title: Change in levels of C-reactive protein (CRP) and serum cortisol in morbidly obese patients after laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  C-Reactive protein (CRP) has been associated with the macro- and microvascular effects of hypertension and diabetes mellitus. Referring to serum cortisol, it has been proposed to contribute to the pathogenesis of metabolic syndrome, and it has been demonstrated that weight loss normalizes cortisol levels and improves insulin resistance. The aims of this study were to analyze CRP and cortisol levels pre- and postoperatively in morbidly obese patients undergoing a laparoscopic sleeve gastrectomy and to correlate them with weight loss and parameters associated with cardiovascular risk.
  
  
  METHODS
  A prospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and May 2011 was performed.
  
  
  RESULTS
  A total of 40 patients were included in the study. CRP levels decreased significantly 12 months after surgery (median reduction of 8.9 mg/l; p = 0.001). Serum cortisol levels decreased significantly 6 months after surgery (median reduction of 34.9 μg/dl; p = 0.001). CRP values reached the normal range (<5 mg/l) 1 year after surgery. Referring to cortisol, a significant association was observed with the cardiovascular risk predictor (triglyceride/high-density lipoprotein cholesterol ratio) from the 6th month after surgery onward (Pearson correlation coefficient, 0.559; p = 0.008).
  
  
  CONCLUSIONS
  CRP levels are increased preoperatively and in the postoperative course up to 1 year after surgery. Serum cortisol levels remain elevated until the 6th month after surgery. From this moment onward, serum cortisol is associated with the cardiovascular risk predictor reflecting the cardiovascular risk decreasement during the weight loss.
authors: Bariatric Surgery Unit, Department of Surgery, General University Hospital Elche, Alicante, Spain. jruiztovar@gmail.com
authors: Jaime
authors: J
authors: Ruiz-Tovar
authors: Inmaculada
authors: I
authors: Oller
authors: Isabel
authors: I
authors: Galindo
authors: Carolina
authors: C
authors: Llavero
authors: Antonio
authors: A
authors: Arroyo
authors: Alicia
authors: A
authors: Calero
authors: María
authors: M
authors: Diez
authors: Lorea
authors: L
authors: Zubiaga
authors: Rafael
authors: R
authors: Calpena
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D002784:Cholesterol / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007333:Insulin Resistance; D010535:Laparoscopy; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism* / Q000517:prevention & control; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000378:metabolism* / Q000601:surgery; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D014280:Triglycerides / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D002784:Cholesterol; D006442:Glycated Hemoglobin; D006854:Hydrocortisone; D014280:Triglycerides; C517652:hemoglobin A1c protein, human