Skip to main content
SpringerLink
Log in

Impact of Weight Loss on Inflammation State and Endothelial Markers Among Individuals with Extreme Obesity After Gastric Bypass Surgery: a 2-Year Follow-up Study

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

The medium-term impact of gastric bypass (GB) surgery on the inflammatory state and endothelial function of patients has yet to be confirmed.

Objective

This study aims to elucidate the inflammatory profile and endothelial dysfunction response of adults with obesity 6 and 24 months after undergoing GB surgery.

Methods

The anthropometric and biochemical markers of 32 adults with obesity (two men and 30 females) were collected preoperatively, and 6 and 24 months postoperatively.

Results

Body mass index (BMI) and excess weight had decreased by 15.79 ± 1.21 kg/m2 (p < 0.01) and 83.80 ± 24.50% respectively at 24 months. Leptin, C-reactive protein (CRP), plasminogen activator inhibitor-1 (PAI-1) levels, and the leptin/adiponectin ratio decreased significantly at both postoperative follow-up points compared with preoperative values (p < 0.01). IL-6 and ICAM-1 levels decreased between 6 and 24 months post-GB (p < 0.01). IL-6 and ICAM-1 levels decreased between 6- and 24-months post-GB (p < 0.01). Resistin levels were significantly decreased (p < 0.01) at 6-month follow-up. The levels of the anti-inflammatory biomarkers IL-10, adiponectin, and the adiponectin/leptin ratio significantly increased postoperatively. There was an improvement in metabolic disorders after surgery.

Conclusion

Our results demonstrated that after GB there was an improvement in the inflammatory profile, identified by a reduction in pro-inflammatory markers (CRP, IL-6, leptin) and an increase in anti-inflammatory markers (adiponectin, IL-10). The decrease in PAI-1 and ICAM-1 levels may suggest improvement in endothelial function. These findings provide clear evidence of the medium-term impact of GB on inflammation state and a number of endothelial markers, and a consequent reduction in the risk of cardiovascular diseases.

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

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Vilahur G, Ben-Aicha S, Badimon L. New insights into the role of adipose tissue in thrombosis. Cardiovasc Res. 2017;113(9):1046–54.

    Article  CAS  Google Scholar 

  2. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde, Secretaria de Gestão Estratégica e Participativa. Vigitel Brasil 2018: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: Ministério da Saúde, 2019. Disponível em: < https://portalarquivos2.saude.gov.br/images/pdf/2019/julho/25/vigitel-brasil-2018.pdf > Acesso em: 15 set. 2019.

  3. WHO (World Health Organization). Obesity and overweight. Key facts. Fact sheet no. 311; February, 2018. Disponível em: <http://www.who.int/mediacentre/factsheets/fs311/en/index.html> Acesso em: 02 jul. 2019.

  4. RakotoArivelo V et al. Inflammatory cytokine profiles in visceral and subcutaneous adipose tissues of obese patients undergoing bariatric surgery reveal lack of correlation with obesity or diabetes. EBioMedicine. 2018;30:237–47.

    Article  Google Scholar 

  5. Unamuno X et al. Adipokine dysregulation and adipose tissue inflammation in human obesity. Eur J Clin Investig. 2018;48:e12997–3008.

    Article  Google Scholar 

  6. Villarroya F et al. Inflammation of brown/beige adipose tissues in obesity and metabolic disease. J Intern Med. 2018;2018:1–13.

    Google Scholar 

  7. Illán-Gomez F et al. Obesity, endothelial function and inflammation: the effects of weight loss after bariatric surgery. Nutr Hosp. 2016;33(6):1340–6.

    Article  Google Scholar 

  8. Chiapetta S et al. The impact of obesity and metabolic surgery on chronic inflammation. Obes Surg. 2018;28:3028–40.

    Article  Google Scholar 

  9. Angrisani L et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.

    Article  Google Scholar 

  10. Yadav R et al. Effect of Roux-en-Y bariatric surgery on lipoproteins, insulin resistance, and systemic and vascular inflammation in obesity and diabetes. Front Immunol. 2017;8:1–7.

    Article  Google Scholar 

  11. Stolberg CR et al. Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function: a randomized controlled trial. Atherosclerosis. 2018;273:37–44.

    Article  CAS  Google Scholar 

  12. Khosravi-Largani M et al. Evaluation of all types of metabolic bariatric surgery and its consequences: a systematic review and meta-analysis. Obes Surg. 2019;29:651–90.

    Article  Google Scholar 

  13. Adami GF, Scopinaro N, Cordera R. Adipokine pattern after bariatric surgery: beyond the weight loss. Obes Surg. 2016;26:2793–801.

    Article  Google Scholar 

  14. Bachmayer C et al. Healthy obese and post bariatric patients – metabolic and vascular patterns. Exp Clin Endocrinol Diabetes. 2013;121:483–7.

    Article  CAS  Google Scholar 

  15. Auguet T et al. Clinical and adipocytokine changes after bariatric surgery in morbidly obese women. Obesity (Silver Spring). 2014;22:188–94.

    Article  CAS  Google Scholar 

  16. Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17:565–8.

    Article  Google Scholar 

  17. Matthews DR et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  Google Scholar 

  18. Katz A et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000;85:2402–10.

    Article  CAS  Google Scholar 

  19. Netto BDM et al. Roux-en-Y gastric bypass decreases pro-inflammatory and thrombotic biomarkers in individuals with extreme obesity. Obes Surg. 2015;25(6):1010–8.

    Article  Google Scholar 

  20. Farias G et al. Neuroendocrine regulation of energy balance: implications on the development and surgical treatment of obesity. Nutr Health. 2017;23:131–46.

    Article  Google Scholar 

  21. Askarpour M, Khani D, Sheikhi A, et al. Effect of bariatric surgery on serum inflammatory factors of obese patients: a systematic review and meta-analysis. Obes Surg. 2019;29:2631–47.

    Article  Google Scholar 

  22. Unamuno X et al. Increase of the adiponectin/leptin ratio in patients with obesity and type 2 diabetes after Roux-en-Y gastric bypass. Nutrients. 2019;11:2069.

    Article  CAS  Google Scholar 

  23. Fruhbeck G et al. Adiponectin-leptin ratio: a promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte. 2018;7:57–62.

    Article  CAS  Google Scholar 

  24. Frikke-Schmidt H et al. Does bariatric surgery improve adipose tissue function? Obes Rev. 2016;17(9):795–809.

    Article  CAS  Google Scholar 

  25. Malden D et al. Body fat distribution and systolic blood pressure in 10,000 adults with whole-body imaging: UK Biobank and Oxford BioBank. Obesity. 2019;27:1200–6.

    CAS  Google Scholar 

  26. Vest AR et al. Bariatric surgery and cardiovascular outcomes: a systematic review. Heart. 2012;98:1763–77.

    Article  Google Scholar 

  27. Wilhelm SM, Young J, Kale-Pradhan PB. Effect of bariatric surgery on hypertension: a meta-analysis. Ann Pharmacother. 2014;48:674–82.

    Article  Google Scholar 

  28. Lager CJ et al. Metabolic parameters, weight loss, and comorbidities 4 years after Roux-en-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2018;28:3415–23.

    Article  Google Scholar 

  29. Lira NS et al. Análise do perfil lipídico de pacientes submetidos à gastrectomia vertical e à derivação gástrica em Y de Roux. Rev Col Bras Cir. 2018;45:e1967.

    Article  Google Scholar 

  30. Schiavon CA et al. Effects of bariatric surgery in obese patients with hypertension. Circulation. 2018;137:1132–42.

    Article  Google Scholar 

  31. Pareek M et al. Metabolic surgery for hypertension in patients with obesity. Circ Res. 2019;124:1009–24.

    Article  CAS  Google Scholar 

Download references

Funding

Grant No. 2013/04136-4 São Paulo Research Foundation (FAPESP) and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) supported the Hospital de Clínicas/Federal University of Paraná (UFPR).

Author information

Authors and Affiliations

  1. Gastrointestinal Surgery Service of Hospital de Clínicas, Federal University of Paraná, UFPR, Rua General Carneiro, 81 - Centro, Curitiba, PR, 80060-900, Brazil

    Gisele Farias & Solange Cravo Bettini

  2. Department of Nutrition, Federal University of Paraná, UFPR, Curitiba, PR, Brazil

    Bárbara Dal Molin Netto & Regina Maria Vilela

  3. Biochemistry Section, Hospital de Clínicas - Universidade Federal do Paraná, UFPR, Curitiba, PR, Brazil

    Katia Boritza

  4. Nutrition Post Graduate Program, Universidade Federal de São Paulo – Escola Paulista de Medicina – UNIFESP-EPM. Nutrition Post Graduate Program, São Paulo, SP, Brazil

    Ana Raimunda Dâmaso

Authors
  1. Gisele Farias
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bárbara Dal Molin Netto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katia Boritza
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Solange Cravo Bettini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Regina Maria Vilela
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ana Raimunda Dâmaso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gisele Farias.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Farias, G., Netto, B.D.M., Boritza, K. et al. Impact of Weight Loss on Inflammation State and Endothelial Markers Among Individuals with Extreme Obesity After Gastric Bypass Surgery: a 2-Year Follow-up Study. OBES SURG 30, 1881–1890 (2020). https://doi.org/10.1007/s11695-020-04411-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-020-04411-9

Keywords

Search

Navigation