Effects of Changes in Body Weight and Insulin Resistance on Inflammation and Endothelial Function in Morbid Obesity after Bariatric Surgery

Vázquez, Luis Alberto; Pazos, Fernando; Berrazueta, José R.; Fernández-Escalante, Carlos; García‐Unzueta, María Teresa; Freijanes, J.; Amado, J. A.

doi:10.1210/jc.2003-032059

Cited by 185 publications

(161 citation statements)

References 54 publications

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“…Similar results were obtained by Vázquez et al (2005) in patients with morbid obesity four months after bariatric surgery, which indicated that inflammatory pathways, including the TNF-α system and IL-6, remain activated. However, in 22 obese and 20 hypertensive patients subjected to BT with thermal water at 38 °C in 15 sessions (each of 30-min duration), Oláh et al (2011) observed a significant decrease in post-treatment CRP levels in a hypertensive group but not in obese subjects.…”

Section: Discussionsupporting

confidence: 81%

“…Xydakis et al (2004) found no differences in TNF-α concentrations among obese individuals (56 women and 24 men with a BMI of >(38.3±0.7) kg/m 2 ) after 4-6 weeks of weight loss induced by a very low calorie diet. Perhaps the metabolic stress results from a relative starvation effect on the inflammatory response (Vázquez et al, 2005;Solá et al, 2009). However, Zahorska-Markiewicz et al (2008) reported an impact of weight loss on the level of TNF-α in obese women.…”

Section: Discussionmentioning

confidence: 99%

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CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

Rość

Adamczyk

Boińska

et al. 2015

J. Zhejiang Univ. Sci. B

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Abstract:Objective: The aim of this study was to evaluate the concentrations of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the degree of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy. Methods: The study included 33 patients (25 females and 8 males; mean age 46 years) with body mass index (BMI) values of >40 kg/m 2 . Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before (baseline data) and three weeks after the treatment. The control group consisted of 20 healthy volunteers (15 females and 5 males) with a mean age of 39 years and BMI values of ≤24.9 kg/m 2 . Results: In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a decreased level of high density lipoprotein (HDL)-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4% reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concentration of CRP, but no change in TNF-α or IL-6. HOMA-IR was significantly reduced. Conclusions: The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

Rość

Adamczyk

Boińska

et al. 2015

J. Zhejiang Univ. Sci. B

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“…Endothelial dysfunction can be curtailed by nonpharmacological measures, such as physical activity 92 and weight loss, 93 or pharmacological ones, such as statins and angiotensin converting enzyme (ACE) inhibitor. 94 …”

Section: Endothelial Dysfunction and Cardiovascular Disease Predictormentioning

confidence: 99%

Menopause, Estrogens, and Endothelial Dysfunction: Current Concepts

Maturana

Irigoyen

Spritzer

2007

Clinics

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Maturana MA, Irigoyen MC, Spritzer PM. Menopause, estrogens, and endothelial dysfunction: current concepts. Clinics. 2007;62(1):77-86. Menopause is defined as the permanent cessation of menses. Cardiovascular disease is the leading cause of death among postmenopausal women in developed countries. The disparity between the incidence of cardiovascular disease among women in pre-and postmenopause has been ascribed to the actions of endogenous estrogen on the cardiovascular system and, particularly, on the vascular endothelium. The endothelium plays an important role in cardiovascular homeostasis, either through the vascular tonus and its regulation, or through coagulation and the inflammatory response. Endothelial dysfunction is implicated in the genesis of atherosclerosis and other chronic disorders, such as diabetes mellitus and hypertension. The pharmacological use of estrogen exerts influence on the circulating levels of markers of vascular tonus, and inflammation, as well as prothrombotic, and fibrinolytic markers, but the impact of these changes on the atherosclerotic disease is still uncertain.

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“…Disturbed endothelial function can be assessed by measuring the level of these molecules. The concentration of soluble intracellular adhesion molecule-1 (sICAM1) and plasminogen activator inhibitor 1 (PAI-1) have been shown to be the earliest markers of endothelial dysfunction (6,7) and there is evidence that these substances are increased in obese patients (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Obesity, endothelial function and inflammation: the effects of weight loss after bariatric surgery

Gómez¹,

Ortega²,

Aragón‐Alonso³

et al. 2016

Nutr Hosp

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Palabras clave:Obesidad. Cirugía bariátrica. Infl amación. Función endotelial. Resistencia a la insulina. ResumenObjetivo: la obesidad está asociada con un aumento del riesgo de enfermedad cardiovascular. Se ha propuesto una relación causal entre obesidad, infl amación, resistencia a la insulina, y disfunción endotelial. El objetivo de este estudio fue valorar marcadores de insulinorresistencia, infl amación y disfunción endotelial en pacientes con obesidad mórbida antes y después de la pérdida de peso por cirugía bariátrica. Métodos: se midieron las concentraciones séricas de moléculas solubles de adhesión intercelular tipo 1 (sICAM-1), inhibidor del activador del plasminógeno tipo 1 (PAI-1), proteína C reactiva de alta sensibilidad (hs-PCR) e interleucina 6 (IL-6) en 79 pacientes con obesidad mórbida antes y a los 3, 6 y 12 meses de la realización de un by-pass gástrico. También se evaluaron índices de resistencia a la insulina. Resultados: a los 12 meses de la cirugía disminuyeron los niveles de sICAM1 (p < 0,001), PAI-1 (p < 0,05), hs-CRP (p < 0,001), IL-6 (p < 0,001) y el índice homeostasis model assessment (HOMA) (p < 0,001) y aumentó el índice McAuley (p < 0,001). Los niveles basales de hs-PCR estaban correlacionados con los de sICAM-1 (r = 0,450, p < 0,01) y de IL-6 (r = 0,451, p < 0,01). También existía correlación entre el descenso de los niveles de PAI-1 y el descenso de hs-PCR (r = 0,425, p < 0,01) y triglicéridos (r = 0,351, p < 0,01). Conclusiones: en pacientes con obesidad mórbida una importante pérdida de peso por cirugía bariátrica se acompaña de una mejora signifi cativa de marcadores infl amatorios, de función endotelial e insulinorresistencia, lo que puede suponer una disminución del riesgo cardiovascular. Existe una relación entre mejora del perfi l infl amatorio y función endotelial. AbstractObjective: Obesity is associated with a high risk for atherosclerotic cardiovascular disease. There is a causal association between obesity, infl ammation, insulin resistance (IR) and endothelial dysfunction. The aim of this study was to evaluate changes in IR, proinfl ammatory state and markers of endothelial dysfunction in morbidly obese patients after weight loss following bariatric surgery. Methods: In this study, we measured the levels of soluble intracellular adhesion molecule-1 (sICAM1), plasminogen activator inhibitor 1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in 79 morbidly obese patients at baseline and 3, 6 and 12 months after gastric bypass. Also, we evaluated changes in IR. Results: Twelve months after surgery, there was a signifi cant decrease in plasma levels of sICAM1 (p < 0.001), PAI-1 (p < 0.05), hs-CRP (p < 0.001), IL-6 (p < 0.001) and homeostasis model assessment (HOMA) (p < 0.001) and a signifi cant increase of McAuley index (McAuley) (p < 0.001). Baseline levels of hs-PCR were positively correlated with sICAM-1 (r = 0.450, p < 0.01) and IL-6 (r = 0.451, p < 0.01). Signifi cant correlations were also found between the decrease of PAI-1 and the ...

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Effects of Changes in Body Weight and Insulin Resistance on Inflammation and Endothelial Function in Morbid Obesity after Bariatric Surgery

Cited by 185 publications

References 54 publications

CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment

Menopause, Estrogens, and Endothelial Dysfunction: Current Concepts

Obesity, endothelial function and inflammation: the effects of weight loss after bariatric surgery

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