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Change in Levels of C-Reactive Protein (CRP) and Serum Cortisol in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy

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Abstract

Background

C-Reactive protein (CRP) has been associated with the macro- and microvascular effects of hypertension and diabetes mellitus. Referring to serum cortisol, it has been proposed to contribute to the pathogenesis of metabolic syndrome, and it has been demonstrated that weight loss normalizes cortisol levels and improves insulin resistance. The aims of this study were to analyze CRP and cortisol levels pre- and postoperatively in morbidly obese patients undergoing a laparoscopic sleeve gastrectomy and to correlate them with weight loss and parameters associated with cardiovascular risk.

Methods

A prospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and May 2011 was performed.

Results

A total of 40 patients were included in the study. CRP levels decreased significantly 12 months after surgery (median reduction of 8.9 mg/l; p = 0.001). Serum cortisol levels decreased significantly 6 months after surgery (median reduction of 34.9 μg/dl; p = 0.001). CRP values reached the normal range (<5 mg/l) 1 year after surgery. Referring to cortisol, a significant association was observed with the cardiovascular risk predictor (triglyceride/high-density lipoprotein cholesterol ratio) from the 6th month after surgery onward (Pearson correlation coefficient, 0.559; p = 0.008).

Conclusion

CRP levels are increased preoperatively and in the postoperative course up to 1 year after surgery. Serum cortisol levels remain elevated until the 6th month after surgery. From this moment onward, serum cortisol is associated with the cardiovascular risk predictor reflecting the cardiovascular risk decreasement during the weight loss.

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Conflict of Interest

All authors (Jaime Ruiz-Tovar, MD, PhD; Inmaculada Oller, MD; Carolina Llavero; Antonio Arroyo, MD, PhD; Alicia Calero, MD; María Diez, MD; Lorea Zubiaga, MD; and Rafael Calpena, MD, PhD) declare that they have no conflict of interests in the preparation of this manuscript.

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Authors and Affiliations

  1. Bariatric Surgery Unit, Department of Surgery, General University Hospital Elche, Alicante, Spain

    Jaime Ruiz-Tovar, Inmaculada Oller, Isabel Galindo, Antonio Arroyo, Alicia Calero, María Diez, Lorea Zubiaga & Rafael Calpena

  2. University Miguel Hernandez. Elche, Alicante, Spain

    Jaime Ruiz-Tovar, Antonio Arroyo, Alicia Calero & Rafael Calpena

  3. Department of Surgical Nursery, Hospital de Sureste, Madrid, Spain

    Carolina Llavero

  4. Corazon de Maria, 64, 7º J, 28002, Madrid, Spain

    Jaime Ruiz-Tovar

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  1. Jaime Ruiz-Tovar
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  2. Inmaculada Oller
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  3. Isabel Galindo
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  4. Carolina Llavero
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  5. Antonio Arroyo
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  6. Alicia Calero
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  7. María Diez
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  8. Lorea Zubiaga
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  9. Rafael Calpena
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Correspondence to Jaime Ruiz-Tovar.

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Ruiz-Tovar, J., Oller, I., Galindo, I. et al. Change in Levels of C-Reactive Protein (CRP) and Serum Cortisol in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy. OBES SURG 23, 764–769 (2013). https://doi.org/10.1007/s11695-013-0865-7

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  • DOI: https://doi.org/10.1007/s11695-013-0865-7

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