Pathogenesis of Obesity and Effects of Treatment Pathogenesis of Obesity and Effects of Treatment

................................................................................ 4 List of papers ........................................................................... 6 Abbreviations .......................................................................... 7 Introduction ............................................................................ 8 Obesity and the metabolic syndrome .......................................... 8 Energy balance ................................................................... 9 Genetics of obesity ............................................................... 10 Obesity treatment ................................................................. 10 Effects of obesity treatment ..................................................... 12 Adipose tissue ..................................................................... 13 Visceral obesity .................................................................. 15 Gut factors in obesity ............................................................ 16 Obesity and cancer ............................................................... 16 Aims ...................................................................................... 17 Subjects and study designs .......................................................... 18 Very Low Calorie Diet (VLCD) study ........................................ 18 Mölndal metabolic study ........................................................ 19 Intestinal Permeability in Visceral Obesity (IPIVO) study ................. 20 Swedish Obese Subjects (SOS) study ......................................... 20 Methods ................................................................................. 22 Anthropometry .................................................................... 22 Computed tomography .......................................................... 22 Dual energy X-ray absorptiometry ............................................. 22 Indirect calorimetry .............................................................. 23 Blood samples, oral glucose tolerance test, and adipose tissue biopsies .. 23 DNA microarray .................................................................. 23 Real-time reverse transcription polymerase chain reaction ................. 24 Small interfering RNA–mediated gene silencing in cultured cells ........ 24 Intestinal permeability test ...................................................... 24 Register information ............................................................. 25 Results and discussion ............................................................... 26 CIDEA and CIDEC in human adipose tissue (Paper I and II) ............. 26 Intestinal permeability in visceral obesity (Paper III) ....................... 32 Effects of obesity treatment on cancer incidence (Paper IV) ............... 35 Conclusions and future perspectives .............................................. 39 Acknowledgements ................................................................... 41 References .............................................................................. 42