Expression of Adipose Tissue Extracellular Matrix-Related Genes Predicts Weight Loss after Bariatric Surgery

Abstract

Background: We evaluated the association between white adipose tissue parameters before bariatric surgery (BS) and post-surgical weight loss, with an especial focus on extracellular matrix (ECM) gene expression. Methods: Paired samples from subcutaneous (SAT) and visceral adipose tissue (VAT) were obtained from 144 subjects undergoing BS. The association between total body weight loss (%TBWL) at 12 months after BS and the histological characteristics and gene expression of selected genes in SAT and VAT was analyzed. Results: Fat cell area, size-frequency distribution, and fibrosis in SAT or VAT prior to surgery were not associated with %TBWL. On the contrary, the SAT expression of COL5A1 and COL6A3 was associated with %TBWL after BS (both p < 0.001), even after adjusting for age, gender, baseline BMI, and type 2 diabetes status (T2D). Furthermore, in logistic regression analyses, the expression of these genes was significantly associated with insufficient WL (IWL = TBWL < 20%) after BS (respectively, p = 0.030 and p = 0.031). Indeed, in ROC analysis, the prediction of IWL based on sex, age, BMI, T2D, and the type of surgery (AUC = 0.71) was significantly improved with the addition of SAT-COL5A1 gene expression (AUC = 0.88, Z = 2.13, p = 0.032). Conclusions: Our data suggest that the expression of SAT ECM-related genes may help explain the variability in TBWL following BS.

Expression Of Visceral Adipose Tissue Extracellular Matrix Related Genes Correlates With Insulin Resistance And Predicts Metabolic Improvement Following Bariatric Surgery

“…The correlation observed between the expression of some genes in the omentum and peritoneum and the HOMA-IR value of the analyzed subjects, especially the strong correlation detected with epiploic S100A8 and peritoneal ADAMTS4 expression and this variable, could suggest a possible role of mesothelial cells in the dysregulation of visceral AT. Moreover, contrary to recent studies that have pointed to the relationship between the expression of ECM-related genes in SAT and the evolution after BS (33), in our study the ndings regarding SAT were unremarkable and correlations with HOMA-IR variation at 1 year of BS were detected only in VATs.…”

Adipose tissue fibrosis: the unwanted houseguest invited by obesity

“…The level of ECM deposition in adipose tissue, particularly as reflected in collagen VI, is an impediment to the success of surgical weight loss interventions (Osorio-Conles et al 2023). These studies suggest that appropriate ECM remodeling, primarily the reduction of ECM deposition and cross-linking and the increase of ECM degradation, may be a key molecular signature for the success of weight-loss surgeries.…”