Reduction in plasma levels of inflammatory and oxidative stress indicators after Roux-en-Y gastric bypass.
BACKGROUND
Obesity is considered to be associated with high levels of oxidative stress and inflammation. Anticipated weight loss secondary to bariatric surgery may offer an opportunity to evaluate this association. We studied a few markers of oxidative stress and inflammation in 20 obese patients submitted to Roux-en-Y gastric bypass (RYGBP).


METHODS
Variations in plasma levels of indicators of oxidative stress (malondialdehyde (MDA), superoxide dismutase (SOD), catalase, glutathione (GSH), glutathione disulfide (GSSG), and total radical antioxidant parameter (TRAP)) and inflammation (alpha1-acid glycoprotein (AGP) and C-reactive protein (CRP)), as well as variations in plasma levels of leptin, glucose, glycated hemoglobin (HbA1c), and insulin were investigated in the preoperative period and 12 months postsurgery in 20 class III obese individuals submitted to bariatric surgery (obese group) and 20 non-obese individuals (control group).


RESULTS
Twelve months postsurgery, there was a significant reduction (p < 0.01) in median values of BMI (46.75/30.17 kg/m(2)) and in plasma levels of MDA (16.70/9.11 nmol/g prot), SOD (10.70/9.24 U/mgHb), GSSG (210.80/148.20 mM/g of Hb), AGP (125.70/75.80 mg/dL), CRP (1.31/0.38 mg/dL), and leptin (15.04/3.58 ng/mL). A significant drop (p < 0.05) in plasma levels of HbA1c (5.81/4.98%) was also observed. On the other hand, a significant increase in plasma levels of GSH (2.002/2.823 mM/g of Hb) and TRAP (585.40/815.48 microM Trolox), p < 0.01, and in catalase plasma levels (12.06/13.22 Deltat/mgHb/min), p < 0.05, was seen. No statistically significant variations in glucose (96.3/84.8 mg/dL) or insulin plasma levels (9.91/7.88 U/mL) occurred. Calculated homeostasis model assessment index did not statistically change 12 months postsurgery (2.36/1.66).


CONCLUSIONS
In the preoperative period, the obese group individuals showed higher oxidation and inflammation levels and lower indices of antioxidant defense than those of the control group. One year after RYGBP, an improvement in antioxidant protection, associated with a reduction in inflammatory and oxidative markers, was observed, indicating that these individuals presented a lower degree of oxidative stress.
João Cabrera
Edilson
E
Pharmaceutical University Hospital, University Hospital, Londrina State University, Londrina, Brazil.
Valezi
Antonio Carlos
AC
Delfino
Vinicius Daher Alvares
VD
Lavado
Edson Lopes
EL
Barbosa
Decio Sabbatini
DS
D000328:Adult; D000975:Antioxidants / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D002374:Catalase / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D015390:Gastric Bypass; D005978:Glutathione / Q000097:blood; D019803:Glutathione Disulfide / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D009961:Orosomucoid / Q000032:analysis; D018384:Oxidative Stress / Q000502:physiology*; D013482:Superoxide Dismutase / Q000097:blood
D000975:Antioxidants; D001786:Blood Glucose; D002097:C-Reactive Protein; D002374:Catalase; D005978:Glutathione; D019803:Glutathione Disulfide; D006442:Glycated Hemoglobin; D007328:Insulin; D020738:Leptin; D008315:Malondialdehyde; D009961:Orosomucoid; D013482:Superoxide Dismutase