human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Adipokines are signaling and mediator proteins secreted from adipose tissue . A novel adipokine , visfatin , was reported as a protein which was mainly expressed in visceral adipose tissue . Controversial results have been shown regarding the changes of adipokines following weight reduction . So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects . Methods : 35 severely obese patients ( 26 females and 9 males ) , aged 15 - 58 years , were studied .  Anthropometric parameters and biochemical parameters  as well as  adiponectin and visfatin were analyzed before and 6 weeks after weight reduction . Results : Anthropometric indices decreased significantly . Blood levels of low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , and triglyceride were reduced significantly . The reduction of visfatin and the elevation of adiponectin were significant as well . However , other parameters like fasting glucose and insulin did not change . Moreover , we could not find any significant correlation between the change of serum visfatin and that of adiponectin . Conclusions : 6-week weight reduction after bariatric surgery result ed in decreased serum visfatin and increased adiponectin levels . However , we can not find any significant correlation between changes of adiponectin , visfatin , BMI , waist circumference , and insulin resistance . Further studies with different design are suggested to clarify these associations ABSTRACT Background : The aim of this study was to examine the relationship between weight loss and resistin , apelin , chemerin , and visfatin after  laparoscopic adjustable gastric b and ing ( LAGB ) .  Methods : The study group consisted of 19 patients who were operated on for morbid obesity ( BMI : 48.7 ± 6.6 kg/m2 ) , and 22 healthy , normal-weight ( BMI : 22.9 ± 2.5 kg/m2 ) subjects formed the control group . We obtained blood sample s from the study subjects at three different times : before undergoing surgery and at one month and 6 months after surgery . Blood was obtained once from the control group . Results : Significant weight loss was achieved at one and 6 months after surgery . Plasma levels of apelin , resistin , chemerin , and visfatin were higher in morbidly obese patients compared with the control group . Obesity-related peptides decreased one month and 6 months after surgery . Conclusions : Elevated plasma resistin , apelin , chemerin , and visfatin levels in morbidly obese patients are gradually reduced after weight loss . According to these findings , LAGB surgery is found to be an important and efficient means for morbidly obese patients both to lose weight and to develop a better metabolic risk profile in a short time period Background Obesity is associated with a chronic low- grade inflammatory state , insulin resistance , and endothelial dysfunction , all of which contribute to increased risk of cardiovascular disease . We hypothesized that gastric bypass would produce rapid improvements in endothelial function , reduce inflammation , and lead to a decrease in cardiovascular risk . Methods We performed a prospect i ve study of morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass ( RYGB ) .  Clinical data , biochemical markers of inflammation , and parameters indicative of cardiovascular risk were collected preoperatively and at 3 and 6 months postoperatively . Metabolic and inflammatory mediators that were quantified included C-reactive protein , fibrinogen , PAI-1 , IL-6 , IL-10 , IL-1Ra , adiponectin , leptin , triglycerides , total cholesterol , HDL , LDL , glucose , insulin , and HbA1c . Brachial artery reactivity testing ( BART ) was performed to assess peripheral arterial endothelial function , and Framingham cardiovascular risk score ( FRS ) was calculated on all study participants pre- and postoperatively . Results Fifteen patients ( 11 female ) were enrolled ( age = 49.2 ± 10.4 years ; BMI = 48.1 ± 5.3 kg/m2 ) . Six months post RYGB , mean BMI decreased to 35.4 ± 4.5 , corresponding to 51.7 % excess weight loss ( P < 0.001 ) . Mean waist circumference decreased significantly from 132 cm at baseline to 110 cm at 3 months ( P = 0.003 ) and 107 cm at 6 months ( P < 0.001 ) . Six months after RYGB , weight loss led to significant improvements in clinical parameters indicative of cardiovascular disease or risk , including brachial artery diameter , endothelial independent vasodilation , and FRS . Favorable improvements in the proinflammatory markers CRP ( P = 0.01 ) and leptin ( P = 0.005 ) , the anti-inflammatory mediator adiponectin ( P = 0.002 ) , and insulin sensitivity ( HOMA-IR , P = 0.007 ) were evident at 3 months . At 6 months , improvements in CRP , leptin , and fasting insulin were maintained and fibrinogen levels also decreased ( P = 0.047 ) . Adiponectin continued to increase at 6 months ( P = 0.004 ) . Conclusion Gastric bypass is associated with early reversal of endothelial dysfunction , a more favorable inflammatory milieu , and , most importantly , a reduction in cardiovascular risk Weight reduction after gastric bypass surgery  has been attributed to a decrease of the orexigenic peptide ghrelin , which may be regulated by insulin and leptin . This study examined effects of long-term weight loss  after laparoscopical adjustable gastric b and ing  on plasma ghrelin and leptin concentrations and their relationship with insulin action . Severely obese patients ( 15 women , three men , 36 + /- 12 yr ) underwent clinical examinations every 3 months and modified oral glucose tolerance tests to assess parameters of insulin sensitivity and secretion every 6 months . After surgery , body mass index fell from 45.3 + /- 5.3 to 37.2 + /- 5.3 and 33.6 + /- 5.5 kg/m(2 ) at 6 and 12 months , respectively ( P < 0.0001 ) . This was associated with lower ( P < 0.0001 ) plasma glucose , insulin , insulin resistance , waist circumference , and blood pressure . Plasma leptin decreased from 27.6 + /- 9.5 to 17.7 + /- 9.8 ( P = 0.0005 ) and 12.7 + /- 5.1 ng/ml ( P < 0.0001 ) . Plasma ghrelin was comparable before and at 6 months ( 234 + /- 53 ; 232 + /- 53 pmol/liter ) but increased at 12 months ( 261 + /- 72 pmol/liter ; P = 0.05 vs. 6 months ) . At 6 and 12 months , ghrelin levels correlated negatively with fasting plasma insulin levels and hepatic insulin extraction but not with body mass or insulin action . In conclusion , prolonged weight loss results in a rise of fasting ghrelin concentrations that correlates with fasting insulin concentrations but not improvement of insulin sensitivity The purpose of present study was to investigate plasma adiponectin response to acute exercise in highly trained male rowers . Ten rowers performed a maximal 6,000-m rowing ergometer test [ mean performance time ≈20 min ; 1,200.8 ( 29.9 ) s ] , and venous blood sample s were obtained before , immediately after and after 30 min of recovery . In addition to adiponectin concentration , leptin , insulin , growth hormone and glucose values were measured . Adiponectin was not changed immediately after the exercise when uncorrected for plasma volume changes ( −8.1 % ; P>0.05 ) . However , adiponectin was decreased immediately after the exercise when adjusted for plasma volume changes ( −11.3 % ; P<0.05 ) . Adiponectin was significantly increased above the resting value after the first 30 min of recovery ( uncorrected for plasma volume , + 19.3 % ; corrected for plasma volume , + 20.0 % ) . No changes occurred in plasma leptin and insulin concentrations with exercise ( uncorrected for plasma volume changes ) . While growth hormone and glucose values were significantly increased and decreased to the pre-exercise level immediately after the exercise and after the first 30 min of recovery , respectively ( uncorrected for plasma volume changes ) , no differences in the responses to exercise were observed in these measured blood parameters when adjusting for plasma volume changes . There were no relationships between plasma adiponectin and other measured blood parameters before and after the exercise , nor were changes in adiponectin related to changes in other measured blood biochemical values after the exercise . These results suggest that plasma adiponectin is altered as a result of maximal acute exercise in highly trained athletes Purpose Bariatric surgery ( BS ) promotes carotid intima-media thickness ( C-IMT ) regression as early as 6 months post-surgery . To verify whether C-IMT regression occurs even earlier , we aim ed at the effect of Roux-en-Y gastric bypass ( RYGBP ) and biliopancreatic diversion ( BPD ) on C-IMT 1–2 months and 12 months post-surgery . Subjects/ Methods Prospect i ve trial . BS was performed on 109 patients either with ( RYGBP = 42 ; BDP = 40 ) or without type 2 diabetes ( RYGBP = 27 ) . Healthy volunteers served as control group . Follow-up : baseline , 1–2 months , 12 months post-surgery . Endpoints : changes ( ∆ ) in C-IMT , weight , body mass index , fat mass , waist and neck circumferences , blood pressure , HbA1c , glucose , insulin , insulin sensitivity [ HOMA-IR ; OGIS , from meal tolerance test ] , lipids , C-reactive protein , leptin , adiponectin , MCP-1 . Results All surgery subgroups had similar levels of ∆-C-IMT . C-IMT in the pooled surgery group reduced from [ mean ( 95 % confidence interval ) ] 0.81 ( 0.77–0.84 ) mm to 0.66 ( 0.63–0.69 ) mm , p < 0.001 [ −17.1 ( −20.4 to −13.8)% ] at 1–2 months , and to 0.63 ( 0.59–0.66 ) mm , p < 0.001 [ −21.8 ( −25.3 to −18.4)% ] at 12 months post-surgery . ∆-C-IMT 1–2 months and 12 months post-surgery correlated to baseline C-IMT , and with ∆-leptin at 1–2 months , but not at 12 months post-surgery . In linear regression analysis , ∆-leptin and baseline C-IMT were predictors of ∆-C-IMT 1–2 months post-surgery . Conclusions A remarkable C-IMT regression occurred as early as 1–2 months after BS in obese patients either with or without type 2 diabetes , which was associated to the early reduction in leptin , ( at least partially ) independent of weight loss . Whether this is a causative or correlative association needs further investigation Introduction Hypoglycemia is a known adverse event following gastric bypass . The incidence of hypoglycemia after  laparoscopic sleeve gastrectomy ( LSG )  is still under investigation . The aim of our study was to verify the presence of oral glucose tolerance test (OGTT)-related hypoglycemia after LSG and to identify any baseline predictors of its occurrence . Methods We analyzed 197 consecutive non-diabetic morbid obese patients that underwent LSG .  All patients were studied before and 12 months after LSG . Evaluation included anthropometric parameters , 3-h OGTT for blood glucose ( BG ) , insulin and c-peptide , lipid profile , interleukin-6 ( IL-6 ) , tumor necrosis factor alpha ( TNF-α ) , highly sensitive C-reactive protein ( hsCRP ) , and leptin . Hypoglycemia was defined as BG ≤ 2.7 mmol/l . Results After surgery , 180 patients completed the OGTT . Eleven patients did not complete the test for gastric intolerance , and in six patients , the test was stopped earlier for the onset of severe symptomatic hypoglycemia . Of the patients , 61/186 ( 32.8 % ) had at least one OGTT-related hypoglycemia . The highest frequency of hypoglycemic events occurred 150′ after glucose load ( 20.2 % ) . At baseline , patients with hypoglycemic events after surgery ( Hypo ) were younger ( 40 ± 11 vs 46 ± 10 years ; p < 0.001 ) , less obese ( BMI 46 ± 5.7 vs 48.4 ± 7.9 kg/m2 ; p < 0.05 ) , and had a worse lipid profile as compared to patients without hypoglycemic events ( N-Hypo ) . Moreover , after L 
    Output:
    
agent
In conclusion , bariatric surgery is associated with a reduction in specific adipokines including leptin , chemerin , and PAI-1 , whereas adiponectin is raised , adaptations that could be indicative of improved fat mass and function
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Adipokines are signaling and mediator proteins secreted from adipose tissue . A novel adipokine , visfatin , was reported as a protein which was mainly expressed in visceral adipose tissue . Controversial results have been shown regarding the changes of adipokines following weight reduction . So we investigated the effects of weight reduction on serum concentrations of adiponectin and visfatin in morbidly obese subjects . Methods : 35 severely obese patients ( 26 females and 9 males ) , aged 15 - 58 years , were studied .  Anthropometric parameters and biochemical parameters  as well as  adiponectin and visfatin were analyzed before and 6 weeks after weight reduction . Results : Anthropometric indices decreased significantly . Blood levels of low-density lipoprotein cholesterol , high-density lipoprotein cholesterol , and triglyceride were reduced significantly . The reduction of visfatin and the elevation of adiponectin were significant as well . However , other parameters like fasting glucose and insulin did not change . Moreover , we could not find any significant correlation between the change of serum visfatin and that of adiponectin . Conclusions : 6-week weight reduction after bariatric surgery result ed in decreased serum visfatin and increased adiponectin levels . However , we can not find any significant correlation between changes of adiponectin , visfatin , BMI , waist circumference , and insulin resistance . Further studies with different design are suggested to clarify these associations ABSTRACT Background : The aim of this study was to examine the relationship between weight loss and resistin , apelin , chemerin , and visfatin after  laparoscopic adjustable gastric b and ing ( LAGB ) .  Methods : The study group consisted of 19 patients who were operated on for morbid obesity ( BMI : 48.7 ± 6.6 kg/m2 ) , and 22 healthy , normal-weight ( BMI : 22.9 ± 2.5 kg/m2 ) subjects formed the control group . We obtained blood sample s from the study subjects at three different times : before undergoing surgery and at one month and 6 months after surgery . Blood was obtained once from the control group . Results : Significant weight loss was achieved at one and 6 months after surgery . Plasma levels of apelin , resistin , chemerin , and visfatin were higher in morbidly obese patients compared with the control group . Obesity-related peptides decreased one month and 6 months after surgery . Conclusions : Elevated plasma resistin , apelin , chemerin , and visfatin levels in morbidly obese patients are gradually reduced after weight loss . According to these findings , LAGB surgery is found to be an important and efficient means for morbidly obese patients both to lose weight and to develop a better metabolic risk profile in a short time period Background Obesity is associated with a chronic low- grade inflammatory state , insulin resistance , and endothelial dysfunction , all of which contribute to increased risk of cardiovascular disease . We hypothesized that gastric bypass would produce rapid improvements in endothelial function , reduce inflammation , and lead to a decrease in cardiovascular risk . Methods We performed a prospect i ve study of morbidly obese patients who underwent laparoscopic Roux-en-Y gastric bypass ( RYGB ) .  Clinical data , biochemical markers of inflammation , and parameters indicative of cardiovascular risk were collected preoperatively and at 3 and 6 months postoperatively . Metabolic and inflammatory mediators that were quantified included C-reactive protein , fibrinogen , PAI-1 , IL-6 , IL-10 , IL-1Ra , adiponectin , leptin , triglycerides , total cholesterol , HDL , LDL , glucose , insulin , and HbA1c . Brachial artery reactivity testing ( BART ) was performed to assess peripheral arterial endothelial function , and Framingham cardiovascular risk score ( FRS ) was calculated on all study participants pre- and postoperatively . Results Fifteen patients ( 11 female ) were enrolled ( age = 49.2 ± 10.4 years ; BMI = 48.1 ± 5.3 kg/m2 ) . Six months post RYGB , mean BMI decreased to 35.4 ± 4.5 , corresponding to 51.7 % excess weight loss ( P < 0.001 ) . Mean waist circumference decreased significantly from 132 cm at baseline to 110 cm at 3 months ( P = 0.003 ) and 107 cm at 6 months ( P < 0.001 ) . Six months after RYGB , weight loss led to significant improvements in clinical parameters indicative of cardiovascular disease or risk , including brachial artery diameter , endothelial independent vasodilation , and FRS . Favorable improvements in the proinflammatory markers CRP ( P = 0.01 ) and leptin ( P = 0.005 ) , the anti-inflammatory mediator adiponectin ( P = 0.002 ) , and insulin sensitivity ( HOMA-IR , P = 0.007 ) were evident at 3 months . At 6 months , improvements in CRP , leptin , and fasting insulin were maintained and fibrinogen levels also decreased ( P = 0.047 ) . Adiponectin continued to increase at 6 months ( P = 0.004 ) . Conclusion Gastric bypass is associated with early reversal of endothelial dysfunction , a more favorable inflammatory milieu , and , most importantly , a reduction in cardiovascular risk Weight reduction after gastric bypass surgery  has been attributed to a decrease of the orexigenic peptide ghrelin , which may be regulated by insulin and leptin . This study examined effects of long-term weight loss  after laparoscopical adjustable gastric b and ing  on plasma ghrelin and leptin concentrations and their relationship with insulin action . Severely obese patients ( 15 women , three men , 36 + /- 12 yr ) underwent clinical examinations every 3 months and modified oral glucose tolerance tests to assess parameters of insulin sensitivity and secretion every 6 months . After surgery , body mass index fell from 45.3 + /- 5.3 to 37.2 + /- 5.3 and 33.6 + /- 5.5 kg/m(2 ) at 6 and 12 months , respectively ( P < 0.0001 ) . This was associated with lower ( P < 0.0001 ) plasma glucose , insulin , insulin resistance , waist circumference , and blood pressure . Plasma leptin decreased from 27.6 + /- 9.5 to 17.7 + /- 9.8 ( P = 0.0005 ) and 12.7 + /- 5.1 ng/ml ( P < 0.0001 ) . Plasma ghrelin was comparable before and at 6 months ( 234 + /- 53 ; 232 + /- 53 pmol/liter ) but increased at 12 months ( 261 + /- 72 pmol/liter ; P = 0.05 vs. 6 months ) . At 6 and 12 months , ghrelin levels correlated negatively with fasting plasma insulin levels and hepatic insulin extraction but not with body mass or insulin action . In conclusion , prolonged weight loss results in a rise of fasting ghrelin concentrations that correlates with fasting insulin concentrations but not improvement of insulin sensitivity The purpose of present study was to investigate plasma adiponectin response to acute exercise in highly trained male rowers . Ten rowers performed a maximal 6,000-m rowing ergometer test [ mean performance time ≈20 min ; 1,200.8 ( 29.9 ) s ] , and venous blood sample s were obtained before , immediately after and after 30 min of recovery . In addition to adiponectin concentration , leptin , insulin , growth hormone and glucose values were measured . Adiponectin was not changed immediately after the exercise when uncorrected for plasma volume changes ( −8.1 % ; P>0.05 ) . However , adiponectin was decreased immediately after the exercise when adjusted for plasma volume changes ( −11.3 % ; P<0.05 ) . Adiponectin was significantly increased above the resting value after the first 30 min of recovery ( uncorrected for plasma volume , + 19.3 % ; corrected for plasma volume , + 20.0 % ) . No changes occurred in plasma leptin and insulin concentrations with exercise ( uncorrected for plasma volume changes ) . While growth hormone and glucose values were significantly increased and decreased to the pre-exercise level immediately after the exercise and after the first 30 min of recovery , respectively ( uncorrected for plasma volume changes ) , no differences in the responses to exercise were observed in these measured blood parameters when adjusting for plasma volume changes . There were no relationships between plasma adiponectin and other measured blood parameters before and after the exercise , nor were changes in adiponectin related to changes in other measured blood biochemical values after the exercise . These results suggest that plasma adiponectin is altered as a result of maximal acute exercise in highly trained athletes Purpose Bariatric surgery ( BS ) promotes carotid intima-media thickness ( C-IMT ) regression as early as 6 months post-surgery . To verify whether C-IMT regression occurs even earlier , we aim ed at the effect of Roux-en-Y gastric bypass ( RYGBP ) and biliopancreatic diversion ( BPD ) on C-IMT 1–2 months and 12 months post-surgery . Subjects/ Methods Prospect i ve trial . BS was performed on 109 patients either with ( RYGBP = 42 ; BDP = 40 ) or without type 2 diabetes ( RYGBP = 27 ) . Healthy volunteers served as control group . Follow-up : baseline , 1–2 months , 12 months post-surgery . Endpoints : changes ( ∆ ) in C-IMT , weight , body mass index , fat mass , waist and neck circumferences , blood pressure , HbA1c , glucose , insulin , insulin sensitivity [ HOMA-IR ; OGIS , from meal tolerance test ] , lipids , C-reactive protein , leptin , adiponectin , MCP-1 . Results All surgery subgroups had similar levels of ∆-C-IMT . C-IMT in the pooled surgery group reduced from [ mean ( 95 % confidence interval ) ] 0.81 ( 0.77–0.84 ) mm to 0.66 ( 0.63–0.69 ) mm , p < 0.001 [ −17.1 ( −20.4 to −13.8)% ] at 1–2 months , and to 0.63 ( 0.59–0.66 ) mm , p < 0.001 [ −21.8 ( −25.3 to −18.4)% ] at 12 months post-surgery . ∆-C-IMT 1–2 months and 12 months post-surgery correlated to baseline C-IMT , and with ∆-leptin at 1–2 months , but not at 12 months post-surgery . In linear regression analysis , ∆-leptin and baseline C-IMT were predictors of ∆-C-IMT 1–2 months post-surgery . Conclusions A remarkable C-IMT regression occurred as early as 1–2 months after BS in obese patients either with or without type 2 diabetes , which was associated to the early reduction in leptin , ( at least partially ) independent of weight loss . Whether this is a causative or correlative association needs further investigation Introduction Hypoglycemia is a known adverse event following gastric bypass . The incidence of hypoglycemia after  laparoscopic sleeve gastrectomy ( LSG )  is still under investigation . The aim of our study was to verify the presence of oral glucose tolerance test (OGTT)-related hypoglycemia after LSG and to identify any baseline predictors of its occurrence . Methods We analyzed 197 consecutive non-diabetic morbid obese patients that underwent LSG .  All patients were studied before and 12 months after LSG . Evaluation included anthropometric parameters , 3-h OGTT for blood glucose ( BG ) , insulin and c-peptide , lipid profile , interleukin-6 ( IL-6 ) , tumor necrosis factor alpha ( TNF-α ) , highly sensitive C-reactive protein ( hsCRP ) , and leptin . Hypoglycemia was defined as BG ≤ 2.7 mmol/l . Results After surgery , 180 patients completed the OGTT . Eleven patients did not complete the test for gastric intolerance , and in six patients , the test was stopped earlier for the onset of severe symptomatic hypoglycemia . Of the patients , 61/186 ( 32.8 % ) had at least one OGTT-related hypoglycemia . The highest frequency of hypoglycemic events occurred 150′ after glucose load ( 20.2 % ) . At baseline , patients with hypoglycemic events after surgery ( Hypo ) were younger ( 40 ± 11 vs 46 ± 10 years ; p < 0.001 ) , less obese ( BMI 46 ± 5.7 vs 48.4 ± 7.9 kg/m2 ; p < 0.05 ) , and had a worse lipid profile as compared to patients without hypoglycemic events ( N-Hypo ) . Moreover , after L 
    Output:
    