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Changes of Plasma Levels of Adipocytokines During 120 Hours of Fasting After Endoscopic Treatment

Hiroshi Maekawa, Shinobu Shioya, Hajime Orita, Mutsumi Sakurada, Tomoyuki Kushida and Koichi Sato

Study background: Adipocytokines are secreted from adipocytes and are important for metabolic regulation and immune response. We investigated differences in plasma adipocytokine levels between diabetes mellitus patients and non-diabetes mellitus patients during 120 hours of fasting after endoscopic treatment. We also compared changes in plasma adipocytokine levels from minimally invasive endoscopically-treated patients to those of patients treated with pancreatoduodenectomy.

Materials and Methods: Seven diabetes mellitus patients, nine non-diabetes mellitus patients, and six patients who underwent pancreatoduodenectomy were analyzed for their WBC counts, plasma levels of CRP, glucose, adiponectin, adipsin, resistin and IL-6 levels at four points. Blood samples were drawn at pre-treatment, 24 hours of fasting, 72 hours of fasting, and 120 hours of fasting after treatment. Adipocytokines were examined using an ELISA method.

Results: Plasma adiponectin levels slightly decreased during the fast, and resistin levels transiently increased at the 24-hour time point in both diabetes mellitus patients and non-diabetes mellitus patients. Plasma adipsin levels were stable. In patients who underwent pancreatoduodenectomy, both a decrease and increase of adipocytokine plasma levels occurred. There was a significant percentage decrease of plasma adiponectin and adipsin levels during the fast in patients who underwent pancreatoduodenectomy compared to those of endoscopically treated patients. In pancreatoduodenectomy patients, plasma resistin, IL-6 levels were significantly increased compared to those of endoscopically treated patients after treatment.

Conclusions: Prolonged fasting after endoscopic treatment did not influence plasma adiponectin, adipsin, and resistin levels both for diabetes mellitus patients and non-diabetes mellitus patients. The decrease of plasma adiponectin and adipsin levels, and the increase of plasma resistin and IL-6 levels were significant in patients who underwent pancreatoduodenectomy. Surgical stress may influence plasma adipocytokine levels, but 120 hours of fasting with minimal invasive stress, such as endoscopic treatment, may have no effect.