Lipopolysaccharide and lipopolysaccharide-binding protein levels and their relationship to early metabolic improvement after bariatric surgery.
BACKGROUND
Bariatric surgery usually results in metabolic improvements within a few days from intervention, but the underlying mechanism is not completely understood and may vary depending on the bariatric procedure. Lipopolysaccharides (LPS) from gut microbiota have been proposed as a triggering factor for the inflammatory state in obesity. Roux-en-Y Gastric Bypass (RYGB) leads to a LPS decrease in the medium-term.


OBJECTIVE
To analyze LPS and LPS-binding protein (LBP) in normoglycemic (NG) and diabetic morbidly obese patients in the short-term after 2 different bariatric surgery procedures.


METHODS
University Hospital, Spain.


METHODS
Fifty morbidly obese patients underwent bariatric surgery: 24 with sleeve gastrectomy (SG) and 26 with biliopancreatic diversion (BPD). Patients were classified according to their glycemic status as NG or prediabetic/diabetic. LPS and LBP levels and biochemical and anthropometric variables were determined before and at days 15 and 90 after surgery.


RESULTS
A significant LPS reduction was seen only in the prediabetic/diabetic patients at 90 days after SG. LBP levels rose at 15 days after BPD but at 90 days returned to baseline in both NG and prediabetic/diabetic patients. At 90 days after SG, LBP levels significantly decreased compared to baseline in NG and prediabetic/diabetic patients. After multivariate analysis only the change in BMI was independently associated with the change in LBP levels at 90 days. None of the changes in biochemical or anthropometrical variables were significantly associated with the changes in LPS levels at 15 days or 90 days.


CONCLUSIONS
This is the first study showing that the short-term LPS decrease after bariatric surgery depends on the surgical procedure used as well as on the previous glycemic status of the patient, with SG having the greatest short-term effect on LPS and LBP levels. LBP is closely related to anthropometric variables and may be an inflammatory marker in bariatric surgery patients.
Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain. Electronic address: mer.cp@hotmail.com.
Mercedes
M
Clemente-Postigo
Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain.
Maria del Mar
Mdel M
Roca-Rodriguez
Lipid and Atherosclerosis Research Unit (IMIBIC). Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
Antonio
A
Camargo
Unidad de Gestión Clínica de Cirugía General, Digestiva y Trasplantes. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria), Málaga, Spain.
Luis
L
Ocaña-Wilhelmi
Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain.
Fernando
F
Cardona
Unidad de Gestión Clínica Endocrinología y Nutrición. Instituto de Investigación Biomédica de Málaga (IBIMA), Complejo Hospitalario de Málaga (Virgen de la Victoria)/Universidad de Málaga (Spain); CIBER Pathophysiology of obesity and nutrition (CB06/03), Spain. Electronic address: fjtinahones@hotmail.com.
Francisco J
FJ
Tinahones
D000209:Acute-Phase Proteins; D000328:Adult; D050110:Bariatric Surgery; D002352:Carrier Proteins / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050356:Lipid Metabolism / Q000502:physiology*; D008070:Lipopolysaccharides / Q000097:blood*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D002352:Carrier Proteins; D008070:Lipopolysaccharides; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein
Bariatric surgery; Lipopolysaccharide; Lipopolysaccharide-binding protein; Obesity