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Published in: Obesity Surgery 5/2020

01-05-2020 | Obesity | Original Contributions

Impact of Weight Loss on Inflammation State and Endothelial Markers Among Individuals with Extreme Obesity After Gastric Bypass Surgery: a 2-Year Follow-up Study

Authors: Gisele Farias, Bárbara Dal Molin Netto, Katia Boritza, Solange Cravo Bettini, Regina Maria Vilela, Ana Raimunda Dâmaso

Published in: Obesity Surgery | Issue 5/2020

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Abstract

Background

The medium-term impact of gastric bypass (GB) surgery on the inflammatory state and endothelial function of patients has yet to be confirmed.

Objective

This study aims to elucidate the inflammatory profile and endothelial dysfunction response of adults with obesity 6 and 24 months after undergoing GB surgery.

Methods

The anthropometric and biochemical markers of 32 adults with obesity (two men and 30 females) were collected preoperatively, and 6 and 24 months postoperatively.

Results

Body mass index (BMI) and excess weight had decreased by 15.79 ± 1.21 kg/m2 (p < 0.01) and 83.80 ± 24.50% respectively at 24 months. Leptin, C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1) levels, and the leptin/adiponectin ratio decreased significantly at both postoperative follow-up points compared with preoperative values (p < 0.01). IL-6 and ICAM-1 levels decreased between 6 and 24 months post-GB (p < 0.01). IL-6 and ICAM-1 levels decreased between 6- and 24-months post-GB (p < 0.01). Resistin levels were significantly decreased (p < 0.01) at 6-month follow-up. The levels of the anti-inflammatory biomarkers IL-10, adiponectin, and the adiponectin/leptin ratio significantly increased postoperatively. There was an improvement in metabolic disorders after surgery.

Conclusion

Our results demonstrated that after GB there was an improvement in the inflammatory profile, identified by a reduction in pro-inflammatory markers (CRP, IL-6, leptin) and an increase in anti-inflammatory markers (adiponectin, IL-10). The decrease in PAI-1 and ICAM-1 levels may suggest improvement in endothelial function. These findings provide clear evidence of the medium-term impact of GB on inflammation state and a number of endothelial markers, and a consequent reduction in the risk of cardiovascular diseases.
Literature
1.
go back to reference Vilahur G, Ben-Aicha S, Badimon L. New insights into the role of adipose tissue in thrombosis. Cardiovasc Res. 2017;113(9):1046–54.CrossRef Vilahur G, Ben-Aicha S, Badimon L. New insights into the role of adipose tissue in thrombosis. Cardiovasc Res. 2017;113(9):1046–54.CrossRef
4.
go back to reference RakotoArivelo V et al. Inflammatory cytokine profiles in visceral and subcutaneous adipose tissues of obese patients undergoing bariatric surgery reveal lack of correlation with obesity or diabetes. EBioMedicine. 2018;30:237–47.CrossRef RakotoArivelo V et al. Inflammatory cytokine profiles in visceral and subcutaneous adipose tissues of obese patients undergoing bariatric surgery reveal lack of correlation with obesity or diabetes. EBioMedicine. 2018;30:237–47.CrossRef
5.
go back to reference Unamuno X et al. Adipokine dysregulation and adipose tissue inflammation in human obesity. Eur J Clin Investig. 2018;48:e12997–3008.CrossRef Unamuno X et al. Adipokine dysregulation and adipose tissue inflammation in human obesity. Eur J Clin Investig. 2018;48:e12997–3008.CrossRef
6.
go back to reference Villarroya F et al. Inflammation of brown/beige adipose tissues in obesity and metabolic disease. J Intern Med. 2018;2018:1–13. Villarroya F et al. Inflammation of brown/beige adipose tissues in obesity and metabolic disease. J Intern Med. 2018;2018:1–13.
7.
go back to reference Illán-Gomez F et al. Obesity, endothelial function and inflammation: the effects of weight loss after bariatric surgery. Nutr Hosp. 2016;33(6):1340–6.CrossRef Illán-Gomez F et al. Obesity, endothelial function and inflammation: the effects of weight loss after bariatric surgery. Nutr Hosp. 2016;33(6):1340–6.CrossRef
8.
go back to reference Chiapetta S et al. The impact of obesity and metabolic surgery on chronic inflammation. Obes Surg. 2018;28:3028–40.CrossRef Chiapetta S et al. The impact of obesity and metabolic surgery on chronic inflammation. Obes Surg. 2018;28:3028–40.CrossRef
9.
go back to reference Angrisani L et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.CrossRef Angrisani L et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.CrossRef
10.
go back to reference Yadav R et al. Effect of Roux-en-Y bariatric surgery on lipoproteins, insulin resistance, and systemic and vascular inflammation in obesity and diabetes. Front Immunol. 2017;8:1–7.CrossRef Yadav R et al. Effect of Roux-en-Y bariatric surgery on lipoproteins, insulin resistance, and systemic and vascular inflammation in obesity and diabetes. Front Immunol. 2017;8:1–7.CrossRef
11.
go back to reference Stolberg CR et al. Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function: a randomized controlled trial. Atherosclerosis. 2018;273:37–44.CrossRef Stolberg CR et al. Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function: a randomized controlled trial. Atherosclerosis. 2018;273:37–44.CrossRef
12.
go back to reference Khosravi-Largani M et al. Evaluation of all types of metabolic bariatric surgery and its consequences: a systematic review and meta-analysis. Obes Surg. 2019;29:651–90.CrossRef Khosravi-Largani M et al. Evaluation of all types of metabolic bariatric surgery and its consequences: a systematic review and meta-analysis. Obes Surg. 2019;29:651–90.CrossRef
13.
go back to reference Adami GF, Scopinaro N, Cordera R. Adipokine pattern after bariatric surgery: beyond the weight loss. Obes Surg. 2016;26:2793–801.CrossRef Adami GF, Scopinaro N, Cordera R. Adipokine pattern after bariatric surgery: beyond the weight loss. Obes Surg. 2016;26:2793–801.CrossRef
14.
go back to reference Bachmayer C et al. Healthy obese and post bariatric patients – metabolic and vascular patterns. Exp Clin Endocrinol Diabetes. 2013;121:483–7.CrossRef Bachmayer C et al. Healthy obese and post bariatric patients – metabolic and vascular patterns. Exp Clin Endocrinol Diabetes. 2013;121:483–7.CrossRef
15.
go back to reference Auguet T et al. Clinical and adipocytokine changes after bariatric surgery in morbidly obese women. Obesity (Silver Spring). 2014;22:188–94.CrossRef Auguet T et al. Clinical and adipocytokine changes after bariatric surgery in morbidly obese women. Obesity (Silver Spring). 2014;22:188–94.CrossRef
16.
go back to reference Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–8.CrossRef Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–8.CrossRef
17.
go back to reference Matthews DR et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRef Matthews DR et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.CrossRef
18.
go back to reference Katz A et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.CrossRef Katz A et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.CrossRef
19.
go back to reference Netto BDM et al. Roux-en-Y gastric bypass decreases pro-inflammatory and thrombotic biomarkers in individuals with extreme obesity. Obes Surg. 2015;25(6):1010–8.CrossRef Netto BDM et al. Roux-en-Y gastric bypass decreases pro-inflammatory and thrombotic biomarkers in individuals with extreme obesity. Obes Surg. 2015;25(6):1010–8.CrossRef
20.
go back to reference Farias G et al. Neuroendocrine regulation of energy balance: implications on the development and surgical treatment of obesity. Nutr Health. 2017;23:131–46.CrossRef Farias G et al. Neuroendocrine regulation of energy balance: implications on the development and surgical treatment of obesity. Nutr Health. 2017;23:131–46.CrossRef
21.
go back to reference Askarpour M, Khani D, Sheikhi A, et al. Effect of bariatric surgery on serum inflammatory factors of obese patients: a systematic review and meta-analysis. Obes Surg. 2019;29:2631–47.CrossRef Askarpour M, Khani D, Sheikhi A, et al. Effect of bariatric surgery on serum inflammatory factors of obese patients: a systematic review and meta-analysis. Obes Surg. 2019;29:2631–47.CrossRef
22.
go back to reference Unamuno X et al. Increase of the adiponectin/leptin ratio in patients with obesity and type 2 diabetes after Roux-en-Y gastric bypass. Nutrients. 2019;11:2069.CrossRef Unamuno X et al. Increase of the adiponectin/leptin ratio in patients with obesity and type 2 diabetes after Roux-en-Y gastric bypass. Nutrients. 2019;11:2069.CrossRef
23.
go back to reference Fruhbeck G et al. Adiponectin-leptin ratio: a promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte. 2018;7:57–62.CrossRef Fruhbeck G et al. Adiponectin-leptin ratio: a promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte. 2018;7:57–62.CrossRef
24.
go back to reference Frikke-Schmidt H et al. Does bariatric surgery improve adipose tissue function? Obes Rev. 2016;17(9):795–809.CrossRef Frikke-Schmidt H et al. Does bariatric surgery improve adipose tissue function? Obes Rev. 2016;17(9):795–809.CrossRef
25.
go back to reference Malden D et al. Body fat distribution and systolic blood pressure in 10,000 adults with whole-body imaging: UK Biobank and Oxford BioBank. Obesity. 2019;27:1200–6. Malden D et al. Body fat distribution and systolic blood pressure in 10,000 adults with whole-body imaging: UK Biobank and Oxford BioBank. Obesity. 2019;27:1200–6.
26.
go back to reference Vest AR et al. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart. 2012;98:1763–77.CrossRef Vest AR et al. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart. 2012;98:1763–77.CrossRef
27.
go back to reference Wilhelm SM, Young J, Kale-Pradhan PB. Effect of bariatric surgery on hypertension: a meta-analysis. Ann Pharmacother. 2014;48:674–82.CrossRef Wilhelm SM, Young J, Kale-Pradhan PB. Effect of bariatric surgery on hypertension: a meta-analysis. Ann Pharmacother. 2014;48:674–82.CrossRef
28.
go back to reference Lager CJ et al. Metabolic parameters, weight loss, and comorbidities 4 years after Roux-en-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2018;28:3415–23.CrossRef Lager CJ et al. Metabolic parameters, weight loss, and comorbidities 4 years after Roux-en-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2018;28:3415–23.CrossRef
29.
go back to reference Lira NS et al. Análise do perfil lipídico de pacientes submetidos à gastrectomia vertical e à derivação gástrica em Y de Roux. Rev Col Bras Cir. 2018;45:e1967.CrossRef Lira NS et al. Análise do perfil lipídico de pacientes submetidos à gastrectomia vertical e à derivação gástrica em Y de Roux. Rev Col Bras Cir. 2018;45:e1967.CrossRef
30.
go back to reference Schiavon CA et al. Effects of bariatric surgery in obese patients with hypertension. Circulation. 2018;137:1132–42.CrossRef Schiavon CA et al. Effects of bariatric surgery in obese patients with hypertension. Circulation. 2018;137:1132–42.CrossRef
31.
go back to reference Pareek M et al. Metabolic surgery for hypertension in patients with obesity. Circ Res. 2019;124:1009–24.CrossRef Pareek M et al. Metabolic surgery for hypertension in patients with obesity. Circ Res. 2019;124:1009–24.CrossRef
Metadata
Title
Impact of Weight Loss on Inflammation State and Endothelial Markers Among Individuals with Extreme Obesity After Gastric Bypass Surgery: a 2-Year Follow-up Study
Authors
Gisele Farias
Bárbara Dal Molin Netto
Katia Boritza
Solange Cravo Bettini
Regina Maria Vilela
Ana Raimunda Dâmaso
Publication date
01-05-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04411-9

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