Systemic Inflammation in Severe Obese Patients Undergoing Surgery for Obesity and Weight-Related Diseases

Abstract

BackgroundObesity is a worldwide disease related to genetic, environmental, and behavioral factors, and it is associated with high rates of morbidity and mortality. Recently, obesity has been characterized by a low-grade inflammatory state known as inflammome indicated by chronic increases in circulating concentrations of inflammatory markers. The purpose of this study was to evaluate the effect of weight loss induced by surgery for obesity and weight-related diseases on pro-inflammatory cytokine (TNF-α) and anti-inflammatory adipokine (adiponectin) levels, and on an adipose-derived hormone (leptin) in severely obese subjects.MethodsThis randomized, controlled trial involved 55 severe obese patients (50 women, age 18–63 years, and body mass index of 35.7–63 kg/m2) who underwent bariatric surgery (BS). Patients with a BMI > 65 kg/m2 and clinical and mental instability, or significant and unrealistic expectations of surgery were excluded. Blood samples were collected during the fasting period to analyze tumor necrosis factor alpha (TNF-α), adiponectin, and leptin levels by enzyme-linked immunosorbent assay.ResultsAt baseline, no significant difference was observed in the anthropometric, demographic, clinical characteristics and biochemistry and inflammatory markers between the control group (CG) and bariatric surgery group (BSG). The same finding was also observed when we compared the baseline variables to those at the 6-month follow-up in the CG. However, the same variables in the BSG group were significantly different between baseline and the 6-month follow-up after BS.ConclusionsWeight loss induced by surgery for obesity and weight-related diseases reduced the inflammome state in severely obese patients.

The leptin to adiponectin ratio (LAR) is reduced by sleeve gastrectomy in adults with severe obesity: a prospective cohort study

“…We found that the reductions in LAR were driven primarily by an increase in adiponectin rather than a reduction in leptin, and these changes were proportional to the reduction in weight after surgery, consistent with the Unamuno study. The changes we observed in leptin and adiponectin concentrations were less than those described after bypass bariatric surgery 3,6,7 and are more consistent with those previously described after banding 8 .…”

“…Conversely, adiponectin reduces circulating free fatty acids by increasing tissue fat oxidation: Adiponectin levels tend to be lower in individuals with obesity 14 . Several studies have described reductions in leptin and increases in adiponectin in adults with severe obesity undergoing bariatric surgery 3 , 6 – 8 , 15 . Recently, investigators described changes in the adiponectin: leptin ratio (ALR) in a cohort of 25 Spanish adults with type 2 diabetes who underwent Roux-en-Y gastric bypass 16 .…”

“…Obesity is a major determinant of type 2 diabetes risk, primarily through its adverse effects on insulin sensitivity 1 . Bariatric surgery to treat severe obesity leads to significant improvements in diabetes control 2 , cardiovascular risk 3,4 , microalbuminuria 5 and systemic inflammation 6 . However, the influence of bariatric surgery on insulin sensitivity is not well defined 7,8 , partly because quantifying insulin sensitivity can be challenging.…”

Bariatric surgery metabolic effects in obese individuals associating insulin resistance status

“…As for the percentage of functional β pancreatic cells, we noticed a statistically significant decrease: the preoperative arithmetic mean is 144.2 (± 74.9) and the postoperative, 86.0 (± 34.9) (p < 0.0001, Student test for dependent batches) (Figure 8). The gender distribution results of this study fall within the limits observed in the literature [17]. Thus, the ratio between genders, clear-cut suitable for the feminine gender, follows the trend observed in similar studies.…”

Zebrafish as an Experimental Model for the Study of Obesity

“…The prevalence of obesity has increased significantly in the last three decades, being considered a pandemic that affects 1.9 billion people worldwide. In developed and developing countries, overweight and obesity are considered public health problems and have a high mortality rate due to associated risk factors [1].…”