title: Effect of massive weight loss induced by bariatric surgery on serum levels of interleukin-18 and monocyte-chemoattractant-protein-1 in morbid obesity.
abstract: BACKGROUND
  Morbid obesity is associated with insulin resistance (IR), chronic inflammation and premature atherosclerosis. Since vascular inflammation may contribute to the increased risk of cardiovascular morbidity and mortality of these patients, we studied circulating Interleukin-18 (L-18) and monocyte-chemoattractant-protein-1 (MCP-1) levels in 37 patients with morbid obesity before and after significant weight loss induced by bariatric surgery and their preoperative and postoperative associations with C-reactive protein (CRP) and IR-associated factors.
  
  
  METHODS
  High sensitivity assays were used to measure concentrations of fasting CRP, IL-18 and MCP-1. Differences between patients before and after bariatric surgery were analyzed by Student's paired t-test. To investigate the associations of the observed reductions of values, delta of parameters were calculated and preoperative, postoperative and delta data were tested by univariate and multivariate linear regression.
  
  
  RESULTS
  After a mean follow-up period of 26.5 months and a massive weight loss of 35 kg induced by bariatric surgery, circulating IL-18 levels decreased by 37% (P<0.001) and circulating MCP-1 levels by 47% (P<0.001). Multiple linear regression of delta values of IL-18 showed that only 2-hour glucose (P=0.008) remained independently and significantly associated with IL-18, whereas multiple linear regression analysis of delta values of MCP-1 revealed that only delta of HOMA-IR (P<0.001) remained independently and significantly associated with MCP-1, respectively.
  
  
  CONCLUSIONS
  Because both biomarkers have been shown to play an important role in the development and progression of atherosclerosis, the observations presented in this study could be of clinical relevance for morbidly obese patients undergoing bariatric surgery.
authors.affiliation: Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Vienna, Austria. guntram.schernthaner@wienkav.at
authors.forename: Gerit-Holger
authors.initials: GH
authors.lastname: Schernthaner
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Kopp
authors.forename: Stefan
authors.initials: S
authors.lastname: Kriwanek
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Krzyzanowska
authors.forename: Miriam
authors.initials: M
authors.lastname: Satler
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.forename: Guntram
authors.initials: G
authors.lastname: Schernthaner
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D018932:Chemokine CCL2 / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D020382:Interleukin-18 / Q000097:blood*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D019518:Postprandial Period / Q000502:physiology; D015431:Weight Loss / Q000502:physiology*
chemical_list: D018932:Chemokine CCL2; D007328:Insulin; D020382:Interleukin-18; D002097:C-Reactive Protein