Plasma MR-proADM Correlates to BMI and Decreases in Relation to Leptin After Gastric Bypass Surgery
Plasma MR-proADM Correlates to BMI and Decreases in Relation to Leptin After Gastric Bypass Surgery
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DOI：
10.1038/oby.2009.22
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发表时间：
2009-06-01
期刊：
影响因子：
6.9
通讯作者：
Luger, Anton
中科院分区：
文献类型：
--
作者：
Vila, Greisa;Riedl, Michaela;Luger, Anton
肾上腺髓质素(ADM)是一种血管活性多肽，与肥胖及其并发症：2型糖尿病、高血压、动脉粥样硬化和冠心病有关。与瘦身受试者相比，肥胖者血浆和脂肪组织中的ADM均增加，被认为是脂肪因子家族的成员。我们测定了357名体重指数在17.5到42.3 kg/m(2)之间且无额外病史的受试者的血浆中区域肾上腺髓质素原(MR-proADM)浓度。同时，对28例拟接受腹腔镜Roux-en-Y胃分流术(RYGB)的重度肥胖患者在手术前和术后1年进行研究。结果测量：MR-proADM、皮质醇、瘦素、C-反应蛋白(CRP)、促甲状腺激素(TSH)、肌酐和代谢参数。体重指数与血浆MR-proADM水平显著相关(r=0.714，P<；0.001)，在调整年龄和性别后也是如此(r=0.767，P<；0.001)。肥胖组MR-proADM与瘦素呈正相关(r=0.511，P=0.006)。治疗后血浆MR-proADM由0.76±0.03pg/ml降至0.62±0.02pg/ml(P<；0.0001)。RYGB诱导的MR-proADM变化与瘦素(r=0.533，P=0.004)和C反应蛋白(r=0.429，P=0.023)的变化显著相关。我们得出结论，BMI是循环MR-proADM水平的独立预测因子。RYGB治疗后体重减轻与血浆MR-proADM显著降低有关，这与手术引起的循环瘦素和全身炎症改变有关。
Adrenomedullin (ADM) is a vasoactive peptide found to be related to obesity and its comorbidities: type 2 diabetes, hypertension, atherosclerosis, and coronary heart disease. ADM is increased both in plasma and in adipose tissue of obese individuals when compared to lean subjects and is considered as a member of the adipokine family. We determined plasma midregional proadrenomedullin (MR-proADM) concentrations in a cohort of 357 subjects with BMI ranging from 17.5 to 42.3 kg/m(2) and no additional medical history. In parallel, 28 severely obese patients scheduled to undergo laparoscopic Roux-en-Y gastric bypass (RYGB) surgery were studied at two time points: before and 1 year after surgery. Outcome measurements were: MR-proADM, cortisol, leptin, C-reactive protein (CRP) thyroid-stimulating hormone (TSH), creatinine and metabolic parameters. BMI correlated significantly to plasma MR-proADM levels (r = 0.714, P < 0.001), also after adjustment for age and gender (r = 0.767, P < 0.001). In obese subjects, there was a positive relationship between MR-proADM and leptin (r = 0.511, P = 0.006). Following RYGB, plasma MR-proADM decreased from 0.76 +/- 0.03 to 0.62 +/- 0.02 pg/ml (P < 0.0001). RYGB-induced changes in MR-proADM correlated significantly to changes in leptin (r = 0.533, P = 0.004) and in CRP (r = 0.429, P = 0.023). We conclude that BMI is an independent predictor of circulating MR-proADM levels. Weight loss after RYGB is associated with a significant decrease in plasma MR-proADM, which is related to surgery-induced changes in both circulating leptin and systemic inflammation.