Macrophage inhibitory factor, plasminogen activator inhibitor-1, other acute phase proteins, and inflammatory mediators normalize as a result of weight loss in morbidly obese subjects treated with gastric restrictive surgery.
Obesity is demonstrated to be associated with an enhanced inflammatory state, which is suggested to be a cause for the development of obesity-related morbidity. It was hypothesized that a decrease in body weight in morbid obese subjects would lead to a reduction of the inflammatory state in these subjects. Weight loss was achieved by gastric restrictive surgery in 27 morbidly obese patients. Preoperative as well as 3-, 6-, 12-, and 24-month postoperative plasma concentrations of inflammatory mediators macrophage inhibitory factor, plasminogen activator inhibitor-1, lipopolysaccharide binding protein, alpha-1 acid glycoprotein, C-reactive protein, soluble TNFalpha receptors 55 and 75, and leptin were measured. Macrophage inhibitory factor levels remained low normal for 6 months, during weight loss, after which they significantly increased to normal levels at 24 months postoperatively. The other inflammatory mediators remained elevated up to minimally 3 months postoperatively; thereafter they decreased significantly. Both TNFalpha receptors remained elevated up to at least 12 months postoperatively to decrease significantly at 2 yr postoperatively. This study demonstrates that during weight loss, after gastric restrictive surgery, inflammatory mediators remain elevated for at least 3 months postoperatively, suggesting initially an ongoing inflammatory state. However, 2 yr after surgery, the inflammatory mediators reach near normal values.These findings may be an explanation for the reduced comorbidity seen in morbidly obese patients after gastric restrictive surgery.
van Dielen
F M H
FM
Department of General Surgery, Nutrition Research Institute Maastricht and University Hospital Maastricht, 6202 AZ Maastricht, The Netherlands. f.vandielen@ah.unimaas.nl
Buurman
W A
WA
Hadfoune
M
M
Nijhuis
J
J
Greve
J W
JW
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002352:Carrier Proteins / Q000097:blood; D015391:Gastroplasty; D006801:Humans; D020738:Leptin / Q000097:blood; D008263:Macrophage Migration-Inhibitory Factors / Q000097:blood*; D008562:Membrane Glycoproteins; D009767:Obesity, Morbid / Q000601:surgery*; D009961:Orosomucoid / Q000378:metabolism; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011184:Postoperative Period; D018124:Receptors, Tumor Necrosis Factor / Q000737:chemistry / Q000378:metabolism; D012995:Solubility; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D015431:Weight Loss; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D002097:C-Reactive Protein; D002352:Carrier Proteins; D020738:Leptin; D008263:Macrophage Migration-Inhibitory Factors; D008562:Membrane Glycoproteins; D009961:Orosomucoid; D017395:Plasminogen Activator Inhibitor 1; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000099231:Lipopolysaccharide-Binding Protein