title: Clinical and adipocytokine changes after bariatric surgery in morbidly obese women.
abstract: OBJECTIVE
  Recent studies report the effect of bariatric surgery on glycaemia control and prevention of type-2-diabetes in obese patients. This study is about the pathophysiological mechanisms associated to these changes.
  
  
  METHODS
  Circulating levels of receptors of tumor necrosis factor (TNF-RI, TNF-RII), visfatin, high molecular weight (HMW) adiponectin, and C reactive protein (CRP) in 30 morbidly obese women (body mass index, BMI>40 kg/m(2) ) and 60 normal-weight controls (BMI>25 kg/m(2) ) were analyzed. Morbidly obese were studied at three time-points: before surgery (baseline), and 6 and 12 months after.
  
  
  RESULTS
  After surgery, the levels of TNF-RI, TNF-RII, visfatin, and CRP were significantly lower than its baseline levels, whereas HMW adiponectin was higher. Fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA2-IR) levels were markedly lower postoperatively. High density lipoproteins (HDL) moderately increased, and triglyceride levels had sharply decreased. The study of the predictive value of variables indicated that preoperative levels of TNF-RI and visfatin correlated positively with levels of glucose, insulin, glycosylated hemoglobin A1c, and HOMA2-IR postoperatively, whereas adiponectin levels correlated negatively. Baseline CRP levels negatively linked to HDL and TNF-RII positively to triglyceride.
  
  
  CONCLUSIONS
  The preoperative profile with high levels of proinflammatory adipocytokines is linked to smaller improvements in glucose homeostasis and lipid factors. The use of a range of biomarkers may predict the level of metabolic changes following bariatric surgery.
authors.affiliation: Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain; Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Auguet
authors.forename: Ximena
authors.initials: X
authors.lastname: Terra
authors.forename: Mercè
authors.initials: M
authors.lastname: Hernández
authors.forename: Fàtima
authors.initials: F
authors.lastname: Sabench
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Porras
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Orellana-Gavaldà
authors.forename: Jordi
authors.initials: J
authors.lastname: Llutart
authors.forename: Esther
authors.initials: E
authors.lastname: Guiu-Jurado
authors.forename: Alba
authors.initials: A
authors.lastname: Berlanga
authors.forename: Salomé
authors.initials: S
authors.lastname: Martinez
authors.forename: Carmen
authors.initials: C
authors.lastname: Aguilar
authors.forename: Daniel Del
authors.initials: DD
authors.lastname: Castillo
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Richart
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000818:Animals; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D011184:Postoperative Period; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D014280:Triglycerides / Q000097:blood
chemical_list: D054392:Adipokines; D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D007328:Insulin; D054409:Nicotinamide Phosphoribosyltransferase; D047888:Receptors, Tumor Necrosis Factor, Type I; D047889:Receptors, Tumor Necrosis Factor, Type II; D014280:Triglycerides