title: Effects of changes in body weight and insulin resistance on inflammation and endothelial function in morbid obesity after bariatric surgery.
abstract: Metabolic alterations such as insulin resistance are thought to underlie the endothelial dysfunction and low grade inflammation found in morbid obesity. Twenty-six morbidly obese patients, aged 39.0 +/- 10.0 (mean +/- sd), were evaluated before and 4.2 +/- 0.8 months after bariatric surgery. A marked increment in the insulin sensitivity index (S(I)) and the endothelium-dependent vasodilatory response in a dorsal hand vein was observed after weight loss following bariatric surgery. Circulating levels of E-selectin, P-selectin, plasminogen activator inhibitor-1, and von Willebrand factor, which were higher than those in the control group, decreased significantly after surgery. Plasma vascular cell adhesion molecule-1, angiotensin-converting enzyme, intercellular adhesion molecule-1, thrombomodulin, and plasma and intraplatelet cGMP levels did not change after weight loss. All inflammatory markers were higher in morbidly obese patients. After surgery, C- reactive protein and sialic acid diminished, whereas circulating levels of IL-6, TNF-alpha, and its soluble receptors did not. Positive correlations were found between changes in adiposity and S(I) and changes in C-reactive protein and between changes in sialic acid and changes in endothelial function. In conclusion, a marked improvement in S(I), endothelial function, and low grade inflammation was observed in the weight-losing, morbidly obese patients after bariatric surgery. S(I) and adiposity appear to play roles in obesity-related, low grade inflammation that contribute to the endothelial dysfunction observed in morbid obesity.
authors.affiliation: Endocrine Unit, University Hospital Marqués de Valdecilla, University of Cantabria, Santander, Spain.
authors.forename: Luis Alberto
authors.initials: LA
authors.lastname: Vázquez
authors.forename: Fernando
authors.initials: F
authors.lastname: Pazos
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Berrazueta
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández-Escalante
authors.forename: María Teresa
authors.initials: MT
authors.lastname: García-Unzueta
authors.forename: Julio
authors.initials: J
authors.lastname: Freijanes
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Amado
mesh_terms: D000328:Adult; D001835:Body Weight; D004727:Endothelium / Q000502:physiology*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1