Omentin is a protein produced by numerous tissues including adipose tissue. Its concentrations are decreased in patients with obesity, type 2 diabetes mellitus (DM) and coronary artery disease (CAD). Experimental studies suggest that omentin may have anti-inflammatory and insulin-sensitizing properties. In the present study, we measured circulating omentin levels and its mRNA expression in epicardial and subcutaneous fat, intercostal and heart muscle before and after elective cardiac surgery in patients with CAD (CAD+, DM-, n=18), combination of CAD and DM (CAD+, DM+, n=9) or with none of these conditions (CAD-, DM-, n=11). The groups did not differ in baseline anthropometric and biochemical characteristics with the exception of higher blood glucose and HBA1c in CAD+, DM+ group. Baseline circulating omentin levels tended to be lower in CAD+, DM- and CAD+, DM+ groups as compared to CAD-, DM- group and cardiac surgery increased its concentration only in CAD-, DMgroup. The change in serum omentin levels during surgery inversely correlated with epicardial fat thickness. While baseline omentin mRNA expression did not differ among the groups in any of the studied tissues, its increase after surgery was present only in subcutaneous fat in CAD-, DM- and CAD+, DM- groups, but not in CAD+, DM+ group. Intercostal muscle omentin mRNA expression increased after surgery only in CAD-, DM- group. In conclusion, cardiac surgery differentially affects omentin levels and subcutaneous fat and skeletal muscle mRNA expression in patients without coronary artery disease and diabetes as compared to patients with these conditions.
We compared graft outcome between two types of a novel
composite three-layer carp-collagen-coated vascular graft in
low-flow conditions in a sheep model. Collagen in group A
underwent more cycles of purification than in group B in order to
increase the ratio between collagen and residual fat. The grafts
were implanted end-to-side in both carotid arteries in sheep
(14 grafts in 7 sheep in group A, 18 grafts in 9 sheep in group B)
and artificially stenosed on the right side. The flow in the grafts
in group A decreased from 297±118 ml/min to 158±159 ml/min
(p=0.041) after placement of the artificial stenosis in group A,
and from 330±164ml/min to 97±29 ml/min (p=0.0052) in
group B (p=0.27 between the groups). From the five surviving
animals in group A, both grafts occluded in one animal 3 and 14
days after implantation. In group B, from the six surviving
animals, only one graft on the left side remained patent
(p=0.0017). Histology showed degradation of the intimal layer in
the center with endothelization from the periphery in group A
and formation of thick fibrous intimal layer in group B. We
conclude that the ratio between collagen and lipid content in the
novel three-layer graft plays a critical role in its patency and
structural changes in vivo.
The objective of the present report was to clarify the postoperative stress response of some inflammatory markers, namely of proinflammatory cytokines and leptin levels during uncomplicated postoperative periods. The results were compared with the dynamics of these parameters during intraabdominal sepsis. We followed 20 patients after a planned resection of colorectal cancer in stage Ib-IV with uncomplicated healing and 13 obese men after laparoscopic non-
adjustable gastric banding. These were compared to 12 patients with proven postoperative sepsis. The control group consisted of 18 healthy men. The observed parameters included serum levels of cytokines, tumor necrosis factor-α(TNFα), interleukin-1β (IL-1β), interleukin-1 receptor antagonist (IL-1ra), IL-6, IL-8, soluble receptor of interleukin-2 (sIL-2R) and leptin. It was found that during the first 24 h after resection there was a significant increase in the serum concentration of IL-6 up to 1125±240 ng/l, which declined within the next 48-72 h. Serum concentration of TNF α was
highest 18-24 h after resection (205±22 ng/l) and after banding (184±77 ng/l). IL-1β had a stable serum concentration without significant elevation. Serum concentration of IL-8 after resection rose to 520±200 ng/l after 36-48 h. Maximal cytokine levels after gastric banding were quantitatively lower (IL-6 414±240 ng/l, TNFα 184±77 ng/l) than after resection. We found significant elevation of plasma leptin concentration (32±10 ng/ml) 24 h after banding compared with preoperative values (18±5 ng/ml, p<0.05). Leptin levels 48 and 72 h after banding rapidly returned to the level before operation. During abdominal surgery leptin shows to be an acute phase reactant. Proinflammatory cytokines can be main regulatory factors of leptin during this period. Significant correlation between leptin and TNFα (similarly
demonstrated by other authors in models of bacterial inflammation) indicates that TNFα can be the crucial regulator of leptin generation in the early postoperative period. On the basis of our results we recommend to observe IL-6 and IL-8 at 24-72 h after the surgery in patients with a high risk of early postoperative septic complications.