Key result
Surgical gastric bypass significantly reduced plasma A-FABP levels from 7.6 to 4.3 (P<0.001) at 1 year in morbid-obese women, remaining independently associated with insulin resistance.
Why the study?
Does surgical gastric bypass reduce A-FABP levels and improve insulin resistance in morbid-obese women?
Cohort (n=77)
Does surgical gastric bypass reduce A-FABP levels and improve insulin resistance in morbid-obese women?
In morbidly obese women, gastric bypass surgery significantly reduces A-FABP levels, which independently correlates with improvements in insulin resistance.
Supports A-FABP decline as marker of insulin resistance response to bypass; hypothesis-generating, needs randomized confirmation.
The aim of the study was to evaluate human plasma circulating levels of adipocyte fatty acid-binding protein (A-FABP) and its relationship with proinflammatory adipocytokines and insulin resistance in a severely obese cohort, before and 1 year after a surgical gastric bypass. Plasmatic levels of A-FABP were measured in 77 morbid-obese women before and 1 year after bariatric surgery. Anthropometrical parameters and body composition by bioelectrical impedance analysis were determined. Circulating levels of soluble tumor necrosis factor receptor 2 (sTNFR2), Interleukin 18 (IL-18), adiponectin, and high-sensitive C-reactive protein (hsCRP) were also analyzed. Insulin resistance by homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated. After massive weight loss, A-FABP plasmatic levels decreased significantly [7.6 (8.9) vs. 4.3 (5.1); P<0,001] but no association with circulating adipokines or proinflammatory cytokines, both at the beginning and at the end of follow-up, was observed. A decrease in sTNFR2, IL-18, hsCRP, and an increase in adiponectin levels (P<0.001 in all cases) were observed after the gastric bypass. HOMA-IR index improved 1 year after surgery and after multiple regression analysis remained associated with A-FABP after controlling for confounding variables (beta=0.322, P=0.014; R2 for the model 0.281). In morbid-obese women, plasma A-FABP concentrations were dramatically reduced after gastric bypass surgery. After weight loss this protein contributed to HOMA-IR index independently of proinflammatory/antinflammatory cytokine profile. Further studies are warranted to elucidate the role of A-FABP in the pathogenesis of insulin resistance in morbid obesity.
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Simón et al. (2009) conducted a cohort in Morbid obesity (n=77). Surgical gastric bypass vs. Baseline (before surgery) was evaluated on Plasmatic levels of A-FABP (p=<0.001). Surgical gastric bypass significantly reduced plasma A-FABP levels from 7.6 to 4.3 (P<0.001) at 1 year in morbid-obese women, remaining independently associated with insulin resistance.
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