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Plasma Steroid Profiles in Individuals With Class II/III Obesity: Association With Weight Loss After Metabolic
Mari Ibusuki1, Kohta Nakatani2, Yayoi Matsuda1
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Context:
Although steroid metabolism is altered in individuals with obesity, comprehensive profiles of steroid metabolites remain unexplored, some of which may be related to weight loss after metabolic surgery.
Objective:
We aimed to characterize comprehensive steroid profiles in individuals with class II/III obesity (body mass index ≥35 kg/m2) and identify metabolite(s) related to weight loss outcomes after laparoscopic sleeve gastrectomy (LSG).
Methods:
Using liquid chromatography-tandem mass spectrometry, we measured 27 plasma steroid metabolites in individuals with class II/III obesity (n = 93), healthy controls (n = 15), and those after LSG (n = 20).
Results:
Discriminant analysis revealed distinct steroid profiles between individuals with class II/III obesity and healthy controls, with statistical significance for 9 metabolites in men (n = 53) and 11 in premenopausal women (n = 44). One year after LSG, the insufficient and sufficient weight loss groups (percent total weight loss (%TWL) < 20%; n = 10 and %TWL ≥ 20%; n = 26) showed distinct preoperative steroid profiles. Preoperative 17α-hydroxypregnenolone (17α-OHPreg) levels, which were lower in individuals with class II/III obesity, were the most significant factor contributing to this distinction, and remained significantly lower in the insufficient weight loss group even after adjusting for confounders (P = .012). The 17α-OHPreg levels significantly increased postoperatively in men (n = 9, P = .024).
Conclusion:
This study is the first detailed analysis of comprehensive steroid profiles in individuals with class II/III obesity and suggests that lower preoperative 17α-OHPreg levels are associated with insufficient weight loss after LSG.
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