None listed
Conditions
Brief summary
Adiponectin, an adipose hormone which exits in various forms (oligomers) in the blood, may be a important link between obesity and it's associated disease states. It is negatively correlated with obesity, insulin resistance and dyslipidaemia, and may have a cardioprotective role. This study will investigate the effect of bariatric surgery for weight loss on adiponectin gene expression, secretion, receptor number and type, and circulation in a group of obese women from whom adipose tissue, muscle and liver biopsy samples will be collected for analysis pre and post surgery.
Interventions
This is an observational study of a bariatric weight loss program investigating the biology of the adipose hormone adiponectin. The intervention will be standard care at a public New Zealand teaching hospital, which will comprise a very low energy diet (VLED) followed by bariatric surgery. Participants will follow the VLED, in the form of Optifast meal replacement, for 4-6 weeks prior to surgery, and then will undergo Roux en Y gastric bypass or sleeve gastrectomy. During surgery tissue biopsy s
This is an observational study of a bariatric weight loss program investigating the biology of the adipose hormone adiponectin. The intervention will be standard care at a public New Zealand teaching hospital, which will comprise a very low energy diet (VLED) followed by bariatric surgery. Participants will follow the VLED, in the form of Optifast meal replacement, for 4-6 weeks prior to surgery, and then will undergo Roux en Y gastric bypass or sleeve gastrectomy. During surgery tissue biopsy samples will be collected from the abdomen and thigh (adipose, muscle) in addition to the liver . At 6 month follow-up repeat subcutaneous biopsies will be collected from the abdomen and thigh. Blood samples will be collected at pre-VLED, surgery and follow-up, and body composition analyses will be performed at these time points to assess body fat distribution. Optifast is a mixture of shakes, soups and bars. Usually taken 3 times a day, if this is poorly tolerated or if a longer period is required then only 2 times a day, with a third meal of steamed veges. Surgery methods Roux en Y: laparoscopic, 30ml pouch, hand sewn gastrojejeunostomy, 100cm roux limb, hand sewn small bowel anastomosis, 3-4 hours Sleeve: laparoscopic, narrow gastric sleeve over 32-36 french bougie, 2-3 hours Body composition measurements: 1. Total body protein (Neutron Activation Analysis) 2. Total body fat (Dual-Energy X-Ray Absorptiometry (DEXA) 3. Total body potassium (TBK) 4. Total body water (Tracer Dilution) 5. Total body water (Bioelectrical Impedance) 6. Skinfolds 7. Grip strength This is all monitored by health care professionals.
Sponsors
The Univeristy of Auckland
Eligibility
Sex/Gender
All
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
Phase 1 A Lean: BMI 18.5-25 kg/m2, weight stable and healthy. Accepted into the Auckland District Health Board Auckland City Hospital General Laparoscopic Upper GI Surgery Clinic. Accepts reversion to open surgery if necessary. Signed informed consent given. Phase 1 B Obese: BMI >40 or >35 kg/m2 with co-morbidities and weight stable. Accepted into the Auckland District Health Board Auckland City Hospital General Laparoscopic Upper GI Surgery Clinic. Accepts reversion to open surgery if necessary. Signed informed consent given. Phase 2: Body Mass Index (BMI) >40 kg/m2 or >35 kg/m2 plus co-morbidities of diabetes, polycystic ovary syndrome, fatty liver disease and severe dyslipidaemia. Accepted for Bariatric Surgery at Auckland City Hospital Signed informed consent given
Exclusion criteria
History of inflammatory or malignant disease. Previous obesity surgery – bariatric, liposuction, lipectomy or liposculpture Pregnant or breastfeeding Participation in another clinical trial No weight loss medication of weight programme attendance. No extreme food restriction and/or excessive physical activity and alters body composition in a short space of time.
Outcome results
None listed