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Changes of Inflammatory Mediators in Obese Patients After Laparoscopic Cholecystectomy

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Abstract

Background

Obesity is associated with the impairment of immunological functions. The aim of this study was to analyze some inflammatory mediators in obese subjects who underwent laparoscopic cholecystectomy.

Methods

Seventeen consecutive female patients with a BMI ranging from 35 to 45 kg/m2 (obese) and 17 consecutive female patients with BMI ranging from 20 to 25 kg/m2 (nonobese) were included in the study. All patients were affected by symptomatic gallbladder stone disease and underwent laparoscopic cholecystectomy. Changes in levels of leukocytes, neutrophils, IL-6, IL-10, leptin, and adiponectin were evaluated.

Results

We observed a significant increase in leukocyte and neutrophil levels in the obese subjects compared to the nonobese subjects. The serum levels of leptin and IL-6 were higher in the postoperative period (compared to the baseline values in both groups), and always higher in the obese. Both adiponectin and IL-10 increased in the postoperative period in nonobese subjects and was always higher than in the obese.

Conclusions

Obese patients have a stronger acute inflammatory response than do nonobese subjects in reaction to surgical stress.

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References

  1. World Health Organization (1998) Obesity: preventing and managing the global epidemic. WHO, Geneva

    Google Scholar 

  2. Mokdad AH, Marks JS, Stroup DF et al (2004) Actual causes of death in the United States, 2000. JAMA 291:1238–1245

    Article  PubMed  Google Scholar 

  3. Khan LK, Bowman BA (1999) Obesity: a major global public health problem. Annu Rev Nutr 19:13–17

    Article  Google Scholar 

  4. Martí A, Marcos A, Martínez JA (2001) Obesity and immune function relationships. Obes Rev 2:131–140

    Article  PubMed  Google Scholar 

  5. Livingstone EH, Ko CY (2002) Use of the health and activities limitation index as a measure of quality of life in obesity. Obes Res 10:824–832

    Article  Google Scholar 

  6. Bamgbade OA, Rutter TW, Nafiu OO et al (2007) Postoperative complications in obese and nonobese patients. World J Surg 31:556–560

    Article  PubMed  Google Scholar 

  7. Dindo D, Muller MK, Weber M et al (2003) Obesity in general elective surgery. Lancet 361:2032–2035

    Article  PubMed  Google Scholar 

  8. Tanaka S, Inoue S, Isoda F et al (1993) Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness. Int J Obes Relat Metab Disord 17:631–636

    CAS  PubMed  Google Scholar 

  9. Gendall KA, Raniga S, Kennedy R et al (2007) The impact of obesity on outcome after major colorectal surgery. Dis Colon Rectum 50:2223–2237

    Article  PubMed  Google Scholar 

  10. de Oliveira AC, Ciosak SI, Ferraz EM et al (2006) Surgical site infection in patients submitted to digestive surgery: risk prediction and the NNIS risk index. Am J Infect Control 34:201–207

    Article  PubMed  Google Scholar 

  11. Ondrula DP, Nelson RL, Prasad ML et al (1992) Multifactorial index of preoperative risk factors in colon resections. Dis Colon Rectum 35:117–122

    Article  CAS  PubMed  Google Scholar 

  12. Brandt M, Harder K, Walluscheck KP et al (2001) Severe obesity does not adversely affect perioperative mortality and morbidity in coronary artery bypass surgery. Eur J Cardiothorac Surg 19:662–666

    Article  CAS  PubMed  Google Scholar 

  13. Mullen JT, Moorman DW, Davenport DL (2009) The obesity paradox: body mass index and outcomes in patients undergoing nonbariatric general surgery. Ann Surg 250:166–172

    Article  PubMed  Google Scholar 

  14. Schwarzenberg SJ, Sinaiko AR (2006) Obesity and inflammation in children. Paediatr Respir Rev 7:239–246

    Article  PubMed  Google Scholar 

  15. Gregoire FM, Smas CM, Sul HS (1998) Understanding adipocyte differentiation. Physiol Rev 78:783–809

    CAS  PubMed  Google Scholar 

  16. Cancello R, Clement K (2006) Is obesity an inflammatory illness? Role of low-grade inflammation and macrophage infiltration in human white adipose tissue. BJOG 113:1141–1147

    Article  CAS  PubMed  Google Scholar 

  17. O’Rourke RW, Kay T, Scholz MH et al (2005) Alterations in T-cell subset frequency in peripheral blood in obesity. Obes Surg 15:1463–1468

    Article  PubMed  Google Scholar 

  18. Di Vita G, Sciumè C, Milano S et al (2001) Inflammatory response in open and laparoscopic cholecystectomy. Ann Ital Chir 72:669–673

    PubMed  Google Scholar 

  19. Schietroma M, Carlei F, Cappelli S et al (2007) Effects of cholecystectomy (laparoscopic versus open) on PMN-elastase. Hepatogastroenterology 54:342–345

    CAS  PubMed  Google Scholar 

  20. Huskisson EC (1982) Measurement of pain. J Rheumatol 9:768–769

    CAS  PubMed  Google Scholar 

  21. Fantuzzi G (2005) Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 115:911–919

    Article  CAS  PubMed  Google Scholar 

  22. Chandra RK, Au B (1980) Spleen hemolytic plaque-forming cell response and generation of cytotoxic cells in genetically obese (C57Bl/6J ob/ob) mice. Int Arch Allergy Appl Immunol 62:94–98

    Article  CAS  PubMed  Google Scholar 

  23. Weber DJ, Rutala WA, Samsa GP et al (1986) Impaired immunogenicity of hepatitis B vaccine in obese persons. N Engl J Med 314:1393

    CAS  PubMed  Google Scholar 

  24. Lago F, Dieguez C, Gómez-Reino J et al (2007) Adipokines as emerging mediators of immune response and inflammation. Nat Clin Pract Rheumatol 3:716–724

    Article  CAS  PubMed  Google Scholar 

  25. Maffei M, Fei H, Lee GH et al (1995) Increased expression in adipocytes of ob RNA in mice with lesions of the hypothalamus and with mutations at the db locus. Proc Natl Acad Sci USA 92:6957–6960

    Article  CAS  PubMed  Google Scholar 

  26. Wolf AM, Wolf D, Rumpold H et al (2004) Wolf adiponectin induces the anti-inflammatory cytokines IL-10 and IL-1RA in human leukocytes. Biochem Biophys Res Commun 323:630–635

    Article  CAS  PubMed  Google Scholar 

  27. Angele MK, Faist E (2002) Clinical review: immunodepression in the surgical patient and increased susceptibility to infection. Crit Care 6:298–305

    Article  PubMed  Google Scholar 

  28. Di Vita G, Patti R, Buscemi S et al (2006) Acute phase response in oldest-old individuals after surgical stress. J Am Geriatr Soc 54:561–563

    Article  PubMed  Google Scholar 

  29. Sietses C, Beelen RH, Meijer S et al (1999) Immunological consequences of laparoscopic surgery, speculations on the cause and clinical implications. Langenbecks Arch Surg 384:250–258

    Article  CAS  PubMed  Google Scholar 

  30. Bone RC (1996) Towards a theory regarding the pathogenesis of the systemic inflammatory response syndrome: what we do and do not know about cytokine regulation. Crit Care Med 24:163–172

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Gaetano Di Vita.

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Vita, G.D., Patti, R., Famà, F. et al. Changes of Inflammatory Mediators in Obese Patients After Laparoscopic Cholecystectomy. World J Surg 34, 2045–2050 (2010). https://doi.org/10.1007/s00268-010-0616-z

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