Skip to main content

Advertisement

SpringerLink
Log in

Glycosaminoglycans of Abdominal Skin After Massive Weight Loss in Post-bariatric Female Patients

  • Basic Science Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

The number of post-bariatric patients had a significant increase over the last years, and a better understanding of the consequences of massive weight loss on skin is imperative. Despite weight-loss-related changes in collagen and elastin have been reported, less is known about changes in another of the matrix components of the skin, the glycosaminoglycans. The objective of this study is to evaluate abdominal skin glycosaminoglycans concentrations and perlecan and collagen III expression in post-bariatric female patients.

Methods

Skin tissue samples from the abdomen of lean (n = 19) and post-bariatric (n = 24) female patients were compared. Sulfated glycosaminoglycans and hyaluronic acid were extracted, characterized and quantified. Perlecan and collagen III expression was assessed by immunofluorescence.

Results

The major glycosaminoglycans found were dermatan sultafe and hyaluronic acid; the others were found in smaller amounts. The skin of the post-bariatric patients had lower concentrations of heparan sulfate (p = 0.002) while hyaluronic acid, dermatan sulfate, and chondroitin sulfate concentrations were similar to the lean women’s skin. Post-bariatric skin showed decreased expression of perlecan and increased expression of collagen III. No correlation was found among glycosaminoglycans concentrations and age, body mass index, frequency of pregnancies, or skin types, but it was observed in higher skin heparan sulfate concentrations in post-bariatric patients who had their weights stabilized for over than 24 months (p = 0.000).

Conclusion

Abdominal skin of post-bariatric women presented decreased heparan sulfate concentrations and perlecan expression and increased expression of collagen III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Yosipovitch G, DeVore A, Dawn A. Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol. 2007;56:901–16.

    Article  PubMed  Google Scholar 

  2. Sati S, Pandya S. Should a panniculectomy/abdominoplasty after massive weight loss be covered by insurance? Ann Plast Surg. 2008;60:502–5.

    Article  PubMed  CAS  Google Scholar 

  3. Sebastian JL. Bariatric surgery and work-up of the massive weight loss patient. Clin Plast Surg. 2008;35:11–26.

    Article  PubMed  Google Scholar 

  4. de Kerviler S, Hüsler R, Banic A, et al. Body contouring surgery following bariatric surgery and dietetically induced massive weight reduction: a risk analysis. Obes Surg. 2009;19:553–9.

    Article  PubMed  Google Scholar 

  5. Pender JR, Pories WJ. Epidemiology of obesity in the United States. Gastroenterol Clin N Am. 2005;34:1–7.

    Article  Google Scholar 

  6. Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity and health care use in morbidly obese patients. Ann Surg. 2004;240:416–24.

    Article  PubMed  Google Scholar 

  7. Greco III JA, Castaldo ET, Nanney LB, et al. The effect of weight loss surgery and body mass index on wound complications after abdominal contouring operations. Ann Plast Surg. 2008;61:235–42.

    Article  PubMed  CAS  Google Scholar 

  8. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190.

    CAS  Google Scholar 

  9. Baptista LS, Silva KR, Pedrosa CSG, et al. Adipose tissue of control and ex-obese patients exhibit differences in blood vessel content and resident mesenchymal stem cell population. Obes Surg. 2009;19:1304–12.

    Article  PubMed  Google Scholar 

  10. Colquitt JL, Picot J, Loveman E, et al. Surgery for obesity. Cochrane Database Syst Rev 2009;(4):CD003641

  11. Light D, Arvanitis GM, Abramson D, et al. Effect of weight loss after bariatric surgery on skin and the extracellular matrix. Plast Reconstr Surg. 2010;125:343–51.

    Article  PubMed  CAS  Google Scholar 

  12. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2008. Obes Surg. 2009;19:1605–11.

    Article  PubMed  Google Scholar 

  13. Blüher M. Adipose tissue dysfunction in obesity. Exp Clin Endocrinol Diabetes. 2009;117:241–50.

    Article  PubMed  Google Scholar 

  14. Choo S, Marti G, Nastai M, et al. Biomechanical properties of skin in massive weight loss patients. Obes Surg. 2010. doi: 10.1007/s11695-010-0147-6

  15. Gusenoff JA, Coon D, De la Cruz C, et al. Superficial epigastric vessels in the massive weight loss population: implications for breast reconstruction. Plast Reconstr Surg. 2008;122:1621–6.

    Article  PubMed  CAS  Google Scholar 

  16. Shermak MA, Chang D, Magnuson TH, et al. An outcomes analysis of patients undergoing body contouring surgery after massive weight loss. Plast Reconstr Surg. 2006;118:1026–31.

    Article  PubMed  CAS  Google Scholar 

  17. Coon D, Gusenoff JA, Kannan N, et al. Body mass and surgical complications in the postbariatric reconstructive patient: analysis of 511 cases. Ann Surg. 2009;249:397–401.

    Article  PubMed  Google Scholar 

  18. Orpheu SC, Coltro PS, Scopel GP, et al. Collagen and elastic content of abdominal skin after surgical weight loss. Obes Surg. 2010;20:480–6.

    Article  PubMed  Google Scholar 

  19. Hidalgo LG. Dermatological complications of obesity. Am J Clin Dermatol. 2002;3:497–506.

    Article  Google Scholar 

  20. Reichenberger MA, Stoff A, Richter DF. Dealing with the mass: a new approach to facilitate panniculectomy in patients with very large abdominal aprons. Obes Surg. 2008;18:1605–10.

    Article  PubMed  Google Scholar 

  21. De Maria EJ, Jamal MK. Surgical options for obsity. Gastroenterol Clin N Am. 2005;34:127–42.

    Article  Google Scholar 

  22. Gmur RU, Banic A, Erni D. Is it safe to combine abdominoplasty with other dermolipectomy procedures to correct skin excess after weight loss? Ann Plast Surg. 2003;51:353–7.

    Article  PubMed  Google Scholar 

  23. Taylor J, Shermak M. Body contouring following massive weight loss. Obes Surg. 2004;14:1080–5.

    Article  PubMed  Google Scholar 

  24. Araco A, Gravante G, Araco F, et al. Body contouring after weight loss: the plastic-bariatric surgery symbiosis. Aesthet Plast Surg. 2006;30:374–6.

    Article  CAS  Google Scholar 

  25. Borud LJ, Warren AG. Body contouring in the postbariatric surgery patient. J Am Coll Surg. 2006;203:82–93.

    Article  PubMed  Google Scholar 

  26. Cintra Jr W, Modolin MLA, Gemperli R, et al. Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg. 2008;18:728–32.

    Article  PubMed  Google Scholar 

  27. Migliori FC, Robello G, Ravetti JL, et al. Histological alterations following bariatric surgery: pilot study. Obes Surg. 2008;18:1305–7.

    Article  PubMed  Google Scholar 

  28. Breitkreutz D, Mirancea N, Nischt R. Histochem Cell Biol. 2009;132:1–10.

    Article  PubMed  CAS  Google Scholar 

  29. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124:869–71.

    Article  PubMed  CAS  Google Scholar 

  30. Perosa SR, Porcionatto MA, Cukiert A, et al. Glycosaminoglycan levels and proteoglycan expression are altered in the hippocampus of patients with mesial temporal lobe epilepsy. Brain Res Bull. 2002;178:311–7.

    Google Scholar 

  31. Dietrich CP, Dietrich SM. Electrophoretic behavior of acidic mucopolysaccharides in diamine buffers. Anal Biochem. 1976;70:645–7.

    Article  PubMed  CAS  Google Scholar 

  32. Martins JRM, Passerotti CC, Maciel RMB, et al. Practical determination of hyaluronan by a non-competitive fluoroassay and its application on serum of normal and cirrhotic patients. Anal Biochem. 2003;319:65–72.

    Article  PubMed  CAS  Google Scholar 

  33. Soler R, Bruschini H, Martins JR, et al. Urinary Glycosaminoglycans as Biomarker for Urothelial Injury: Is It Possible to Discriminate Damage From Recovery? Urology. 2008;72:937–42.

    Article  PubMed  Google Scholar 

  34. Willen MD, Sorrell JM, Lekan CC, et al. Patterns of glycosaminoglycan/proteoglycan immunostaining in human skin during aging. J Invest Dermatol. 1991;96:968–74.

    Article  PubMed  CAS  Google Scholar 

  35. Dreyfuss JL, Veiga SS, Coulson-Thomas VJ, et al. Differences in the expression of glycosaminoglycans in human fibroblasts derived from gingival overgrowths is related to TGF-beta up-regulation. Growth Factors. 2010;28:24–33.

    Article  PubMed  CAS  Google Scholar 

  36. Takano CC, Bezerra LRPS, Zucchi EV, et al. Long-term and short-term effects of simulated birth trauma, cesarean and vaginal delivery on sulfated glycosaminoglycans in the urethra of female rats. Int Urogynecol J. 2010;21:705–10.

    Article  Google Scholar 

  37. Dreyfuss JL, Regatieri CV, Jarrouge TR, et al. Heparan sulfate proteoglycans: structure, protein interactions and cell signaling. An Acad Bras Cienc. 2009;81:409–29.

    Article  PubMed  CAS  Google Scholar 

  38. De la Torre NG, Rubio MA, Bordiú E, et al. Effects of weight loss after bariatric surgery for morbid obesity on vascular endothelial growth factor-A, adipocytokines, and insulin. J Clin Endocrinol Metab. 2008;93:4276–81.

    Article  Google Scholar 

  39. Silha JV, Krsek M, Sucharda P, et al. Angiogenic factors are elevated in overweight and obese individuals. Int J Obes. 2005;29:1308–10.

    Article  CAS  Google Scholar 

  40. Yurchenco PD, Patton BL. Developmental and pathogenic mechanisms of basement membrane assembly. Curr Pharm Des. 2009;15:1277–94.

    Article  PubMed  CAS  Google Scholar 

  41. Farach-Carson MC, Carson DD. Perlecan—a multifunctional extracellular proteoglycan scaffold. Glycobiology. 2007;17:897–905.

    Article  PubMed  CAS  Google Scholar 

  42. Sher I, Zisman-Rozen S, Eliahu L, et al. Targeting perlecan in human keratinocytes reveals novel roles for perlecan in epidermal formation. J Biol Chem. 2006;281:5178–87.

    Article  PubMed  CAS  Google Scholar 

  43. Xing L, Culbertson EJ, Wen Y, et al. Impaired laparotomy wound healing in obese rats. Obes Surg. 2011; (in press)

  44. Koehler MJ, Hahn S, Preller A, et al. Morphological skin ageing criteria by multiphoton laser scanning tomography: non-invasive in vivo scoring of the dermal fibre network. Exp Dermatol. 2008;17:519–23.

    Article  PubMed  Google Scholar 

  45. Leong PL. Aging changes in the male face. Facial Plast Surg Clin N Am. 2008;16:277–9.

    Article  Google Scholar 

  46. Lenhardt R, Hopf HW, Marker E, et al. Perioperative collagen deposition in elderly and young men and women. Arch Surg. 2000;135:71–4.

    Article  PubMed  CAS  Google Scholar 

  47. Jorgensen LN, Sorenson LT, Kallehave F, et al. Premenopausal women deposit more collagen than men during healing of an experimental wound. Surgery. 2002;131:338–43.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq 471468/2008-8).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Plastic Surgery, Department of Surgery, Universidade Federal de São Paulo, Rua Napoleão de Barros, 715, 4º andar, 04024-002, São Paulo, São Paulo, Brazil

    Daniela Francescato Veiga, Rodolpho A. Bussolaro, Elvio B. Garcia & Lydia M. Ferreira

  2. Division of Plastic Surgery, Department of Surgery, Universidade do Vale do Sapucaí, Pouso Alegre, Brazil

    Daniela Francescato Veiga

  3. Division of Molecular Biology, Department of Biochemistry, Universidade Federal de São Paulo, São Paulo, Brazil

    Elsa Y. Kobayashi, Valquíria P. Medeiros, João R. M. Martins & Helena B. Nader

  4. Division of Endocrinology and Metabolism, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

    João R. M. Martins

  5. Department of Bioestatistics, Universidade do Vale do Sapucaí, Pouso Alegre, Brazil

    Neil F. Novo

Authors
  1. Daniela Francescato Veiga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rodolpho A. Bussolaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elsa Y. Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Valquíria P. Medeiros
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. João R. M. Martins
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elvio B. Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Neil F. Novo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Helena B. Nader
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lydia M. Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Francescato Veiga.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Veiga, D.F., Bussolaro, R.A., Kobayashi, E.Y. et al. Glycosaminoglycans of Abdominal Skin After Massive Weight Loss in Post-bariatric Female Patients. OBES SURG 21, 774–782 (2011). https://doi.org/10.1007/s11695-011-0405-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-011-0405-2

Keywords

Search

Navigation