Skip to main content

Advertisement

SpringerLink
Log in

Inhibition of C-Reactive Protein in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Obesity is considered a low-grade chronic inflammatory condition as reflected by increased C-reactive protein (CRP) levels. Inflammation is emerging as a predictor of cardiovascular disease and it may be a precursor of the metabolic syndrome. Bariatric surgery is commonly performed as a treatment for morbid obesity offering significant reductions in premature myocardial infarction. Laparoscopic sleeve gastrectomy (LSG) is a relatively new bariatric procedure that is currently used as a definitive procedure for weight loss. The aim of this study is to assess the impact of sleeve gastrectomy on CRP levels.

Methods

This study is part of an ongoing, prospective, cohort study to evaluate LSG impact on iron indices. CRP levels were compared preoperatively and 6 months after surgery. Similarly, demographics including body mass index and excess weight were also compared at these same study points. Data were analyzed using Student paired t test and Pearson product moment correlation analysis.

Results

Twenty-nine morbidly obese patients were included. There was significant decrease in body mass index (BMI) between the preoperative and 6-month period (50.9 ± 13.2 and 35.1 ± 6.85, respectively; P < 0.001). Also CRP levels were statistically significantly lower at 6 months after surgery (preoperative 12.3 ± 7.53 mg/L and postoperative 5.6 ± 4.2 mg/L. P < 0.0001). The significant weight loss as reflected by change in BMI was correlated with the difference between preoperative and postoperative CRP levels.

Conclusions

Massive weight loss in morbidly obese patients induced by LSG causes a significant decrease in CRP levels, which could reduce the risk of cardiovascular diseases in these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Grundy SM, Hansen B, Smith SC Jr, et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation 2004;109:551–6.

    Article  Google Scholar 

  2. Trayhurn P, Beattie JH. Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc 2001;60:329–39.

    Article  CAS  Google Scholar 

  3. Esposito K, Pontillo A, Di Palo C, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA 2003;289:1799–804.

    Article  CAS  Google Scholar 

  4. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135–43.

    Article  CAS  Google Scholar 

  5. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003;111:1805–12.

    Article  CAS  Google Scholar 

  6. Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: prospective study and updated meta-analyses. BMJ 2000;321:199–204.

    Article  CAS  Google Scholar 

  7. Danesh J, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med 2004;350:1387–97.

    Article  CAS  Google Scholar 

  8. Duncan BB, Schmidt MI, Pankow JS, et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003;52:1799–805.

    Article  CAS  Google Scholar 

  9. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 2003;107:499–511.

    Article  Google Scholar 

  10. Selvin E, Paynter NP, Erlinger TP. The effect of weight loss on C-reactive protein: a systematic review. Arch Intern Med 2007;167:31–9.

    Article  CAS  Google Scholar 

  11. Torgerson JS, Sjostrom L. The Swedish Obese Subjects (SOS) study—rationale and results. Int J Obes Relat Metab Disord 2001;25(Suppl 1):S2–4.

    Article  Google Scholar 

  12. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–52.

    Article  Google Scholar 

  13. Vilarrasa N, Vendrell J, Sanchez-Santos R, et al. Effect of weight loss induced by gastric bypass on proinflammatory interleukin-18, soluble tumour necrosis factor-alpha receptors, C-reactive protein and adiponectin in morbidly obese patients. Clin Endocrinol 2007;67:679–86.

    Article  CAS  Google Scholar 

  14. Zagorski SM, Papa NN, Chung MH. The effect of weight loss after gastric bypass on C-reactive protein levels. Surg Obes Relat Dis 2005;1:81–5.

    Article  Google Scholar 

  15. Khaodhiar L, Ling PR, Blackburn GL, et al. Serum levels of interleukin-6 and C-reactive protein correlate with body mass index across the broad range of obesity. JPEN 2004;28:410–5.

    Article  CAS  Google Scholar 

  16. Emery CF, Fondow MD, Schneider CM, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg 2007;17:759–63.

    Article  Google Scholar 

  17. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg 2005;15:1024–9.

    Article  CAS  Google Scholar 

  18. Anonymous. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults—the evidence report. National Institutes of Health. Obes Res. 1998;6(Suppl 2):51S–209S.

  19. Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267–82.

    Article  CAS  Google Scholar 

  20. Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg 2005;15:1124–8.

    Article  Google Scholar 

  21. Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg 2007;17:57–62.

    Article  Google Scholar 

  22. Horowitz M, Collins PJ, Chatterton BE, et al. Gastric emptying after gastroplasty for morbid obesity. Br J Surg 1984;71:435–7.

    Article  CAS  Google Scholar 

  23. Stevens J, Cai J, Pamuk ER, et al. The effect of age on the association between body-mass index and mortality. N Engl J Med 1998;338:1–7.

    Article  CAS  Google Scholar 

  24. Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg 2007;17:1069–74.

    Article  CAS  Google Scholar 

  25. Pickup JC, Mattock MB, Chusney GD, et al. NIDDM as a disease of the innate immune system: association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia 1997;40:1286–92.

    Article  CAS  Google Scholar 

  26. Biertho L, Steffen R, Ricklin T, et al. Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. J Am Coll Surg 2003;197:536–44.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Pharmacist-Surgery, Pharmacy Services Division, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354 MBC#11, Riyadh, 11211, Saudi Arabia

    Hakeam A. Hakeam

  2. General and Laparoscopic Surgery Section, General Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Patrick J. O’Regan, Abdulrahman M. Salem & Fahad Y. Bamehriz

  3. Nursing Affairs, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

    Lina F. Jomaa

Authors
  1. Hakeam A. Hakeam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patrick J. O’Regan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdulrahman M. Salem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fahad Y. Bamehriz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lina F. Jomaa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hakeam A. Hakeam.

Additional information

My coauthors and I do not have any conflict of interest to report.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hakeam, H.A., O’Regan, P.J., Salem, A.M. et al. Inhibition of C-Reactive Protein in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy. OBES SURG 19, 456–460 (2009). https://doi.org/10.1007/s11695-008-9729-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-008-9729-y

Keywords

Search

Navigation