Journal of Hepatology
Volume 51, Issue 4 , Pages 765-777, October 2009

Effects of weight loss induced by bariatric surgery on hepatic adipocytokine expression☆

  • Alexander R. Moschen

      Affiliations

    • Christian Doppler Research Laboratory for Gut Inflammation, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
    • Internal Medicine II (Gastroenterology and Hepatology), Innsbruck Medical University, Innsbruck, Austria
    • These authors contributed equally to this work.
    • ,
  • Clemens Molnar

      Affiliations

    • Internal Medicine I (Metabolic Diseases, Pulmology, Infectious Diseases, Endocrinology, Rheumatology and Angiology), Innsbruck Medical University, Innsbruck, Austria
    • These authors contributed equally to this work.
    • ,
  • Anna Maria Wolf

      Affiliations

    • Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Helmut Weiss

      Affiliations

    • Department of General and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Ivo Graziadei

      Affiliations

    • Internal Medicine II (Gastroenterology and Hepatology), Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Susanne Kaser

      Affiliations

    • Internal Medicine I (Metabolic Diseases, Pulmology, Infectious Diseases, Endocrinology, Rheumatology and Angiology), Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Christoph F. Ebenbichler

      Affiliations

    • Internal Medicine I (Metabolic Diseases, Pulmology, Infectious Diseases, Endocrinology, Rheumatology and Angiology), Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Sylvia Stadlmann

      Affiliations

    • Institute of Pathology, Kantonsspital Baden, Baden, Switzerland
    • ,
  • Patrizia L. Moser

      Affiliations

    • Institute of Pathology, Innsbruck Medical University, Innsbruck, Austria
    • ,
  • Herbert Tilg

      Affiliations

    • Christian Doppler Research Laboratory for Gut Inflammation, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
    • Internal Medicine II (Gastroenterology and Hepatology), Innsbruck Medical University, Innsbruck, Austria
    • Corresponding Author InformationCorresponding author. Tel.: +43 512 5040; fax: +43 512 5046723374.

Received 3 January 2009; received in revised form 20 May 2009; accepted 2 June 2009. published online 06 July 2009.

Associate Editor: C.P. Day

Background/Aims

Adipocytokines play a key role in the pathophysiology of non-alcoholic fatty liver diseases (NAFLD). Whereas adiponectin has mainly anti-inflammatory functions, leptin, resistin and pre-B cell enhancing factor (PBEF)/Nampt/visfatin are considered as mainly pro-inflammatory mediators regulating metabolic and immune processes.

Methods

We prospectively examined the effect of weight loss on systemic levels and/or hepatic expression of adiponectin/adiponectin receptors, leptin/leptin receptors, resistin and PBEF/Nampt/visfatin. Severely obese patients underwent laparoscopic adjustable gastric banding (LABG) and serum samples (n=30) were collected before, and after 6 and 12 months. Paired liver biopsies (before and 6 months after LABG) were obtained from 18 patients.

Results

Bariatric surgery improved insulin resistance, abnormal liver function tests and liver histology. Pronounced weight loss after 6 and 12 months was accompanied by a significant increase in serum adiponectin levels whereas both leptin and PBEF/Nampt/visfatin levels decreased. Resistin serum levels increased after 6 months but fell below baseline values after 12 months. Liver mRNA expression of adiponectin increased slightly after 6 months whereas leptin mRNA expression did not change. Interestingly, weight loss resulted in a significant decrease of hepatic mRNA expression of resistin, PBEF/Nampt/visfatin and both leptin receptor isoforms while expression of type 1 and 2 adiponectin receptor was not affected. Liver immunohistochemistry performed on index and follow-up liver biopsies revealed an increase in adiponectin staining, showed no effect on resistin/leptin positivity, and demonstrated a decrease in PBEF/Nampt/visfatin immunoreactivity.

Conclusions

Weight loss after LABG surgery drives the adipocytokine milieu towards a more anti-inflammatory direction both systemically and in the liver.

Abbreviations: NAFLD, non-alcoholic fatty liver disease, NASH, non-alcoholic steatohepatitis, LAGB, laparoscopic adjustable gastric banding, IR, insulin resistance, adipoR, adiponectin receptor, IL, interleukin, TNF, tumor necrosis factor, CRP, C-reactive protein, RT-PCR, reverse-transcription polymerase chain reaction, GAPDH, glyceraldehyde-3-phosphate dehydrogenase, LEPR, leptin receptor, TIIDM, type II diabetes mellitus

Keywords: Adipocytokine, NAFLD, NASH, Weight loss, Bariatric surgery

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

☆ The authors who have taken part in this study declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript.

PII: S0168-8278(09)00443-7

doi:10.1016/j.jhep.2009.06.016

Journal of Hepatology
Volume 51, Issue 4 , Pages 765-777, October 2009

Article Tools

* Image Usage & Resolution