Endocrine Abstracts

Introduction: Adiponectin is an adipocyte-derived hormone with an important role in regulation of glucose and lipid metabolism. Its variation might mediate an ameliorated metabolic profile associated with weight loss after bariatric surgery. The aim of our study was to evaluate adiponectin change as early as 6 months after laparoscopic sleeve gastrectomy (LSG) and to indicate preoperative factors that might influence its dynamic.

Methods: A number of 88 extremely obese women (mean age=42.1±11.24 years, mean BMI=45.77±7.6 kg/m²) were evaluated before and 6 months after LSG. This included complete clinical examination, as well as metabolic and hormonal lab tests. Serum adiponectin was measured using ELISA method, while for C-reactive protein (CRP), IGF1 and insulin we used chemiluminiscence. Since IGF1 levels are age-dependent, we calculated the SDS of IGF1 levels according to age (z-score). Parametric variables are presented as mean±S.D., while non-parametric ones (such as adiponectin) as median (interquartile range).

Results: Six months after LSG, mean BMI decreased from 45.77±7.6 to 33.24±7.1 kg/m², P<0.001, while adiponectin levels increased from 7.76 (3.74) to 10.4 (6.37) mg/l, P<0.001. Postoperative adiponectin levels negatively correlated with preoperative triglyceride (r=−0.294, P=0.008), HOMA-IR (r=−0.326, P=0.005), and CRP (r=−0.337, P=0.004) levels and positively correlated with preoperative adiponectin levels (r=0.442, P<0.001) and IGF1 z-score (r=0.245, P=0.029). There was also a positive correlation between postoperative adiponectin levels and the percentage of weight loss (r=0.318, P=0.004). In multivariate analysis, stepwise method, which included all the aforementioned variables, preoperative adiponectin and HOMA-IR levels and the percentage of weight loss remained independently associated with postoperative adiponectin levels, together explaining 52.7% of its variability.

Conclusion: Preoperative metabolic status (appreciated by adiponectin and HOMA-IR levels) and the percentage of weight loss are independent determinants of adiponectin levels attained 6 months after LSG.