Abstract:
Obesity is a global public health problem, associated with various metabolic comorbidities. Among its pathophysiological characteristics, the accumulation of white adipose tissue (WAT) stands out. In addition, it is widely recognized that the WAT plays an important endocrine role, particularly in the production of adipokines. Among the adipokines produced, adiponectin is particularly noteworthy.
Adiponectin has pleiotropic functions, acting as a metabolic mediator and regulator of inflammatory and immune processes. Its effects include increased insulin sensitivity in the liver, muscles, and adipose tissue, along with the regulation of inflammation through reduced production of pro-inflammatory cytokines and increased secretion of anti-inflammatory cytokines. Recent studies show that serum adiponectin levels are significantly lower in individuals with obesity, which is associated with an increased risk of developing obesity-related diseases.
When conventional clinical interventions fail to effectively control obesity, bariatric surgery is often recommended for individuals with severe obesity. However, there is still a lack of studies evaluating the evolution of adiponectin levels in patients undergoing bariatric surgery, especially in medium- to long-term follow-ups.
In this study, we conducted a retrospective analysis of women with obesity who underwent RYGB and were followed for two years. The study aimed to assess changes in anthropometric and metabolic parameters according to preoperative adiponectin levels. Thirty women were classified into two groups: normoadiponectinemia (≥10.0 µg/mL) and hypoadiponectinemia (<10.0 µg/mL) based on their preoperative serum adiponectin levels. Anthropometric data, lipid profiles, glucose metabolism markers, and inflammatory parameters were evaluated preoperatively, and at 6 and 24 months post-surgery. The research was approved by Ethics Committee in Research with Humans of the Clinical Hospital of the Federal University of Paraná (CAAE 4.539.851/21).
Our findings demonstrated that women with higher preoperative adiponectin levels (normoadiponectinemia group) exhibited significantly greater improvements in weight loss, BMI reduction, excess weight loss, and insulin sensitivity (HOMA-AD) compared to those with hypoadiponectinemia. Over the two-year period, a substantial proportion of participants initially classified as hypoadiponectinemic transitioned to normoadiponectinemia, suggesting that weight loss induced by bariatric surgery can progressively restore adiponectin levels. Nevertheless, at 24 months, women who remained hypoadiponectinemic continued to present higher BMI and less favorable metabolic profiles.
These results support the growing evidence that preoperative adiponectin levels may serve as a predictive biomarker of metabolic response following bariatric surgery. Patients with normoadiponectinemia prior to surgery may experience more favorable outcomes in terms of weight reduction and metabolic improvements. However, given the small sample size and inclusion of only female participants, further studies involving larger, more diverse populations are warranted to validate these findings and explore potential sex-specific effects.
