title: Comparison of early and late changes in immunoglobulins and acute phase reactants after laparoscopic adjustable gastric banding in patients with morbid obesity.
abstract: BACKGROUND
  There are differences in the levels of inflammation mediators, lipids, and formed elements of the blood in morbidly obese patients compared with individuals of normal weight. In the current study, the change in these parameters was determined in patients who achieved weight loss by undergoing laparoscopic adjustable gastric banding (LAGB) by comparing preoperative, and early (3 months) and late (12 months) postoperative values.
  
  
  METHODS
  The body mass index (BMI), weight, blood pressure, and waist circumference of 72 patients treated by LAGB procedures between September 2006 and February 2009 were measured and recorded. Pre- and postoperative 3- and 12-month C-reactive protein (CRP), immunoglobulin (Ig) G, IgA, IgM, fibrinogen (Fbg), complement components C3 and C4, total cholesterol, triglycerides, low-density lipoprotein-C and high-density lipoprotein-C levels, and leukocyte, neutrophil, lymphocyte, and platelet counts were also measured. Results were presented as mean +/- SD. The preoperative values were compared with the 3- and 12-month values. A p value < 0.05 was considered statistically significant.
  
  
  RESULTS
  BMI, weight, blood pressure, and waist circumference measurements were reduced at 3 and 12 months postoperatively compared with preoperative values (p < 0.05). Among the inflammatory mediators, IgG, IgM, and Fbg were reduced to near-normal values, beginning in the early postoperative period (p < 0.05). There was no significant reduction parallel to weight loss with respect to CRP, C3, C4, and IgA values at 3 months postoperatively (p > 0.05). However, the 12-month values of these parameters were significantly reduced (p < 0.05).
  
  
  CONCLUSIONS
  Morbid obesity leads to significant changes in the levels of inflammation mediators. While there is a significant reduction in some of these mediators accompanying slight weight loss in the early period following an LAGB procedure, significant changes occur in other mediators in the late period when there is a larger amount of weight loss.
authors.affiliation: Department of General Surgery, Numune Teaching and Research Hospital, 06100 Ankara, Turkey. ibrahimsakcak@yahoo.com
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sakçak
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Avşar
authors.forename: Enver Okan
authors.initials: EO
authors.lastname: Hamamci
authors.forename: Settar
authors.initials: S
authors.lastname: Bostanoğlu
authors.forename: Muhittin
authors.initials: M
authors.lastname: Sonişik
authors.forename: Akin
authors.initials: A
authors.lastname: Bostanoğlu
authors.forename: Nihal Zekiye
authors.initials: NZ
authors.lastname: Erdem
authors.forename: Erdal
authors.initials: E
authors.lastname: Coşgun
mesh_terms: D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007136:Immunoglobulins / Q000097:blood*; D010535:Laparoscopy / Q000379:methods; D007958:Leukocyte Count; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003176:Complement C3; D003181:Complement C4; D007136:Immunoglobulins; D014280:Triglycerides; D002097:C-Reactive Protein