Korean J Obes 2005; 14(2): 82-93
Published online April 1, 2005
Copyright © Korean Society for the Study of Obesity.
Sat Byul Park, Kyu Wol Yun*, Sung Jin Cho**
Department of Family Practice, School of Medicine, Ajou University, Kyunggi-Do, Dept. of Neuropsychiatry, College of Medicine, Ewha Womans University*, Dept. of pathology, College of Medicine, Hallym University**, Korea
Though serious efforts for clinical and genetic approaches in pathophysiological mechanisms on obesity have been made, it has been rarely studied on psychological factors as well as gene expression of various adipokines. The objective of this study is to investigate the expression of four major adipokines such as leptin, adiponectin, vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) and correlate psychosocial factors with clinico-pathological parameters.
Forty eight adult cases of patients admitted for abdominal surgery which are not related with inflammatory or neoplastic condition were analyzed for expression of 4 adipokines and 4 kinds of psychosocial tests. Pre-operative anthropometric measurement and medical examination for all adult cases were made. Serum samples were obtained for analysis of fasting glucose, total cholesterol, high sensitivity c-reactive protein (hs-CRP), insulin, cortisol and 4 adipokines. Serum insulin and cortisol were measured using radioimmunoassay (RIA) method. 4 serum adipokines were measured using enzyme-linked immunosorbent assay (ELISA) method. 40 adult cases were analyzed for mRNA expression in both subcutaneous and visceral fat tissues using RT-PCR method. The psychosocial tests included The Eating Attitude Test(EAT), Center for Epidemiological Studies-Depression Scale(CES-D), Moudsley obsessive-compulsive inventory(MOCI), and Index of Clinical Stress (ICS) by means of questionnaires. Obesity is defined as BMI above 25.0 kg/㎡.
The Obese group was 23 samples(47.9%) and normal group was 25 samples(52.1%) among the subjects. Compared to normal group, circumference of waist and hip, body weight and blood pressure with levels of total cholesterol, insulin and hsCRP of the obese group were significantly higher. The mRNA expression and plasma levels of leptin, VEGF and HGF were significantly higher in obese group than normal. The adiponectin mRNA expression and plasma level was lower in obese group than normal. mRNA expression of leptin, adiponectin and HGF was significantly more detected in subcutaneous fat tissue than visceral fat. mRNA expression of VEGF was significantly less detected in subcutaneous fat tissue than visceral fat. The psychosocial degrees showed no significant difference, but stress index score had increased tendency in obese group. The more cortisol increases, the higher hsCRP is and the less serum adiponectin is. EAT was correlated with depression scale and stress index among psychosocial factors. Stress index was also correlated with depression scale. Compared to sex, CES-D was reverse related with VEGF in visceral fat tissue and stress index was correlated with cholesterol at male. Meanwhile, only CES-D was reverse related with waist-hip ratio at female.
These results suggest that anatomic location of fat tissue have much influence on degree of adipokine appearance and psychosocial factors are associated with some items of clinical and laboratory obesity characteristics. Various factors including psychosocial, biochemical and molecular mechanism may by applied to indices of obesity. Also these factors may contribute to the pathophysiological mechanism of obesity.
Keywords: Obesity, Adipokine, Psychosocial factors