Skip to main content
Top
Published in: Obesity Surgery 4/2009

01-04-2009 | Research Article

Inhibition of C-Reactive Protein in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy

Authors: Hakeam A. Hakeam, Patrick J. O’Regan, Abdulrahman M. Salem, Fahad Y. Bamehriz, Lina F. Jomaa

Published in: Obesity Surgery | Issue 4/2009

Login to get access

Abstract

Background

Obesity is considered a low-grade chronic inflammatory condition as reflected by increased C-reactive protein (CRP) levels. Inflammation is emerging as a predictor of cardiovascular disease and it may be a precursor of the metabolic syndrome. Bariatric surgery is commonly performed as a treatment for morbid obesity offering significant reductions in premature myocardial infarction. Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric procedure that is currently used as a definitive procedure for weight loss. The aim of this study is to assess the impact of sleeve gastrectomy on CRP levels.

Methods

This study is part of an ongoing, prospective, cohort study to evaluate LSG impact on iron indices. CRP levels were compared preoperatively and 6 months after surgery. Similarly, demographics including body mass index and excess weight were also compared at these same study points. Data were analyzed using Student paired t test and Pearson product moment correlation analysis.

Results

Twenty-nine morbidly obese patients were included. There was significant decrease in body mass index (BMI) between the preoperative and 6-month period (50.9 ± 13.2 and 35.1 ± 6.85, respectively; P < 0.001). Also CRP levels were statistically significantly lower at 6 months after surgery (preoperative 12.3 ± 7.53 mg/L and postoperative 5.6 ± 4.2 mg/L. P < 0.0001). The significant weight loss as reflected by change in BMI was correlated with the difference between preoperative and postoperative CRP levels.

Conclusions

Massive weight loss in morbidly obese patients induced by LSG causes a significant decrease in CRP levels, which could reduce the risk of cardiovascular diseases in these patients.
Literature
1.
go back to reference Grundy SM, Hansen B, Smith SC Jr, et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004;109:551–6.CrossRef Grundy SM, Hansen B, Smith SC Jr, et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004;109:551–6.CrossRef
2.
go back to reference Trayhurn P, Beattie JH. Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc 2001;60:329–39.CrossRef Trayhurn P, Beattie JH. Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc 2001;60:329–39.CrossRef
3.
go back to reference Esposito K, Pontillo A, Di Palo C, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA 2003;289:1799–804.CrossRef Esposito K, Pontillo A, Di Palo C, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA 2003;289:1799–804.CrossRef
4.
go back to reference Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135–43.CrossRef Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135–43.CrossRef
5.
go back to reference Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003;111:1805–12.CrossRef Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003;111:1805–12.CrossRef
6.
go back to reference Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 2000;321:199–204.CrossRef Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 2000;321:199–204.CrossRef
7.
go back to reference Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004;350:1387–97.CrossRef Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004;350:1387–97.CrossRef
8.
go back to reference Duncan BB, Schmidt MI, Pankow JS, et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003;52:1799–805.CrossRef Duncan BB, Schmidt MI, Pankow JS, et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003;52:1799–805.CrossRef
9.
go back to reference Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499–511.CrossRef Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499–511.CrossRef
10.
go back to reference Selvin E, Paynter NP, Erlinger TP. The effect of weight loss on C-reactive protein: a systematic review. Arch Intern Med 2007;167:31–9.CrossRef Selvin E, Paynter NP, Erlinger TP. The effect of weight loss on C-reactive protein: a systematic review. Arch Intern Med 2007;167:31–9.CrossRef
11.
go back to reference Torgerson JS, Sjostrom L. The Swedish Obese Subjects (SOS) study—rationale and results. Int J Obes Relat Metab Disord 2001;25(Suppl 1):S2–4.CrossRef Torgerson JS, Sjostrom L. The Swedish Obese Subjects (SOS) study—rationale and results. Int J Obes Relat Metab Disord 2001;25(Suppl 1):S2–4.CrossRef
12.
go back to reference Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–52.CrossRef Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–52.CrossRef
13.
go back to reference Vilarrasa N, Vendrell J, Sanchez-Santos R, et al. Effect of weight loss induced by gastric bypass on proinflammatory interleukin-18, soluble tumour necrosis factor-alpha receptors, C-reactive protein and adiponectin in morbidly obese patients. Clin Endocrinol 2007;67:679–86.CrossRef Vilarrasa N, Vendrell J, Sanchez-Santos R, et al. Effect of weight loss induced by gastric bypass on proinflammatory interleukin-18, soluble tumour necrosis factor-alpha receptors, C-reactive protein and adiponectin in morbidly obese patients. Clin Endocrinol 2007;67:679–86.CrossRef
14.
go back to reference Zagorski SM, Papa NN, Chung MH. The effect of weight loss after gastric bypass on C-reactive protein levels. Surg Obes Relat Dis 2005;1:81–5.CrossRef Zagorski SM, Papa NN, Chung MH. The effect of weight loss after gastric bypass on C-reactive protein levels. Surg Obes Relat Dis 2005;1:81–5.CrossRef
15.
go back to reference Khaodhiar L, Ling PR, Blackburn GL, et al. Serum levels of interleukin-6 and C-reactive protein correlate with body mass index across the broad range of obesity. JPEN 2004;28:410–5.CrossRef Khaodhiar L, Ling PR, Blackburn GL, et al. Serum levels of interleukin-6 and C-reactive protein correlate with body mass index across the broad range of obesity. JPEN 2004;28:410–5.CrossRef
16.
go back to reference Emery CF, Fondow MD, Schneider CM, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg 2007;17:759–63.CrossRef Emery CF, Fondow MD, Schneider CM, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg 2007;17:759–63.CrossRef
17.
go back to reference Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005;15:1024–9.CrossRef Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005;15:1024–9.CrossRef
18.
go back to reference Anonymous. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obes Res. 1998;6(Suppl 2):51S–209S. Anonymous. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obes Res. 1998;6(Suppl 2):51S–209S.
19.
go back to reference Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267–82.CrossRef Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267–82.CrossRef
20.
go back to reference Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.CrossRef Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.CrossRef
21.
go back to reference Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg 2007;17:57–62.CrossRef Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg 2007;17:57–62.CrossRef
22.
go back to reference Horowitz M, Collins PJ, Chatterton BE, et al. Gastric emptying after gastroplasty for morbid obesity. Br J Surg 1984;71:435–7.CrossRef Horowitz M, Collins PJ, Chatterton BE, et al. Gastric emptying after gastroplasty for morbid obesity. Br J Surg 1984;71:435–7.CrossRef
23.
go back to reference Stevens J, Cai J, Pamuk ER, et al. The effect of age on the association between body-mass index and mortality. N Engl J Med 1998;338:1–7.CrossRef Stevens J, Cai J, Pamuk ER, et al. The effect of age on the association between body-mass index and mortality. N Engl J Med 1998;338:1–7.CrossRef
24.
go back to reference Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg 2007;17:1069–74.CrossRef Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg 2007;17:1069–74.CrossRef
25.
go back to reference Pickup JC, Mattock MB, Chusney GD, et al. NIDDM as a disease of the innate immune system: association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia 1997;40:1286–92.CrossRef Pickup JC, Mattock MB, Chusney GD, et al. NIDDM as a disease of the innate immune system: association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia 1997;40:1286–92.CrossRef
26.
go back to reference Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg 2003;197:536–44.CrossRef Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg 2003;197:536–44.CrossRef
Metadata
Title
Inhibition of C-Reactive Protein in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy
Authors
Hakeam A. Hakeam
Patrick J. O’Regan
Abdulrahman M. Salem
Fahad Y. Bamehriz
Lina F. Jomaa
Publication date
01-04-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 4/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9729-y

Other articles of this Issue 4/2009

Obesity Surgery 4/2009 Go to the issue