Treatment of obesity and the metabolic syndrome (and type 2 diabetes) - both as to diet and pharmacology

Obesity and related complications such as Metabolic Syndrome, Type 2 Diabetes, and cardiovascular diseases are very common. Thus, treatment and prevention of obesity and its complications is a main focus of our research with both dietary and pharmacological clinical investigations. The department has been involved in several large international investigations with a dietary focus (Vessby et al. 2001);on-going investigations concern  the effects of carbohydrates ( i.e. fructose and glycemic index) (Maersk et al 2012), polyphenols (i.e. resveratrol),  stevioside,  proteins (i.e. whey and ketogenic amino acids), and  fat quality. In addition, pharmacological treatment of these conditions has been and still is an important focus and we have been involved in numerous multicenter investigations of anti-obesity drugs i.e. orlistat (Richelsen et al. 2007), sibutramine, rimonabant, liraglutide (Astrup et al. 2012) as well as studies in treatment and prevention of Metabolic Syndrome and Type 2 Diabetes (Nauck et al 2009).

We also conduct research in more rare diseases of adipose tissue deposition such as generalized and partial lipodystrophies and more extreme lipomatosis.


Contacts


Bjørn Richelsen, professor, MD, DMSci, bjoric@rm.dk
Kjeld Hermansen, professor, MD, DMSci, kjeld.hermansen@aarhus.rm.dk
Steen Bønløkke Pedersen, professor, MD, DMSci,  steepede@rm.dk

Adipose tissue function – in the etiology of obesity, insulin resistance, and in the treatment of obesity complications.

Distribution of body fat is very gender specific and we studied the interplay between steroid hormones and body fat distribution. Estrogen increases the number of anti-lipolytic alpha2A adrenergic receptors in subcutaneous adipose tissue and thus favour a female body shape (Pedersen et al. 2004). We have demonstrated that adipocytes from the visceral depot have higher lipolysis compared to subcutaneous adipocytes (Richelsen B et al. 1991) and that adipose tissue from the visceral depot produces higher amounts of cytokines (Bruun JM et al. 2005). As adipose tissue is the only tissue  producing adiponectin which seemingly improves insulin sensitivity, we investigated  how the production of adiponectin could be regulated and found that inflammatory cytokines produced in the adipose tissue could inhibit the production of adiponectin (Bruun JM et al. 2003). Possibly the association between the adipose tissue and its metabolic consequences is development of a “low-grade” inflammation in the adipose tissue in obese subjects.

We are currently investigating how this low-grade inflammation evolves. Other studies target the inflammation directly and monitor the effect on whole body metabolism. Furthermore, we investigate the association between  macrophages (number, activation etc.) in adipose tissue and  inflammatory response.


Contacts


Bjørn Richelsen, professor, MD, DMSci, bjoric@rm.dk
Steen B, Pedersen, professor, MD, DMSci,  steepede@rm.dk

Obesity (bariatric) surgery


Due to the minor effect of conventional treatment of obesity, obesity surgery has become  increasingly common (Richelsen 2011). At the department we have been involved in obesity surgery for decades, and our main current research focus is

  1. optimizing the selection of individuals for this treatment.
  2. investigating the factors involved in the improvement of glucose-insulin homeostasis after gastric bypass.
  3. optimizing the treatment of nutritional complications (hypoglycemia, malnutrition etc.) after gastric bypass.
  4. developing  new and less invasive surgical procedures and to test their efficacy (Pedersen et al. 2005).

 

Contacts

Bjørn Richelsen, professor, MD, DMSci, bjoric@rm.dk
Steen B, Pedersen, professor, MD, DMSci,  amtssp@gmail.com