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Published in:

01-08-2016

Effect of bariatric surgery on systemic and adipose tissue inflammation

Authors: Valerie G. Sams, Camille Blackledge, Nadeeja Wijayatunga, Patrick Barlow, Matthew Mancini, Gregory Mancini, Naima Moustaid-Moussa

Published in: Surgical Endoscopy | Issue 8/2016

Abstract

Background

Obese patients are predisposed to developing insulin resistance and associated metabolic diseases such as diabetes and cardiovascular disease. The objective of this study was to determine the effect of bariatric surgery on adipose-derived inflammatory cytokines (adipokines), which play a key role in insulin resistance and obesity. We hypothesized that there is a significant increase in serum and tissue anti-inflammatory adiponectin with a decrease in circulating pro-inflammatory TNF-α and MCP-1, leading to reduced inflammation post-bariatric surgery.

Methods

In this study, we investigated the effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic gastric band on serum and tissue levels of adiponectin and serum levels of MCP-1 and TNF-α. Samples of serum and adipose tissue were collected at the time of surgery, 2 weeks and 6 months postoperatively. Adipokine levels were assayed by ELISA kits.

Results

A significant increase in adiponectin levels 2 weeks after surgery was observed in the subcutaneous adipose tissue in both groups combined. Serum adiponectin in LRYGB patients showed an increasing trend, while MCP-1 showed a decreasing trend post-surgery. There was no difference in TNF-α among the groups. The number of patients enrolled did not allow for statistical power to be reached.

Conclusion

Our results show significant and rapid increases in subcutaneous adipose adiponectin as early as 2 weeks post-bariatric surgery demonstrating reduced inflammation and possibly reduced insulin resistance. Future studies are warranted in larger cohorts with additional measurements of insulin sensitivity and inflammation.

Ogden CL, Carroll MD, Kit BK, Flegal KM (2013) Prevalence of obesity among adults: United States, 2011–2012. NCHS Data Brief 131:1–8PubMed

Poirier P, Cornier M-A, Mazzone T et al (2011) Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation 123(15):1683–1701CrossRefPubMed

Flegal KM, Kit BK, Orpana H, Graubard BI (2013) Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 309(1):71–82CrossRefPubMedPubMedCentral

Colquitt JL, Pickett K, Loveman E, Frampton G (2014) Surgery for weight loss in adults. Cochrane Database Syst Rev 8:CD003641PubMed

Knop FK, Taylor R (2013) Mechanism of metabolic advantages after bariatric surgery: it’s all gastrointestinal factors versus it’s all food restriction. Diabetes Care 36(Supplement 2):S287–S291CrossRefPubMedPubMedCentral

Feng B, Zhang T, Xu H (2013) Human adipose dynamics and metabolic health. Ann N Y Acad Sci 1281(1):160–177CrossRefPubMedPubMedCentral

Ouchi N, Parker JL, Lugus JJ, Walsh K (2011) Adipokines in inflammation and metabolic disease. Nat Rev Immunol 11(2):85–97CrossRefPubMedPubMedCentral

Whitehead JP, Richards AA, Hickman IJ, Macdonald GA, Prins JB (2006) Adiponectin—a key adipokine in the metabolic syndrome. Diabetes Obes Metab 2:264–280CrossRef

Faraj M, Havel PJ, Phélis S, Blank D, Sniderman AD, Cianflone K (2003) Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab 88(4):1594–1602CrossRefPubMed

10.

Kwon H, Pessin JE (2013) Adipokines mediate inflammation and insulin resistance. Front Endocrinol 4:71CrossRef

11.

Mun EC, Blackburn GL, Matthews JB (2001) Current status of medical and surgical therapy for obesity. Gastroenterology 120:669–681CrossRefPubMed

12.

Sjostrom L, Lindroos AK, Peltonen M et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351:2683–2693CrossRefPubMed

13.

Buchwold H, Avidor Y, Braunwald E et al (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737CrossRef

14.

Shah M, Simha V, Garg A (2006) Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab 91(11):4223–4231CrossRefPubMed

15.

Thaler JP, Cummings DE (2009) Minireview: hormonal and metabolic mechanisms of diabetes remission after gastrointestinal surgery. Endocrinology 150(6):2518–2525CrossRefPubMed

16.

Andreelli F, Amouyal C, Magnan C, Mithieux G (2009) What can batriatric surgery teach us about the pathophysiology of type 2 diabetes? Diabetes Metab 35(6pt2):499–507CrossRefPubMed

17.

Kalupahana NS, Voy BH, Fletcher S et al (2009) Mechanisms linking overproduction of angiotensinogen by adipose tissue to inflammation, glucose intolerance and insulin resistance. Obesity 17(suppl2):S58

18.

Kanda H, Tateya S, Tamori Y et al (2006) MCP-1 contributes to macrophage infiltration into adipose tissue, insulin resistance, and hepatic steatosis on obesity. J Clin Investig 116:1494–1505CrossRefPubMedPubMedCentral

19.

Sato C, Shikata K, Hirota D et al (2011) P-selectin glycoprotein ligand-1 deficiency is protective against obesity-related insulin resistance. Diabetes 60:189–199CrossRefPubMed

20.

Weisberg SP, Hunter D, Huber R et al (2006) CCR2 modulates inflammatory and metabolic effects of high-fat feeding. J Clin Investig 116:115–124CrossRefPubMed

21.

Hotamisligil GS, Shargil NS, Spiegelman BM (1993) Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 259:87–91CrossRefPubMed

22.

Luo N, Liu J, Chung BH et al (2010) Macrophage adiponectin expression improves insulin sensitivity and protects against inflammation and atherosclerosis. Diabetes 59:791–799CrossRefPubMedPubMedCentral

23.

Rubino F, Schauer PR, Lee KM, Cummings DE (2010) Metabolic surgery to treat type 2 diabetes: clinical outcomes and mechanisms of action. Annu Rev Med 61:393–411CrossRefPubMed

24.

Pournaras DJ, Aasheim ET, Bueter M et al (2012) Effect of bypassing the proximal gut on gut hormones involved with glycemic control and weight loss. Surg Obes Relat Dis 8(4):371–374CrossRefPubMed

25.

Miller GD, Nicklas BJ, Fernandez A (2011) Serial changes in inflammatory biomarkers after Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis 7(5):618–624CrossRefPubMedPubMedCentral

Title: Effect of bariatric surgery on systemic and adipose tissue inflammation
Authors: Valerie G. Sams
Camille Blackledge
Nadeeja Wijayatunga
Patrick Barlow
Matthew Mancini
Gregory Mancini
Naima Moustaid-Moussa
Publication date: 01-08-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4638-3

At a glance: The STEP trials

Springer Medicine

Effect of bariatric surgery on systemic and adipose tissue inflammation

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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