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

Author(s)

Netto, Barbara Dal Molin ^[1] ; Bettini, Solange Cravo ^{[2, 3]} ; Grotti Clemente, Ana Paula ^[1] ; de Carvalho Ferreira, Joana Pereira ^[1] ; Boritza, Katia ^{[3, 4]} ; Souza, Sandy de Fatima ^[5] ; Von der Heyde, Maria Emilia ^[6] ; Earthman, Carrie P. ^[7] ; Damaso, Ana R. ^{[8, 1, 9]}

Affiliation

^[1] Univ Fed Sao Paulo UNIFESP, Postgrad Program Nutr, BR-04020060 Sao Paulo, SP - Brazil

^[2] Univ Fed Parana UFPR, Bariatr Surg Serv, Hosp Clin, Curitiba, Parana - Brazil

^[3] Univ Fed Parana UFPR, Hosp Clin, Curitiba, Parana - Brazil

^[4] Univ Fed Parana UFPR, Biochem Sect, Hosp Clin, Curitiba, Parana - Brazil

^[5] Univ Fed Parana UFPR, Graduat Nutr, Curitiba, Parana - Brazil

^[6] Univ Fed Parana UFPR, Dept Nutr, Curitiba, Parana - Brazil

^[7] Univ Minnesota Twin Cities, Dept Food Sci & Nutr, St Paul, MN - USA

^[8] Univ Fed Sao Paulo, Dept Biosci, Sao Paulo - Brazil

^[9] Univ Fed Sao Paulo, Postgrad Program Interdisciplinary Hlth Sci, Sao Paulo - Brazil

• Document type: Journal article
• Source: OBESITY SURGERY; v. 25, n. 6, p. 1010-1018, JUN 2015.
• Web of Science Citations: 25

Abstract

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. 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. 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/m(2), 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-alpha) 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). 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. (AU)

• FAPESP's process: 13/04136-4 - Analysis of neuroendocrine regulation of balance energy and inflammatory factors in obese adults submitted to bariatric surgery
• Grantee: Ana Raimunda Dâmaso
• Support Opportunities: Regular Research Grants