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Expression of inflammatory and insulin signaling genes in adipose tissue in response to elective surgery
Anna Witasp1, Louise Nordfors, Martin Schalling
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Centre for Molecular Medicine, L8:00 Karolinska University Hospital, 171 76 Stockholm, Sweden. anna.witasp@ki.se
Context:
The mechanisms behind postoperative insulin resistance and impaired glucose utilization are not fully understood.
Objective:
In this study, we aimed to specifically evaluate the transcription profile of genes in the insulin and adipokine signaling pathways in sc and omental adipose tissue after surgical injury.
Design:
Relative expression of 21 target genes was analyzed in both sc and omental adipose tissue sampled at the beginning and at the end of operation.
Setting:
The study was conducted at a university-affiliated hospital.
Patients:
Twelve nondiabetic patients [seven females; age, 65 (range, 46-72) yr; body mass index, 24.8 (16.5-29.8) kg/m(2)] undergoing major abdominal surgery were included.
Main Outcome Measurements:
The changes in mRNA levels were analyzed.
Results:
After surgery, both sc and omental adipose tissue mRNA levels of genes involved in the IL6 and nicotinamide phosphoribosyltransferase pathways were increased, whereas mRNA levels of insulin receptor substrate 1 and adiponectin were reduced (P < 0.05). TNF pathway genes were differently regulated between sc and omental adipose tissue, and glucose transporter 4 mRNA levels were decreased only in omental adipose tissue.
Conclusions:
The transcriptional output of pivotal inflammatory and insulin signaling pathway genes is altered after surgery, and this pattern differs between different fat depots. This could be of importance for the metabolic aberrations associated to postsurgical complications, such as insulin resistance and hyperglycemia.
Insights
Surgery alters gene expression in fat tissue, impacting insulin and inflammatory pathways. This may explain postsurgical insulin resistance and hyperglycemia, highlighting differences between subcutaneous and omental fat depots.
Area of Science:
- Metabolic Surgery
- Molecular Biology
- Endocrinology
Background:
- Postoperative insulin resistance and impaired glucose utilization mechanisms remain unclear.
- Surgical stress significantly impacts metabolic homeostasis.
Purpose of the Study:
- To investigate gene transcription profiles in insulin and adipokine signaling pathways.
- To compare these profiles in subcutaneous (sc) and omental adipose tissue post-surgery.
Main Methods:
- Analysis of relative mRNA expression for 21 target genes.
- Tissue sampling from sc and omental adipose tissue at the start and end of major abdominal surgery.
- Study included 12 non-diabetic patients undergoing major abdominal surgery.
Main Results:
- Increased mRNA levels for IL6 and nicotinamide phosphoribosyltransferase pathway genes in both fat depots.
- Reduced mRNA levels for insulin receptor substrate 1 and adiponectin.
- Differential regulation of TNF pathway genes and decreased glucose transporter 4 mRNA in omental adipose tissue.
Conclusions:
- Surgical injury alters the transcription of key inflammatory and insulin signaling genes.
- These alterations differ between sc and omental fat depots.
- This transcriptional shift may contribute to postsurgical metabolic complications like insulin resistance and hyperglycemia.
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