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Role of dehydroepiandrosterone sulfate levels on body composition after laparoscopic adjustable gastric banding in pre-menopausal morbidly obese women

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Abstract

In humans, dehydroepiandrosterone (DHEAS) has been postulated to have anabolic and lipolytic properties that could potentially counteract the catabolic effect of cortisol. DHEAS secretion is reduced in morbid obesity, likely due to hyperinsulinemia, and laparoscopic adjustable gastric banding (LASGB), by inducing considerable and rapid weight loss, reduces insulin levels. To investigate the role of decreased insulin levels after LASGB-induced weight loss on DHEAS levels and on body composition changes, we studied 30 pre-menopausal morbidly obese women (BMI ranging 37–62 kg/m2) before, 6, 12 and 24 months after LASGB. Total body water (TBW), fat-free mass (FFM) and fat mass (FM) were measured by bioelectrical impedance analysis; tissue hydration was also assessed by impedance vector analysis. At study ending, the subjects had a total weight loss of 28% of baseline body weight (15% after 6 months). After LASGB, weight loss was mainly due to decreased FM, and TBW, FFM, and body hydration were not significantly reduced. Weight loss was associated with an 82% rise in serum DHEAS already after 6 months while cortisol, cortisol/DHEAS molar ratio, and insulin levels fell by 5.5, 62 and 50%, respectively, after 6, 12 and 24 months (p<0.05). Conclusions: LASGB associated with a well balanced low-calorie diet permits a satisfactory 2-yr weight loss, sparing FFM and without body fluid alterations. As the result of a stable weight reduction program weight loss is associated to decrease in cortisol, cortisol/DHEAS molar ratio, and insulin plasma levels with marked rise in DHEAS. Higher cortisol/DHEAS molar ratio values at baseline are also associated to lower weight loss after LASGB, with lower decrease in FM and higher reduction in FFM and body cell mass, in spite of no differences in dietary regimes. Cortisol/DHEAS molar ratio is likely to represent a reliable marker of favourable modifications in body composition.

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References

  1. Ebeling P, Koivisto VA. Physiological importance of dehydroepiandrosterone. Lancet 1994, 343: 1479–81.

    Article  PubMed  CAS  Google Scholar 

  2. Baulieu EE. Dehydroepiandrosterone (DHEA): a fountain of yought? J Clin Endocrinol Metab 1996, 81: 3147–51.

    Article  PubMed  CAS  Google Scholar 

  3. Khorram O. DHEA: a hormone with multiple effects. Curr Opin Obstet Gynecol 1996, 8: 351–4.

    Article  PubMed  CAS  Google Scholar 

  4. Nestler JE, Clore JN, Blackward WG. Dehydroepiandrosterone: the missing link between hyperinsulinaemia and atherosclerosis? FASEB J 1992, 6: 3073–5.

    PubMed  CAS  Google Scholar 

  5. Tchernof A, Labrie F. Dehdroepiandrosterone, obesity and cardiovascular risk. A review of human study. Eur J Endocrinol 2004, 151: 1–14.

    Article  PubMed  CAS  Google Scholar 

  6. Nestler JE. Regulation of human dehydroepiandrosterone sulphate metabolism by insulin. Ann NY Acad Sci 1995, 774: 73–81.

    Article  PubMed  CAS  Google Scholar 

  7. Carlstrom K, Brody S, Lunnell NO, et al. Dehydroepiandrosterone sulphate and dehydroepiandrosterone in serum: differences related to age and sex. Maturitas 1988, 10: 297–306.

    Article  PubMed  CAS  Google Scholar 

  8. Maccario M, Mazza E, Ramunni J, et al. Relationships between dehydroepiandrosterone sulphate and anthropometric, metabolic and hormonal variables in a large cohort of obese women. Clin Endocrinol (Oxf) 1999, 50: 595–600.

    Article  CAS  Google Scholar 

  9. Laughlin GA, Barrett-Connor E. Sexual dimorphism in the influence of advanced aging on adrenal hormone levels: the Rancho Bernardo Study. J Clin Endocrinol Metab 2000, 85: 3561–8.

    PubMed  CAS  Google Scholar 

  10. Kalimi M, Shafagoi Y, Loria R, et al. Antiglucocorticoid effects of dehydroepiandrosterone (DHEA). Mol Cell Biochem 1994, 131: 99–104.

    Article  PubMed  CAS  Google Scholar 

  11. Moriyama Y, Yasue H, Yoshimura M, et al. The plasma levels of dehydroepiandrosterone sulphate are decreased in patients with chronic heart failure in proportion to the severity. J Clin Endocrinol Metab 2000, 85: 1834–40.

    PubMed  CAS  Google Scholar 

  12. Christeff N, Melchior JC, Mammes O, Gherbi N, Dalle MT, Nunez EA. Correlation between increased cortisol: DHEA ratio and malnutrition in HIV-positive men. Nutrition 1999, 15: 534–9.

    Article  PubMed  CAS  Google Scholar 

  13. Saris WH. Fit, fat and fat free: the metabolic aspects of weight control. Int J Obes 1998, 22 (Suppl 2): S15–21.

    Google Scholar 

  14. Benedetti G, Mingrone G, Marcoccia S, et al. Body composition and energy expenditure after weight loss following bariatric surgery. J Am Coll Nutr 2000, 19: 270–4.

    Article  PubMed  CAS  Google Scholar 

  15. Tacchino RM, Mancini A, Perrelli M, et al. Body composition and energy expenditure: relationship and changes in obese subjects before and after biliopancreatic diversion. Metabolism 2003, 52: 552–8.

    Article  PubMed  CAS  Google Scholar 

  16. Das SK, Roberts SB, McCrory MA, et al. Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery. Am J Clin Nutr 2003, 78: 22–30.

    PubMed  CAS  Google Scholar 

  17. Gastrointestinal Surgery for severe obesity. National Institutes of Health Consensus Development Conference Draft Statement. Obes Surg 1991, 1: 257–66.

    Article  Google Scholar 

  18. Hu FB, Rimm E, Smith-Warner SA, et al. Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 1999, 69: 243–9.

    PubMed  CAS  Google Scholar 

  19. Kuzmak LI. A review of seven years experience with silicone gastric banding. Obes Surg 1991, 1: 403–8.

    Article  PubMed  Google Scholar 

  20. Angrisani L, Lorenzo M, Esposito G, et al. Laparoscopic adjustable silicone gastric banding: preliminary results of Naples experience. Obes Surg 1997, 7: 19–21.

    Article  PubMed  CAS  Google Scholar 

  21. Busetto L, Pisent C, Segato G, et al. The influence of a new timing strategy of band adjustment on the vomiting frequency and the food consumption of obese women operated with laparoscopic adjustable silicone gastric banding (LAP-BAND(r)). Obes Surg 1997, 7: 505–12.

    Article  PubMed  CAS  Google Scholar 

  22. Busetto L, Valente P, Pisent C, et al. Eating pattern in the first year following adjustable silicone gastric banding (ASGB) for morbid obesity. Int J Obes Relat Metab Disord 1996; 20: 539–46.

    PubMed  CAS  Google Scholar 

  23. Kushner RF. Bioelectrical impedance analysis: A rewiew of principles and applications. J Am Coll Nutr 1992, 11: 199–209.

    PubMed  CAS  Google Scholar 

  24. Kotler DP, Burastero S, Wang J, et al. Prediction of body cell mass, fat-free mass, and total body water with bioelectrical impedance analysis: effect of race, sex, and disease. Am J Clin Nutr 1996, 64: 489S-97S.

    Google Scholar 

  25. Piccoli A, Rossi B, Pillon L, Bucciante G. A new method for monitoring body fluid variation by bioimpedance analysis: The RXc graph. Kidney Int 1994, 46: 534–9.

    Article  PubMed  CAS  Google Scholar 

  26. Guida B, De Nicola L, Trio R, et al. Comparison of vector and conventional bioelectrical impedance analysis in the optimal dry weight prescription in hemodialysis. Am J Nephrol 2000, 20: 311–8.

    Article  PubMed  CAS  Google Scholar 

  27. Piccoli A, Brunani A, Savia G, et al. Discriminating between body fat and fluid changes in the obese adult using bioimpedance vector analysis. Int J Obes 1998, 22: 97–104.

    Article  CAS  Google Scholar 

  28. Sergi G, Lupoli L, Busetto L, et al. Changes in fluids compartments and body composition after weight loss induced by gastric banding. Ann Nutr Metab 2003, 47: 152–7.

    Article  PubMed  CAS  Google Scholar 

  29. Oi Y, Okuda T, Miyoshi H, Koishi H. Effects of low energy diets on protein metabolism studies with [15N]glycine in obese patients. J Nutr Sci Vitaminol 1987, 33: 227–37.

    Article  PubMed  CAS  Google Scholar 

  30. Guida B, Belfiore A, Angrisani L, et al. Laparoscopic gastric banding and body composition in morbid obesity. Nutr Metab Cardiovasc Dis 2005, 15: 198–203.

    Article  PubMed  Google Scholar 

  31. Björntorp P. Endocrine abnormalities in obesity. Diabetes Rev 1997, 5: 52–68.

    Google Scholar 

  32. Vettor R, Fabris C, Pagano C, Federspil G. Neuroendocrine regulation of eating behavior. J Endocrinol Invest 2002, 25: 836–54.

    Article  PubMed  CAS  Google Scholar 

  33. Schwartz MW, Dallman MF, Woods SC. Hypothalamic response to starvation: implications for the study of wasting disorders. Am J Physiol 1995, 269: R949–57.

    PubMed  CAS  Google Scholar 

  34. Savastano S, Valentino R, Belfiore A, et al. Early carotid atherosclerosis in normotensive severe obese premenopausal women with low DHEA(S). J Endocrinol Invest 2003, 26: 236–43.

    Article  PubMed  CAS  Google Scholar 

  35. Miller WL, Auchis RJ, Gelle DH. The regulation of 17,20 lyase activity. Steroids 1997, 62: 133–42.

    Article  PubMed  CAS  Google Scholar 

  36. Hankey CR, Wallace AM, Lean MEJ. Plasma lipids, dehydroepiandrosterone sulphate and insulin concentration in elderly owerweight angina patients, and effect of weight loss. Int J Obes Relat Metab Disord 1997, 21: 72–7.

    Article  PubMed  CAS  Google Scholar 

  37. Jakubowicz DJ, Beer NA, Beer RM, Nestler JE. Disparate effcts of weight reduction by diet on serum dehydroepiandrosterone sulfate levels in obese men and women. J Clin Endocrinol Metab 1995, 80: 3373–6.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Endocrinology Unit, Department of Molecular and Clinical Endocrinology and Oncology, “Federico II” University, Italy

    S. Savastano MD, F. Orio Jr, T. Cascella, F. Milone, G. Lombardi & A. Colao

  2. Unit of Nutrition, “Federico II” University, Italy

    A. Belfiore & B. Guida

  3. Department of Surgery, “S. Giovanni Bosco” Hospital, Naples, Italy

    L. Angrisani

  4. Unit of Psychotherapy, Department of Neuroscience, “Federico II” University, Italy

    F. Micanti

  5. Department of Internal Medicine, “Federico II” University, Italy

    G. Saldalamacchia

Authors
  1. S. Savastano MD
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  2. A. Belfiore
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  3. B. Guida
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  4. L. Angrisani
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  5. F. Orio Jr
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  6. T. Cascella
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  7. F. Milone
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  8. F. Micanti
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  9. G. Saldalamacchia
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  10. G. Lombardi
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  11. A. Colao
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Correspondence to S. Savastano MD.

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Savastano, S., Belfiore, A., Guida, B. et al. Role of dehydroepiandrosterone sulfate levels on body composition after laparoscopic adjustable gastric banding in pre-menopausal morbidly obese women. J Endocrinol Invest 28, 509–515 (2005). https://doi.org/10.1007/BF03347238

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  • DOI: https://doi.org/10.1007/BF03347238

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