, Volume 17, Issue 5, pp 672-678
Date: 10 May 2007

Plasma Adhesion and Inflammation Markers: Asymmetrical Dimethyl-L-Arginine and Secretory Phospholipase A2 Concentrations before and after Laparoscopic Gastric Banding in Morbidly Obese Patients

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Background

The aim of this study was to examine the relationship between subclinical inflammation and weight loss by laparoscopic adjustable gastric banding (LAGB).

Methods

Plasma concentrations of intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), sensitive C-Reactive Protein (sCRP), asymmetrical dimethyl-L-arginine (ADMA), Secretory Phospholipase A2 (sPLA2), and metabolic markers, such as homeostatic model assessment –insulin resistance (HOMA-IR) and body mass index (BMI) were determined in morbidly obese patients (n––8, BMI 48.6 ±–.7 kg/m2) at baseline and 1 month after operations. Baseline levels in patients were also compared with age-matched controls (n––0, BMI 21.3 ±–.8 kg/m2). Plasma ICAM-1,VCAM, sCRP and ADMA, and sPLA2 concentrations were determined by enzyme-linked immunoassay methods and colorimetric method, respectively.

Results

Plasma sCRP, ICAM-1, ADMA and sPLA2 concentrations and HOMA-IR were significantly higher in morbidly obese patients than in controls (for each, P–lt;–.01). Plasma VCAM-1 concentration was not changed in obese patients. HOMA-IR was significantly correlated with ICAM-1, ADMA and sPLA2 in the obese group at baseline (for each, P–lt;–.01). There was a significant correlation between plasma sCRP and plasma glucose,VCAM-1, ICAM-1, ADMA and sPLA2 concentrations (for each, P–lt;–.01). 1 month after LAGB, mean body weight loss was 13.2 ±–.3 kg, and plasma sCRP and ADMA concentrations and HOMA-IR and BMI were significantly decreased (for each, P–lt;–.01). However, these levels cannot be decreased to the levels of the controls.

Conclusion

Obesity and insulin resistance appear to be associated with low-grade inflammation and endothelial dysfunction. Insulin resistance and endothelial dysfunction were improved by weight loss after LAGB.