Roux-en-Y Gastric Bypass Decreases Pro-inflammatory and Thrombotic Biomarkers in Individuals with Extreme Obesity

Bárbara Dal Molin Netto, Solange Cravo Bettini, Ana Paula Grotti Clemente, Joana Pereira de Carvalho Ferreira, Katia Boritza, Sandy de Fátima Souza, Maria Emilia Von der Heyde, Carrie P. Earthman, Ana R. Dâmaso

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Conclusions: We observed that individuals with obesity that have hyperleptinemia have higher circulating PAI-1 levels, which could indicate increased risk for cardiovascular disease. The biomarkers of inflammation and thrombosis measured in this study decreased after RYGB, suggesting that the surgery may be effective in reducing pro-inflammatory and thrombotic risk in individuals with extreme obesity.

Results: It was found that plasminogen activator inhibitor-1 (PAI-1) concentrations were higher among extremely obese individuals with hyperleptinemia than in those without hyperleptinemia (p < 0.01).In relation to the baseline, post-surgery body mass index (BMI) was reduced by 12.9 kg/m2, corresponding to 63.50 % of excess weight loss. Additionally, waist circumference was found to decrease significantly from 126.2 to 101.4 cm. Plasma total cholesterol (p < 0.01), LDL cholesterol (p = 0.02), triglycerides (p < 0.01), and glucose (p = 0.01) were also found to decrease. Pro-inflammatory biomarkers were observed to decrease: PAI-1 by 55.9 ± 6.0 % (p < 0.01), C-reactive protein (CRP) by 18.8 ± 3.4 % (p < 0.01), intercellular adhesion molecule-1 (ICAM-1) by 89.9 ± 5.7 % (p < 0.01), leptin by 27.9 ± 3.2 % (p < 0.01), and resistin by 69.3 ± 5.8 % (p < 0.01). Additionally, significant decreases of tumor necrosis factor alpha (TNF-α) and leptin/adiponectin ratio were observed. Anti-inflammatory cytokines adiponectin and interleukin-10 (IL-10) were significantly increased (170.7 ± 82.5 %, p < 0.01; 122.7 ± 55.1 %, p = 0.02). CRP levels were predictive of ICAM-1 (p = 0.04), and changes in leptin concentrations were associated with decreased PAI-1 levels (p = 0.03).

Methods: The sample was composed of 41 extremely obese who underwent Roux-en-Y gastric bypass (RYGB). Anthropometric and clinical data, and biochemical markers of inflammation were collected prior to surgery and 6 months post-RYGB.

Background: The low-grade inflammatory state in obesity leads to insulin resistance and endothelial dysfunction, which promote cardiovascular diseases in individuals with obesity. The purpose of this study was to evaluate the early effects of weight loss achieved through bariatric surgery on the inflammatory and prothrombotic states. This study also aimed to identify the role of hyperleptinemia on the prothrombotic state.

Original languageEnglish (US)
Pages (from-to)1010-1018
Number of pages9
JournalObesity Surgery
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2015

Bibliographical note

Funding Information:
Grant# 2013/04136-4 São Paulo Research Foundation (FAPESP), CNPq, CAPES [BEX 2262/14-2], CAPES 2566/2011, UNIFESP-EPM, supported the Hospital de Clínicas/Federal University of Paraná (UFPR).

Publisher Copyright:
© 2014, Springer Science+Business Media New York.

Keywords

  • Cardiovascular
  • Hyperleptinemia
  • Inflammation
  • Obesity
  • Roux-en-Y gastric bypass

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