Bariatric surgery decreased the serum level of an endotoxin-associated marker: lipopolysaccharide-binding protein.
BACKGROUND
Recent studies have shown serum lipopolysaccharide binding protein (LBP) is associated with obesity and related metabolic disorder. Bariatric surgery can significantly reduce weight, but reports about the change of LBP after bariatric surgery are limited. We investigated LBP concentration and its associations with clinical variables.


METHODS
We enrolled 178 obese patients receiving different bariatric surgeries and 38 normal weight individuals. Fasting blood samples were collected at baseline in all and 1 year after surgery in obese individuals. The serum LBP concentration was measured.


RESULTS
The percentage of excess weight loss of mini-gastric bypass, Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric band were 72.0±20.0%, 65.5±23.0%, 67.2±18.4%, and 16.1±14.3%, respectively. Serum LBP levels were higher in the obese participants than in the normal weight participants (49.9±15.7 versus 25.2±7.5 μg/mL; P<.001) at baseline and significantly decreased to 35.1±22.6 μg/mL after bariatric surgery (P<.001) in the obese group. In the bariatric participants, after multivariate analyses, preoperative LBP and the change of LBP with surgery were independently associated only with high sensitive C-reactive protein (hs-CRP) (P<.001) and the change of hs-CRP (P = .012), respectively, while none of the postoperative variables was independently associated with LBP.


CONCLUSIONS
LBP is associated with body mass index and hs-CRP. Bariatric surgery significantly decreased the serum level of LBP. The relationship between LBP and hs-CRP disappeared after bariatric surgery.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital Jin-Shan Branch, New Taipei City, Taiwan; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Po-Jen
PJ
Yang
Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
Wei-Jei
WJ
Lee
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ping-Huei
PH
Tseng
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Po-Huang
PH
Lee
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: linmt@ntu.edu.tw.
Ming-Tsan
MT
Lin
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wsyang@ntu.edu.tw.
Wei-Shiung
WS
Yang
D000209:Acute-Phase Proteins; D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D002352:Carrier Proteins / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D016014:Linear Models; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000097:blood* / Q000453:epidemiology / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D015415:Biomarkers; D002097:C-Reactive Protein; D002352:Carrier Proteins; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein
Bariatric surgery; LBP; Obesity; hs-CRP