Adrenomedullin is a vasoactive peptide originally discovered in extracts of human pheochromocytoma. It is highly expressed in plasma and adipose tissue of obese subjects and considered as a member of the adipokine family. Adrenomedullin inhibits adipogenesis under the transcriptional control of insulin. We determined plasma adrenomedullin concentrations in a cohort of 360 healthy subjects and found a very significant positive correlation to body mass index (BMI). In parallel, 28 morbidly obese patients were selected from the cohort scheduled to undergo laparoscopic gastric bypass surgery, and studied at two time points: just before and one year after surgery. As expected, bariatric surgery induced significant decreases in body weight, BMI, insulin resistance, plasma leptin, total cholesterol, LDL-cholesterol and CRP. Plasma adrenomedullin levels decreased one year after bypass surgery in all the subjects studied: preoperative adrenomedullin was 0.757±0.033 and postoperative values were 0.624±0.025 (P<0.001). In obese subjects, basal plasma adrenomedullin significantly correlated with leptin. Moreover, there was a positive association of surgery induced changes in plasma adrenomedullin and leptin. In summary, we present here a positive significant correlation of adrenomedullin with BMI in healthy patients. Weight loss after bariatric surgery is associated with a significant decrease in plasma adrenomedullin.
03 - 07 May 2008
European Society of Endocrinology