The Change of Serum S14 Level in Severely Obese Patients Undergoing Bariatric Surgery

• Main Authors: Po-Ju Hung, 洪泊儒
• Other Authors: Wei-Shiung Yang
• Format: Others
• Language: en_US
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/p55kft

碩士 === 國立臺灣大學 === 臨床醫學研究所 === 106 === ABSTRACT Introduction Obesity is a worldwide issue, more than half a billion adults were obese. It is a condition in which excess fat has accumulated in the body, such that it can have an adverse effect on health. Excessive fat accumulation in adipose tissue and ectopic fat accumulation in non-adipose tissue may lead to dysfunction of different tissues or organs. Studies had revealed that obesity is characterized by the chronic low-grade activation of the innate immune system. Macrophage-elicited inflammation and adipocyte-macrophage interaction might play a pivotal role. Interleukin-1β (IL-1β) is one of those accumulated pro-inflammatory cytokines. Using IL-1β treated mouse 3T3-L1 cells with control, gene expression chip showed that thyroid hormone responsive (THRSP) was the only one significantly down-regulated gene. The protein product Spot 14 (S14) is a liver and adipose tissue-secreted protein which is stimulated by thyroid hormone, carbohydrate and insulin. It is a potent stimulator of de novo lipogenesis in mice. However, little is known about the role of S14 in humans. In obese human subjects, the expression of S14 is abnormally-regulated. We conducted this study to further investigate the role of S14 in obese human subjects receiving bariatric surgery. Methods and Materials Patients who met the criteria and received bariatric surgery at National Taiwan University Hospital Center for Obesity, Life Style and Metabolic Surgery since May, 2013 were evaluated in this study. A total of 87 patients were included. The information of their anthropometric measurements, biochemical data, medical history and medication usage were documented. The serum samples of those patients who received follow-up at 6 months after the surgery were analyzed. A competitive enzyme-linked immunoassay (ELISA) was used to measure fasting serum levels of S14. Results There were 87 patients received laparoscopic sleeve gastrectomy (LSG). The mean age is 38 ± 10.7 years old. Among these subjects, 39 of them are males and 47 are females. Most of the subjects had fatty liver disease (N = 80, 91.9%). More than half of these subjects had hyperlipidemia (N = 50, 57.5%) and hypertension (N = 44, 50.6%). Only about one-third had diabetes (N = 31, 35.6%). The reductions in body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 28.5 ±8.0 kg, 10.3 ±2.8 kg/m2, 21.3 ±7.3 cm, 16.9 ±6.9 cm, 12.7 ±15.9 mmHg and 9.2 ±13.4 mmHg, respectively. The differences between the means of these variables before and after surgery were highly significant (all p <0.0001). We also observed a significant improvement in fasting plasma glucose (FPG), glycated hemoglobulin (HbA1c), insulin, triglyceride (TG), high density lipoprotein cholesterol (HDL-C), uric acid and C-reactive protein (CRP) after surgery (all p < 0.0001). However, there was no significant changes in total cholesterol (TC) (p = 0.2729) and low density lipoprotein cholesterol (LDL-C) (p = 0.6779). The level of LDL-C even increased after surgery. There was no significant change of S14 level before (432.9 ng/dL (±313.1)) and after (368.1 ng/dL (±216.6)) the surgery (p = 0.6956). Discussion Our study is the first to investigate whether weight reduction is associated with the change in serum S14. In this study, we observed no changes in serum S14, a measure of possible regulator of lipogenesis, in obese subjects receiving bariatric surgery. Cross-sectional analysis in our results did not reveal correlation between baseline serum S14 level and pre-operation body weight. Cross-sectional study in a larger scale comparing obese subjects with control groups deserve further investigation. Conclusion In our study, showed that the change of serum levels of S14 in obese patients receiving LSG were not significant after 6 months.