Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding.
OBJECTIVE
We measured markers of acute-phase response and immunological markers in morbid obese patients and in formerly morbid obese patients after a massive weight loss following adjustable gastric banding (GB).


METHODS
A total of 49 morbid obese female patients with a body mass index (BMI) above 40 kg/m(2) were investigated during a study period of 6 months. Of these, 24 patients received a gastric banding (GB) and lost a minimum of 20 kg in 1 y (GB group) and 25 patients maintained their weight (obese group). In sum, 13 normal weight subjects (BMI<24 kg/m(2)) were taken for controls.


METHODS
Plasma concentration of the acute-phase proteins, C-reactive protein (CRP), orosomucoid, complement factors C3 and C4 and white blood cell count, lymphocyte subsets and serum immunoglobulins were analyzed.


RESULTS
Acute-phase proteins were significantly lower in GB compared to morbid obese patients and remained significantly elevated in GB compared to controls. In addition, leukocytes, polymorphonuclear leukocytes and lymphocytes were significantly lower after GB and reached levels comparable to controls (except PMN). No difference in CD3 counts was observed in the three groups. CD4 increased and CD8 decreased in obese and GB patients when compared to controls whereas no statistical difference was found between obese and GB patients.


CONCLUSIONS
Our results confirm the positive effect of GB followed by a massive weight loss without apparent malnutrition. Subclinical chronical inflammation in morbid obese patients leads to irregularities in leukocyte and lymphocyte subsets. These alterations can be positively influenced by GB.
Hanusch-Enserer
U
U
Department of Internal Medicine V, Wilhelminenspital, Vienna, Austria.
Cauza
E
E
Spak
M
M
Dunky
A
A
Rosen
H R
HR
Wolf
H
H
Prager
R
R
Eibl
M M
MM
D000209:Acute-Phase Proteins / Q000378:metabolism; D000210:Acute-Phase Reaction; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007958:Leukocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000276:immunology / Q000601:surgery*; D011184:Postoperative Period; D015431:Weight Loss / Q000276:immunology
D000209:Acute-Phase Proteins; D007136:Immunoglobulins