title: Effect of bariatric surgery-induced weight loss on renal and systemic inflammation and blood pressure: a 12-month prospective study.
abstract: BACKGROUND
  Bariatric surgery improves arterial hypertension and renal function; however, the underlying mechanisms and effect of different surgical procedures are unknown. In the present prospective study, we compared the 12-month follow-up results after Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy on weight loss, hypertension, renal function, and inflammatory status.
  
  
  METHODS
  A total of 34 morbidly obese patients were investigated before, one and 12 months after Roux-en-Y gastric bypass (n = 10), laparoscopic adjustable gastric banding (n = 13), and laparoscopic sleeve gastrectomy (n = 11) for hypertension, kidney function, urinary and serum cytokine levels of macrophage migration inhibitory factor, monocyte chemotactic protein-1, and chemokine ligand-18.
  
  
  RESULTS
  At 12 months after surgery, the patients in all 3 treatment arms showed a significant decrease in the mean body mass index, mean arterial pressure, and urinary and serum inflammatory markers (all P < .001). The reduction in urinary and serum cytokine levels correlated directly with body weight loss (P < .05). Patients with impaired renal function at baseline (corresponding to serum cystatin C >.8 mg/L) had a marked improvement in renal function 12 months after surgery (P < .05).
  
  
  CONCLUSIONS
  Surgically induced weight loss is associated with a marked decrease in renal and systemic inflammation and arterial hypertension and improvement in renal function in patients with pre-existing renal impairment. These effects appear to be independent of surgical procedure. The improvement in renal inflammation could be 1 of the mechanisms contributing to the beneficial effects of bariatric surgery on arterial blood pressure, proteinuria, and renal function.
authors.affiliation: Imperial Weight Centre, Department of Investigative Medicine, Imperial College London, London, United Kingdom.
authors.forename: Wiebke K
authors.initials: WK
authors.lastname: Fenske
authors.forename: Sukhpreet
authors.initials: S
authors.lastname: Dubb
authors.forename: Marco
authors.initials: M
authors.lastname: Bueter
authors.forename: Florian
authors.initials: F
authors.lastname: Seyfried
authors.forename: Karishma
authors.initials: K
authors.lastname: Patel
authors.forename: Frederick W K
authors.initials: FW
authors.lastname: Tam
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Frankel
authors.forename: Carel W
authors.initials: CW
authors.lastname: le Roux
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D003404:Creatinine / Q000378:metabolism; D055316:Cystatin C / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D007249:Inflammation / Q000503:physiopathology / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000503:physiopathology / Q000601:surgery; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology
chemical_list: D055316:Cystatin C; D016207:Cytokines; D003404:Creatinine