title: Changes in C-reactive protein predict insulin sensitivity in severely obese individuals after weight loss surgery.
abstract: The production of inflammatory mediators by abdominal adipose tissue may link obesity and insulin resistance. We determined the influence of systemic levels of interleukin-6 and C-reactive protein on insulin sensitivity after weight loss via Roux-en-Y gastric bypass surgery. Severely obese individuals (n = 15) were evaluated at baseline and at 6 months after surgery. Insulin sensitivity was determined by frequently sampled intravenous glucose tolerance testing at the same time points. Visceral and subcutaneous adipose tissue volumes were quantified by computed tomography. Interleukin-6 and C-reactive protein were measured by enzyme-linked immunoassay in plasma and in adipose tissue biopsies. Correlation analysis was used to determine associations between insulin sensitivity and other outcome variables. Significance was set at P < 0.05. Plasma interleukin-6 concentrations were significantly correlated to the IL-6 content of subcutaneous adipose tissue (r = 0.71). At 6 months postsurgery, subcutaneous and visceral adipose tissue volumes were significantly reduced (34.7% and 44.1%, respectively) and insulin sensitivity had improved by 160.9%. Significant longitudinal correlations were found between insulin sensitivity and plasma C-reactive protein (r = -0.61), but not plasma interleukin-6 at 6 months. These findings offer insights that link obesity and insulin resistance via the activity of inflammatory mediators.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA. ngletsu@emory.edu
authors.forename: Nana
authors.initials: N
authors.lastname: Gletsu
authors.forename: Edward
authors.initials: E
authors.lastname: Lin
authors.forename: Leena
authors.initials: L
authors.lastname: Khaitan
authors.forename: Scott A
authors.initials: SA
authors.lastname: Lynch
authors.forename: Bruce
authors.initials: B
authors.lastname: Ramshaw
authors.forename: Randall
authors.initials: R
authors.lastname: Raziano
authors.forename: William E
authors.initials: WE
authors.lastname: Torres
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Ziegler
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Papanicolaou
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001823:Body Composition; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D015390:Gastric Bypass; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000378:metabolism; D008137:Longitudinal Studies; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein