title: Lifestyle changes followed by bariatric surgery lower inflammatory markers and the cardiovascular risk factors C3 and C4.
abstract: BACKGROUND
  Morbidly obese patients are at risk of developing insulin resistance and cardiovascular disease. Low-grade systemic inflammation is an important factor for this development. We evaluated the effect of bariatric surgery on markers of inflammation, coagulation and glucose metabolism.
  
  
  METHODS
  Ninety-seven morbidly obese patients and 17 lean subjects (control group) participated. Anthropometric measurements as well as fasting blood samples were obtained at first admission, prior to surgery, and 1 year after surgery.
  
  
  RESULTS
  At admission, the morbidly obese group had significantly elevated levels of the complement components C3 and C4 compared to the lean control group (P<0.0001). Levels of C3 and C4 dropped significantly in the morbidly obese group over time (P<0.0001), and, 1 year after the operation, levels were comparable to those of the control group. The same changes were seen for markers of inflammation (high-sensitivity C-reactive protein, tumor necrosis factor-α, interferon-γ, interleukin-1 receptor antagonist, IL-6, and IL-13), coagulation (fibrinogen and plasminogen activator inhibitor-1), and glucose metabolism (leptin and insulin). There was a positive correlation between changes in C3 and body mass index, weight, coagulation parameters, inflammatory parameters, and leptin, respectively.
  
  
  CONCLUSIONS
  Bariatric surgery in morbidly obese patients reduced weight effectively. Even more importantly, the increased levels of several risk factors associated with diabetes and cardiovascular co-morbidity normalized 1 year after surgery.
authors.affiliation: 1 Department of Surgery, Nordland Hospital , Bodø, Norway .
authors.forename: Torunn Kristin
authors.initials: TK
authors.lastname: Nestvold
authors.forename: Erik Waage
authors.initials: EW
authors.lastname: Nielsen
authors.forename: Judith Krey
authors.initials: JK
authors.lastname: Ludviksen
authors.forename: Hilde
authors.initials: H
authors.lastname: Fure
authors.forename: Anne
authors.initials: A
authors.lastname: Landsem
authors.forename: Knut Tore
authors.initials: KT
authors.lastname: Lappegård
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D003176:Complement C3 / Q000378:metabolism*; D003181:Complement C4 / Q000378:metabolism*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000628:therapy; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003176:Complement C3; D003181:Complement C4