Morbid obesity and inflammation: a prospective study after adjustable gastric banding surgery.
BACKGROUND
Inflammatory status underlying obesity seems to be implicated in several aspects of metabolic syndrome.


OBJECTIVE
This study aimed to investigate the association between weight loss achieved by laparoscopic gastric banding (LAGB) surgery, chronic inflammatory markers, and nutritional state.


METHODS
Thirty-two morbid obese females were enrolled in the study and evaluated at baseline, 1 and 18 months after LAGB surgery. Serum immunoglobulin G (IgG), IgA, IgM, C-reactive protein (CRP), haptoglobin, alpha-1 antitrypsin, total proteins, albumin, prealbumin, transferrin, ferritin, and transferrin soluble receptor were evaluated. In addition, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and fasting glucose were also evaluated.


RESULTS
In average, patients presented 18.7% and 63.2% excess body weight loss 1 and 18 months after LAGB, respectively (p < 0.01). CRP and total cholesterol mean levels were elevated (1.03 +/- 1.11 mg dL(-1) and 2.02 +/- 0.41 g L(-1)) at the presurgery study. CRP mean levels were significantly reduced when compared to reference range (p < 0.01) 18 months after the LAGB surgery. Prealbumin as well as serum total protein mean levels decreased 1 month after surgery (p < 0.01) and values returned to normal at 18 months after surgery. Albumin mean levels showed an increase during the postsurgery evaluations. Serum IgA and IgM concentrations were significantly increased at 1 month after surgery compared to baseline (p < 0.01, both cases).


CONCLUSIONS
Our results indicate that amelioration of inflammatory markers after LAGB does not seem to negatively impact nutritional status following weight reduction surgery. However, careful attention should be driven to serum IgA. Adequacy of nutritional intake and complete serial laboratory measurements should be always included in the required life-long follow-up of patients surgically treated for morbid obesity.
Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4202, Porto, Portugal. rrenata@med.up.pt
Renata
R
Ramalho
Cristina
C
Guimarães
Cidália
C
Gil
Celestino
C
Neves
João Tiago
JT
Guimarães
Luís
L
Delgado
D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007249:Inflammation / Q000097:blood; D007501:Iron / Q000378:metabolism; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology*
D015415:Biomarkers; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D002097:C-Reactive Protein; D007501:Iron