Impact of Significant Surgical Reduction of Adipose Tissue on Plasma Levels and Genetic Expression of Adipokines Associated With Ischemic Heart Disease in Type I Obesity.

Adipose tissue is with endocrine properties and secretes many cytokines. Some of these cytokines are concerned with ischemic heart disease. I hypothesized that significant surgical reduction in adipose tissue mass leads to decrease in its cell population which may pose significantly reduced production of adipokines ( Leptin and Angiotensin) associated with ischemic heart disease in obese people. Study objectives are analysis of Leptin, Angiotensin-II, mRNA expression analysis of leptin, leptin receptor and Angiotensin-II. investigation of genetic variations in the Leptin, Leptin receptors, Angiotensin-I and Angiotensin-II receptors, confirm SNPs of selected sample. Ddetermination of the association of genetic variation in Leptin receptor, angiotensin-I and Angiotensin-II receptors with Leptin and Angiotensin-II levels and determination of effect of genetic variation on the transcriptional regulation. Case control study having 212 patients (106 patients in each group) with type I Obese adults, both males and pre-menopausal females belonging to ASA 1 and 2 requiring stagged liposuction will be included. Exclusion of subjects with Diabetes mellitus, Metabolic syndrome, Endocrine disorders, on statin drugs, not willing to participate. After informed consent, blood samples will be taken to quantify plasma levels of Leptin and Angiotensin II pre-operatively by ELISA. DNA will also be extracted from blood and SNPs will be analysed. The selected SNPs will be amplified by PCR and product will be purified and analysed by agarose gel electrophoresis. Patients will undergo liposuction and RNA will be isolated from subcutaneous adipose tissue for reverse transcription. After 3 months, patients will be called back for second session of liposuction and plasma level of Leptin and Angiotensin II will be quantified again. Similarly, expression profile of transcription factors will also be analysed again. Paired t-test will be used to compare clinical parameters like serum adipokines levels and adipokines expression levels and p value \<0.05 will be taken as statistically significant. The results will be utilized to determine impact of surgical reduction on plasma level and expression of the adipokines in minimizing cardiovascular risk factors.