Plasma adhesion and inflammation markers: asymmetrical dimethyl-L-arginine and secretory phospholipase A2 concentrations before and after laparoscopic gastric banding in morbidly obese patients.
BACKGROUND
The aim of this study was to examine the relationship between subclinical inflammation and weight loss by laparoscopic adjustable gastric banding (LAGB).


METHODS
Plasma concentrations of intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), sensitive C-Reactive Protein (sCRP), asymmetrical dimethyl-L-arginine (ADMA), Secretory Phospholipase A2 (sPLA2), and metabolic markers, such as homeostatic model assessment insulin resistance (HOMA-IR) and body mass index (BMI) were determined in morbidly obese patients (n=18, BMI 48.6 +/- 1.7 kg/m2) at baseline and 1 month after operations. Baseline levels in patients were also compared with age-matched controls (n=20, BMI 21.3 +/- 1.8 kg/m2). Plasma ICAM-1, VCAM, sCRP and ADMA, and sPLA2 concentrations were determined by enzyme-linked immunoassay methods and colorimetric method, respectively.


RESULTS
Plasma sCRP, ICAM-1, ADMA and sPLA2 concentrations and HOMA-IR were significantly higher in morbidly obese patients than in controls (for each, P<0.01). Plasma VCAM-1 concentration was not changed in obese patients. HOMA-IR was significantly correlated with ICAM-1, ADMA and sPLA2 in the obese group at baseline (for each, P<0.01). There was a significant correlation between plasma sCRP and plasma glucose, VCAM-1, ICAM-1, ADMA and sPLA2 concentrations (for each, P<0.01). 1 month after LAGB, mean body weight loss was 13.2 +/- 6.3 kg, and plasma sCRP and ADMA concentrations and HOMA-IR and BMI were significantly decreased (for each, P<0.01). However, these levels cannot be decreased to the levels of the controls.


CONCLUSIONS
Obesity and insulin resistance appear to be associated with low-grade inflammation and endothelial dysfunction. Insulin resistance and endothelial dysfunction were improved by weight loss after LAGB.
Istanbul University, Cerrahpasa Medical Faculty, Department of Biochemistry, Istanbul, Turkey.
Dildar
D
Konukoglu
Hafize
H
Uzun
Sinem
S
Firtina
Pinar
P
Cigdem Arica
Ahmet
A
Kocael
Mustafa
M
Taskin
D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D015391:Gastroplasty; D054501:Group II Phospholipases A2; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D010741:Phospholipases A / Q000097:blood*; D054467:Phospholipases A2; D015431:Weight Loss / Q000502:physiology
D015815:Cell Adhesion Molecules; C018524:N,N-dimethylarginine; D002097:C-Reactive Protein; D001120:Arginine; D010741:Phospholipases A; D054501:Group II Phospholipases A2; D054467:Phospholipases A2