<p>Detrimental Effect of C-Reactive Protein on the Cardiometabolic Cells and Its Rectifying by Metabolic Surgery in Obese Diabetic Patients</p>

Abstract

Background: High-sensitivity C-reactive protein (hs-CRP) has been regarded as a biomarker of low-degree inflammation in illness; however, whether CRP exerts its pathogenic effect on the cardiometabolic system remains unknown. Aside from the beneficial effects of metabolic surgery on cardiometabolic system, its impact on inflammation still worth examining. Thus, this study aims to investigate the effect of CRP on adipose and vascular cells, and their responses to metabolic surgery in obese diabetic patients. Patients and Methods: The expression of CRP and RAS-and ERK-related factors in the adipocytes and VSMCs were measured. Obese patients with type 2 diabetes who underwent metabolic surgery were followed up for 2 years thereafter. Laboratory tests, which included serum hs-CRP levels and visceral fat thickness (VFT), were obtained before and after surgery. Results: CRP administration significantly and dose-dependently increased the intracellularfree calcium concentration ([Ca2+]i) in cultured adipocytes and in the VSMCs. CRP administration significantly increased ACE, Ang II, AT1R and pERK expressions, but reduced ACE2 expression in both the adipocytes and VSMCs. Clinical study showed that VFT was closely associated with serum hs-CRP. Furthermore, VFT and serum hs-CRP were found to be highly associated with blood pressure. Finally, metabolic surgery remarkably decreased blood pressure, visceral fat and serum hs-CRP levels. Conclusion: CRP has a detrimental effect on cardiometabolic cells, aside from functioning merely as a biomarker. Serum hs-CRP levels are highly associated with hypertension and visceral obesity, which can be antagonized by metabolic surgery in obese diabetic patients.

PREX proteins level correlation with insulin resistance markers and lipid profile in obese and overweight non-diabetic patients

“…Elevated levels of high-sensitivity CRP was suggested to indicate future insulin resistance in individuals without diabetes [34]. In addition to being produced by the liver and pancreas during inflammation, CRP has also been observed to be created and secreted by adipocytes [35,36]. A favorable correlation has been shown between CRP levels and BMI in both healthy persons and those who are fat or overweight [37].…”

Changes in thyroid hormones predict weight regain in patients with obesity who undergo metabolic surgery

“…Patients with morbid obesity usually exhibit several types of endocrine system disturbances, including insulin resistance, growth hormone resistance and thyroid dysfunction 2 . For patients with morbid obesity, metabolic surgery (MS) is more effective at reducing weight and exerting beneficial effects on metabolism than lifestyle interventions and medication 3–6 . However, weight loss is not sustained after MS; by contrast, weight regain is a common concern and can even occur early and last for many years, resulting in the return of obesity‐associated co‐morbidities and a decrease in the quality of life of the patient 7,8 …”