Weight Loss and Adhesion Molecules - Adhesion Molecules - page 219

ADHESION MOLECULES IN OBESITY
Obesity is associated with increased levels of CAMs (Mora et al. 2006). h e ef ect
of obesity on CAMs is relatively modest, with those in the highest quintile of
body mass index (BMI) having median levels 14% higher than those in the lowest
quintile for ICAM-1 in a cross-sectional study of 27,158 women in the United
States (Mora et al. 2006). A similar association was also seen in obese children
compared with controls but this was not independent of other risk factors for
obesity (Glowinska et al. 2005, Meyer et al. 2006).
ADHESION MOLECULES AND WEIGHT LOSS
Weight loss of 7-18% following either lifestyle programs or bariatric surgery reduces
ICAM-1, VCAM-1 and E-selectin by 15-28%, 15% and 20-35% respectively (Ferri
et al. 1999, Ito et al. 2002, Pontiroli et al. 2004, Vazquez et al. 2005). However,
the ef ect of weight loss on adhesion molecules is very variable. In a study by
Pontiroli et al. (2008), BMI was reduced from 44.3 ± 0.43 to 36.4 ± 0.39 kg/m 2
with a corresponding reduction in ICAM-1 concentrations from 313.1 ± 9.69 to
275.2 ± 6.16 ng/m (a 12% reduction). E-selectin was reduced from 64.1 ± 4.04 to
44.1 ± 1.96 ng/ml (a 31% reduction).
Vazquez et al. (2005) observed that E- and P-selectin improved at er weight
loss of 24 kg, but ICAM-1 levels did not change and VCAM-1 increased, PAI-1
and CRP fell but TNF-alpha and IL6 did not change. Plat et al. (2007) in a study
evaluating the ef ects of i sh oil and moderate weight loss in 11 obese men (BMI
30-35 kg/m 2 ) found that i sh oil did not af ect s-ICAM-1, whereas weight loss of
9.4 kg reduced fasting levels (p = 0.009) and post-prandial s-ICAM-1 responses
(p < 0.001).
A number of other studies have observed similarly mixed results (Ziccardi
et al. 2002, Hamdy et al. 2003, Hanusch-Enserer et al. 2004, Pontiroli et al. 2004,
Sharman and Volek 2004, Trøseid et al. 2005, McLaughlin et al. 2006, Konukoglu
et al. 2007, Swarbrick et al. 2008). In a study of 18 morbidly obese patients who
underwent gastric banding, subjects were evaluated before surgery and 6 and 12
mon at er surgery. BMI dropped from 45.22 ± 5.62 to 36.99 ± 4.34 kg/m 2 at er 6
mon and to 33.72 ± 5.55 kg/m 2 at er 12 mon (both p < 0.0001). E-selectin levels
decreased signii cantly at er 6 and 12 mon (p = 0.05), whereas signii cantly lower
levels of ICAM-1 and PAI-1 were seen at er 6 mon but were not sustained at 12
mon. No changes were observed in VCAM-1 (Hanusch-Enserer et al. 2004). h is
was a small study and despite large weight loss these patients remain obese, which
may explain the variability in the ef ects on adhesion molecules at er maintenance
of weight loss.
Pontiroli et al. (2004) found that ICAM-1, E-selectin, and endothelin-1 (ET-1)
were higher in 96 obese patients compared with 30 lean controls. In those 26