Abstract |
One of the main goals of weight reduction in morbidly obese subjects is its benefit on coronary heart disease (CHD) risk. A cross-sectional study was designed to randomly assign 79 morbidly obese subjects (27 men and 52 women; age: 30-45 years) either to a diet protocol (20 kcal per kg fat-free mass (FFM); 55% carbohydrates, 30% fat, and 15% proteins) or to malabsorptive surgery ( biliopancreatic diversion). Fatness parameters, measured by dual-energy X-ray absorptiometry, lipid profile, insulin, leptin, sex steroid hormones and sex hormone-binding globulin (SHBG) levels were compared at baseline and 1 year after the beginning of the study. The data showed that plasma SHBG levels, but not testosterone levels, correlated negatively to fasting insulin levels and positively to HDL-cholesterol in both men and women. Total leptin levels were significantly lower (P<0.0001) in post-BPD subjects of both sexes compared to dietary treated obese subjects. The logarithm of plasma leptin correlated significantly and positively with insulin but negatively with SHBG.A step-down regression analysis showed that FFM and SHBG, but not insulin levels, were the most powerful independent variables for predicting HDL-cholesterol levels in morbidly obese patients. The negative relationship between SHBG levels and CHD risk appears to be mediated by a concomitant variation in body fatness. Finally, in obese patients, SHBG levels seem to be an indicator of total adiposity rather than an index of an altered insulin/ glucose homeostasis.
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Authors | G Mingrone, A V Greco, A Giancaterini, A Scarfone, M Castagneto, M Pugeat |
Journal | Atherosclerosis
(Atherosclerosis)
Vol. 161
Issue 2
Pg. 455-62
(Apr 2002)
ISSN: 0021-9150 [Print] Ireland |
PMID | 11888531
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Biomarkers
- Cholesterol, HDL
- Leptin
- Sex Hormone-Binding Globulin
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Topics |
- Adult
- Biomarkers
(analysis)
- Body Composition
- Cardiovascular Diseases
(blood, epidemiology)
- Cholesterol, HDL
(metabolism)
- Cohort Studies
- Cross-Sectional Studies
- Diet, Fat-Restricted
- Female
- Gastroplasty
- Humans
- Incidence
- Leptin
(metabolism)
- Male
- Middle Aged
- Multivariate Analysis
- Obesity, Morbid
(diet therapy, epidemiology, surgery)
- Probability
- Regression Analysis
- Risk Factors
- Sensitivity and Specificity
- Sex Hormone-Binding Globulin
(metabolism)
- Weight Loss
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