Systemic Inflammation and Cardiovascular Risk Factors: Are Morbidly Obese Subjects Different?
- First Online:
- 158 Downloads
Systemic inflammation is a hallmark of obesity as well as of other chronic diseases, usually indicating increased cardiovascular risk; however, studies with arterial documentation in morbid obesity are extremely scarce. Aiming to analyze correlation between inflammatory markers, pulse-wave velocity (PWV), and intima-media thickness (IMT), a prospective study was designed.
Morbidly obese patients [n = 29, age 46.3 ± 5.2 years, 82.8% females (24/29), BMI 44.9 ± 5.2 kg/m2] with C-reactive protein/CRP > 5 mg/l but free from trauma, infection, inflammation, or cancer were enrolled in this study. All were clinically stable candidates for elective bariatric operation. Variables included comorbidities, metabolic profile, inflammatory and coagulatory markers, and arterial morpho-functional indices.
Patients suffered from arterial hypertension (72.4%), metabolic syndrome (58.6%), and other comorbidities, but PWV and IMT were less aberrant than expected. Univariate correlation confirmed worse prognosis for those with metabolic syndrome and other accepted clinical risk factors. Multivariate confirmation was achieved for triglycerides (PWV) and D-dimer (IMT), but not for CRP, serum amyloid A, or neutrophil count, which were reversed in certain circumstances.
(1) Metabolic syndrome, hyperglycemia, hypertriglyceridemia and D-dimer were positively correlated with arterial measurements, whereas inflammatory and coagulatory markers often exhibited paradoxical association; (2) stratification confirmed that at certain levels of systemic inflammation or body mass index, acute phase proteins and other markers became unreliable or shifted signals; (3) when controlled for blood pressure, PWV was only moderately elevated, and IMT remained normal; (4) taken together, these findings are consistent with a unique interaction between adiposity, inflammation, and cardiovascular risk in seriously obese subjects.
KeywordsMorbid obesity Atherosclerosis Pulse wave velocity Intima media thickness Arterial stiffness Metabolic syndrome Arterial hypertension Diabetes Inflammation C-reactive protein
- 10.Third Report of the National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–421.Google Scholar
- 13.Cao JJ, Arnold AM, Manolio TA, Polak JF, Psaty BM, Hirsch CH, et al. Association of carotid artery intima-media thickness, plaques, and C-reactive protein with future cardiovascular disease and all-cause mortality: the Cardiovascular Health Study. Circulation. 2007;116:32–8.PubMedCrossRefGoogle Scholar
- 15.Singh U, Dasu MR, Yancey PG, Afify A, Devaraj S, Jialal I. Human C-reactive protein promotes oxidized low-density lipoprotein uptake and matrix metalloproteinase-9 release in wistar rats. J Lipid Res. 2008 Feb 2 (in press).Google Scholar
- 18.Shargorodsky M, Fleed A, Boaz M, Gavish D, Zimlichman R. The effect of a rapid weight loss induced by laparoscopic adjustable gastric banding on arterial stiffness, metabolic and inflammatory parameters in patients with morbid obesity. Int J Obes (Lond). 2006 Nov;30(11):1632–8.CrossRefGoogle Scholar