patients (61.7% female; age 31.8 ± 10.0 years, BMI 39.4 ± 5.8 kg/m2) submitted to LSG. Patients were subdivided in two groups: euthyroid group and subclinical hypothyroidism (SCH) group. TSH, FT4, anthropometric data, and inflammatory markers were collected pre- and 1, 3, 6, and 12 months post-LSG. Results: The mean percent weight loss at 12 months was 37.2% ± 11.8%. The mean BMI decreased from 39.4 ± 5.8 kg/m2 to 27.1 ± 3.9 kg/m2. Patients with SCH (37.5% of patients) and higher TSH showed higher BMI, HOMA-IR, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) than those in euthyroid group (all P < 0.05). After surgery, TSH levels significantly decreased at 1, 3, 6, and 12 months regardless of thyroid function, which presented more apparent in SCH group. Additionally, we observed marked reduction of IL-6, IL-8, TNF-α, and CRP levels in SCH group, as well as IL-8, TNF-α, and CRP in euthyroid group from baseline by 12 months postoperatively. Moreover, decreased TSH levels correlated significantly with decreased BMI, HOMA-IR, IL-6, and TNF-α at 12 months after LSG. Conclusion: SCH in severely obesity subjects appears to be associated with excess weight, insulin resistance, and elevated inflammatory markers. LSG promotes a decrease of TSH that is significantly greater in patients with SCH, and associated with alleviation of inflammatory status in addition to substantial weight loss and improved insulin resistance after surgery. Disclosure C. Zhu: None. F. Mei: None. J. Gao: None. X. Wang: None. L. Li: None. L. Lu: None. D. Zhou: None. S. Qu: None.

Background: Acanthosis nigricans (AN) is a skin condition commonly often accompanied by insulin resistance and hyperinsulinemia. Patients with AN are prone to diabetes, especially in young obesity. Metformin were usually used to treat these patients. However, reports about the effectiveness of LSG surgery on young obese patients with AN are rare. Objective: The aim of our study was to evaluate the efficacy of LSG surgery on insulin secretion patterns and anthropometric variables for obese patients with AN. Methods: 30 young obese patients with AN were recruited for this study. Before and at 12 months after the LSG surgery, BMI and blood samples were collected. OGTT were used to evaluate the insulin level and its rhythm of secretion. AN extent and AN texture were determined according to the scale developed and validated. Results: For these patients, BMI decreased from 40.98±4.93 kg/m2 to 27.27±4.13 kg/m2 at 12 months after surgery. Along with weight loss, triglycerides and total cholesterol decreased significantly, and high-density lipoprotein cholesterol (HDL-C) increased significantly as of 12 months after surgery. But the change of low-density lipoprotein cholesterol (LDL-C) is not obvious. A significant decrease in insulin resistant (HOMA-IR) was observed. The insulin release curves showed hyperinsulinemia and abnormal rhythm of secretion before surgery. At 12 months after surgery the fasting, 2h postprandial insulin levels and the rhythm of insulin secretion were restored to normal level. But the insulin levels at 30min and 60min were higher than before surgery. The extent of AN for most patients were improved. Only 23.4% patients still were severe (vs. 59.3% before surgery). More than 50% patients were remission. Conclusion: In this study of LSG in obesity patients with AN, we found significant improvements in weight, dyslipidemia, hyperinsulinemia and AN extent. LSG will be a new effective therapeutic approach for young obesity patients with AN. Disclosure C. Qian: None. S. Qu: None. C. Zhu: None. J. Gao: None. F. Mei: None. L. Bu: None.

Background: Gut uses variety of pathways to establish closely contact with obesity and obesity related diabetes, including gut-brain cross-talk, gut microbiota, immune pathway and gastrointestinal hormones. In this study, we aimed to identify the key pathways and genes of gastric mucosa in obesity patients with or without type 2 diabetes. Methods: Our study was divided into three groups, healthy control group with normal BMI, patients with simple obesity(OB) and obesity with type 2 diabetes mellitus(OD), three cases in each groups. Gastric mucosal tissues were isolated then analyzed by gene microarray. The differentially expressed genes were screened by functional enrichment analysis and pathway analysis. Results: 262 up-regulated genes and 265 down-regulated genes were differentially expressed between OB and normal-BMI patients. Besides, 1756 up-regulated genes and 1053 down-regulated genes were differentially expressed between OD and control subjects (fold change>2 p < 0.05). For DEGs comparisons in each group, 13 genes were co-up regulated, 10 genes were co-down regulated, and an additional 12 genes showed different trends. After analyzing the biological process and molecule function of differential expression genes, these genes were found to play crucial roles mainly in cellular metabolic, protein binding and other biological process. The analysis of KEGG showed that the relevant genes participate in Citrate cycle, NF-kappa B and PI3K-Akt signaling pathway. Conclusions: During the process of obesity and obesity related diabetes, in gut there is not only one specific gene or pathway, but multiple genes and pathways that change. The effects of genes expressed in gastric mucosa mainly influence cellular metabolic processes, NF-kappa B and other proinflammatory signaling pathway. Disclosure X. Wen: None. Y. Zhang: None. R.J. Wu: None. C. Zhu: None. R. Cui: None. Y. Hui: None. F.Y. Mei: None. J. Gao: None. S. Qu: None. L. Bu: None.

To investigate the gut microbiota in healthy volunteers (HVs), patients with overweight (OW), and patients with obesity (OB), including those with acanthosis nigricans (AN) or without AN (N-AN).Microbial 16S rRNA genes were examined by using pyrosequencing technology and analyzed by using bioinformatics methods.Subjects in the OW and OB groups showed severe disturbances in glycemic control, lipid profile, and inflammatory markers (all P 0.05); patients with AN had worse metabolic status (P 0.001) and a lower diversity of microbiota (P 0.05). The OB and HV groups showed totally different gut microbiota composition. In the OB group, beneficial microbiotas including Bifidobacterium (0.01% vs. 0.05%, false discovery rate [FDR] = 4.27*10Gut microbiotas and their functions were significantly changed in obesity. More prospective studies on association and causality between microbiota and obesity are imperative and might contribute to the prevention, diagnosis, and treatment of obesity.