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Increased Plasma Visfatin Concentrations in Morbidly Obese Subjects Are Reduced after Gastric Banding

Departments of Clinical Pharmacology (D.G.H., G.S., M.W.) and Medicine III (K.S., M.W., B.L.), Division of Endocrinology and Metabolism, and Department of Surgery (G.P.), Division of General Surgery, Medical University of Vienna, 1090 Vienna, Austria

Address all correspondence and requests for reprints to: Bernhard Ludvik, M.D., Medical University of Vienna, Department of Internal Medicine III, Division of Endocrinology and Metabolism, Allgemeines Krankenhaus Wien, Währinger Gürtel 18-20, 1090 Vienna, Austria. E-mail: bernhard.ludvik{at}meduniwien.ac.at.

Context: The insulin-mimetic adipocytokine visfatin has been linked to obesity. The influence of weight loss on plasma visfatin concentrations in obese subjects is unknown yet.

Objectives: In this study we investigated whether plasma visfatin concentrations are altered by weight loss in patients with obesity.

Design and Patients: In a prospective study, fasting plasma visfatin, leptin, and adiponectin concentrations were measured before and 6 months after gastric banding in 31 morbidly obese patients aged 40 ± 11 yr with a body mass index (BMI) of 46 ± 5 kg/m². Fourteen healthy subjects aged 29 ± 5 yr with a BMI less than 25 kg/m² served as controls.

Results: Visfatin plasma concentrations were markedly elevated in obese subjects (0.037 ± 0.008 µg/ml), compared with controls (0.001 ± 0.000 µg/ml, P < 0.001). Gastric banding reduced BMI to 40 ± 5 kg/m², visfatin to 19.2 ± 10.9 ng/ml, and leptin from 39.0 ± 12.4 to 29.7 ± 10.0 ng/ml and increased adiponectin from 0.015 ± 0.007 to 0.017 ± 0.007 µg/ml (all P < 0.05) after 6 months. Insulin sensitivity as estimated by the homeostasis model assessment insulin resistance index was unchanged from 5.8 ± 3.1 to 4.6 ± 1.9 (P = 0.13), but individual changes of insulin resistance and visfatin were significantly associated (P < 0.05, r = –0.43).

Conclusions: Elevated plasma visfatin concentrations in morbidly obese subjects are reduced after weight loss. This may be related to changes in insulin resistance over time.

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