Increased plasma visfatin concentrations in morbidly obese subjects are reduced after gastric banding

Context: The insulin-mimetic adipocytokine visfatin has been linked to obesity. The influence of weight loss on plasma visfatin concentrations in obese subjects is unknown yet. Objectives: In this study we investigated whether plasma visfatin concentrations are altered by weight loss in patients with obesity. Design and Patients: In a prospective study, fasting plasma visfatin, leptin, and adiponectin concentrations were measured before and 6 months after gastric banding in 31 morbidly obese patients aged 40 +/- 11 yr with a body mass index (BMI) of 46 +/- 5 kg/m(2). Fourteen healthy subjects aged 29 +/- 5 yr with a BMI less than 25 kg/m(2) served as controls. Results: Visfatin plasma concentrations were markedly elevated in obese subjects (0.037 +/- 0.008 mu g/ml), compared with controls (0.001 +/- 0.000 mu g/ml, P < 0.001). Gastric banding reduced BMI to 40 +/- 5 kg/m(2), visfatin to 19.2 +/- 10.9 ng/ml, and leptin from 39.0 +/- 12.4 to 29.7 +/- 10.0 ng/ml and increased adiponectin from 0.015 +/- 0.007 to 0.017 +/- 0.007 mu g/ml ( all P < 0.05) after 6 months. Insulin sensitivity as estimated by the homeostasis model assessment insulin resistance index was unchanged from 5.8 +/- 3.1 to 4.6 +/- 1.9 ( P = 0.13), but individual changes of insulin resistance and visfatin were significantly associated ( P < 0.05, r = - 0.43). Conclusions: Elevated plasma visfatin concentrations in morbidly obese subjects are reduced after weight loss. This may be related to changes in insulin resistance over time.