The American Journal of Medicine
Volume 121, Issue 11 , Pages 966-973 , November 2008

Dramatic Reversal of Derangements in Muscle Metabolism and Left Ventricular Function After Bariatric Surgery

  • Joshua G. Leichman, MD

      Affiliations

    • Department of Internal Medicine, The University of Texas Health Science Center at Houston
    • ,
  • Erik B. Wilson, MD

      Affiliations

    • Department of Surgery, The University of Texas Health Science Center at Houston
    • ,
  • Terry Scarborough, MD

      Affiliations

    • Department of Surgery, The University of Texas Health Science Center at Houston
    • ,
  • David Aguilar, MD

      Affiliations

    • Department of Internal Medicine, The University of Texas Health Science Center at Houston
    • ,
  • Charles C. Miller III, PhD

      Affiliations

    • Department of Cardiovascular and Thoracic Surgery, The University of Texas Health Science Center at Houston
    • ,
  • Sherman Yu, MD

      Affiliations

    • Department of Surgery, The University of Texas Health Science Center at Houston
    • ,
  • Mohamed F. Algahim, BSc

      Affiliations

    • Department of Internal Medicine, The University of Texas Health Science Center at Houston
    • ,
  • Manuel Reyes, MD

      Affiliations

    • Department of Internal Medicine, The University of Texas Health Science Center at Houston
    • ,
  • Frank G. Moody, MD

      Affiliations

    • Department of Surgery, The University of Texas Health Science Center at Houston
    • ,
  • Heinrich Taegtmeyer, MD, DPhil

      Affiliations

    • Department of Internal Medicine, The University of Texas Health Science Center at Houston
    • Corresponding Author InformationRequests for reprints should be addressed to Heinrich Taegtmeyer, MD, DPhil, University of Texas Houston Medical School, Department of Medicine/Cardiology, 6431 Fannin, MSB 1.246, Houston, TX 77030

References 

  1. Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355:763–778
  2. Friedman JJ. Fat in all the wrong places. Nature. 2002;415:268–269
  3. Unger R, Zhou Y, Orci L. Regulation of fatty acid homeostasis in cells: novel role of leptin. Proc Natl Acad Sci U S A. 1999;96:2327–2332
  4. Young ME, Guthrie PH, Razeghi P, et al. Impaired long-chain fatty acid oxidation and contractile dysfunction in the obese Zucker rat heart. Diabetes. 2002;51:2587–2595
  5. Shulman GI. Cellular mechanisms of insulin resistance. J Clin Invest. 2000;106:171–176
  6. Sharma S, Adrogue JV, Golfman L, et al. Intramyocardial lipid accumulation in the failing human heart resembles the lipotoxic rat heart. FASEB J. 2004;18:1692–1700
  7. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Engl J Med. 2002;347:305–313
  8. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: how much, and who's paying?. Health Aff (Millwood). 2003;Suppl Web Exclusives:W3-219-226
  9. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–2693
  10. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–752
  11. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357:753–761
  12. Bray GA. The missing link—lose weight, live longer. N Engl J Med. 2007;357:818–820
  13. Leichman JG, Aguilar D, King TM, et al. Improvements in systemic metabolism, anthropometrics, and left ventricular geometry 3 months after bariatric surgery. Surg Obes Relat Dis. 2006;2:592–599
  14. Buchwald H. Bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. J Am Coll Surg. 2005;200:593–604
  15. Higa KD, Boone KB, Ho T, Davies OG. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 2000;135:1029–1034
  16. Fielding GA, Allen JW. A step-by-step guide to placement of the LAP-BAND adjustable gastric banding system. Am J Surg. 2002;184:26S–30S
  17. Razeghi P, Young ME, Alcorn JL, et al. Metabolic gene expression in fetal and failing human heart. Circulation. 2001;104:2923–2931
  18. Razeghi P, Sharma S, Ying J, et al. Atrophic remodeling of the heart in vivo simultaneously activates pathways of protein synthesis and degradation. Circulation. 2003;108:2536–2541
  19. Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998;21:2191–2192
  20. Liu JE, Roman MJ, Pini R, et al. Cardiac and arterial target organ damage in adults with elevated ambulatory and normal office blood pressure. Ann Intern Med. 1999;131:564–572
  21. Munagala VK, Jacobsen SJ, Mahoney DW, et al. Association of newer diastolic function parameters with age in healthy subjects: a population-based study. J Am Soc Echocardiogr. 2003;16:1049–1056
  22. Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000;106:473–481
  23. Lelliott C, Vidal-Puig AJ. Lipotoxicity, an imbalance between lipogenesis de novo and fatty acid oxidation. Int J Obes Relat Metab Disord. 2004;28(Suppl 4):S22–S28
  24. Enoch HG, Strittmatter P. Role of tyrosyl and arginyl residues in rat liver microsomal stearylcoenzyme A desaturase. Biochemistry. 1978;17:4927–4932
  25. Hulver MW, Berggren JR, Carper MJ, et al. Elevated stearoyl-CoA desaturase-1 expression in skeletal muscle contributes to abnormal fatty acid partitioning in obese humans. Cell Metab. 2005;2:251–261
  26. Cohen P, Miyazaki M, Socci ND, et al. Role for stearoyl-CoA desaturase-1 in leptin-mediated weight loss. Science. 2002;297:240–243
  27. Bowker-Kinley MM, Davis WI, Wu P, et al. Evidence for existence of tissue-specific regulation of the mammalian pyruvate dehydrogenase complex. Biochem J. 1998;329(Pt 1):191–196
  28. Wu P, Sato J, Zhao Y, et al. Starvation and diabetes increase the amount of pyruvate dehydrogenase kinase isoenzyme 4 in rat heart. Biochem J. 1998;329:197–201
  29. Fuller SJ, Randle PJ. Reversible phosphorylation of pyruvate dehydrogenase in rat skeletal-muscle mitochondria (Effects of starvation and diabetes). Biochem J. 1984;219:635–646
  30. Holness MJ, Smith ND, Bulmer K, et al. Evaluation of the role of peroxisome-proliferator-activated receptor alpha in the regulation of cardiac pyruvate dehydrogenase kinase 4 protein expression in response to starvation, high-fat feeding and hyperthyroidism. Biochem J. 2002;364:687–694
  31. Rosa G, Di Rocco P, Manco M, et al. Reduced PDK4 expression associates with increased insulin sensitivity in postobese patients. Obes Res. 2003;11:176–182
  32. Peterson LR, Waggoner AD, Schechtman KB, et al. Alterations in left ventricular structure and function in young healthy obese women: assessment by echocardiography and tissue Doppler imaging. J Am Coll Cardiol. 2004;43:1399–1404
  33. Bella JN, Palmieri V, Roman MJ, et al. Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: the Strong Heart Study. Circulation. 2002;105:1928–1933
  34. Smith GL, Masoudi FA, Vaccarino V, et al. Outcomes in heart failure patients with preserved ejection fraction: mortality, readmission, and functional decline. J Am Coll Cardiol. 2003;41:1510–1518
  35. Leichman JG, Aguilar D, King TM, et al. Association of plasma free fatty acids and left ventricular diastolic function in patients with clinically severe obesity. Am J Clin Nutr. 2006;84:336–341
  36. Finck BN, Han X, Courtois M, et al. A critical role for PPARalpha-mediated lipotoxicity in the pathogenesis of diabetic cardiomyopathy: modulation by dietary fat content. Proc Natl Acad Sci U S A. 2003;100:1226–1231
  37. Young ME, Laws FA, Goodwin GW, Taegtmeyer H. Reactivation of peroxisome proliferator-activated receptor alpha is associated with contractile dysfunction in hypertrophied rat heart. J Biol Chem. 2001;276:44390–44395
  38. Vikramadithyan RK, Hirata K, Yagyu H, et al. Peroxisome proliferator-activated receptor agonists modulate heart function in transgenic mice with lipotoxic cardiomyopathy. J Pharmacol Exp Ther. 2005;313:586–593
  39. Sambandam N, Morabito D, Wagg C, et al. Chronic activation of PPARalpha is detrimental to cardiac recovery after ischemia. Am J Physiol Heart Circ Physiol. 2006;290:H87–H95

 Supported by the National Heart, Lung, and Blood Institute of the US Public Health Service (R01HL73162 and M01 RR02558). None of the authors of this work have any financial conflicts of interest to disclose. All authors had access to the data and a role in writing the article.

 Clinical Trials Registry: ClinicalTrials.gov Identifier: NCT00178633; http:/www.clinicaltrials.gov

PII: S0002-9343(08)00756-0

doi: 10.1016/j.amjmed.2008.06.033

The American Journal of Medicine
Volume 121, Issue 11 , Pages 966-973 , November 2008

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