title: Effects of Roux-en-Y gastric bypass on fasting and postprandial inflammation-related parameters in obese subjects with normal glucose tolerance and in obese subjects with type 2 diabetes.
abstract: BACKGROUND
  Obesity is characterized by low grade inflammation and an altered secretion of inflammatory cytokines from the adipose tissue. Weight loss has shown to reduce inflammation; however, changes in cytokine profiles during massive weight loss are not well described. The present study explored the hypothesis that Roux-en-Y gastric bypass (RYGB) reduces circulating levels of pro-inflammatory cytokines, while increasing anti-inflammatory cytokines in obese subjects with type 2 diabetes (T2D) and in obese normal glucose tolerant (NGT) subjects.
  
  
  METHODS
  Thirteen obese subjects with T2D [weight; 129 ± 14 kg, glycated hemoglobin (HbA1c); 7.0 ± 0.9%, body mass index (BMI); 43.2 ± 5.3 kg/m(2), mean ± SD] and twelve matched obese NGT subjects [weight; 127 ± 15 kg, HbA1c; 5.5 ± 0.4%, BMI; 41.5 ± 4.8 kg/m(2), mean ± SD] were examined before, one week, three months, and one year after surgery. Interleukin (IL)-6, leptin, adiponectin, IL-8, transforming growth factor beta (TGF-β), and the incretin hormone glucagon-like peptide-1 (GLP-1) were measured in the fasting state and during a liquid meal. Insulin resistance was evaluated by HOMA-IR.
  
  
  RESULTS
  Weight loss did not differ between the two groups. Before surgery, HbA1c was higher and HOMA-IR lower in T2D patients, however, converged to the values of NGT subjects one year after surgery. Circulating cytokine concentrations did not differ between the two groups at any time point. One week after surgery, circulating IL-6 and IL-8 were increased, while adiponectin and leptin were reduced compared with pre-surgical concentrations. Three months after surgery, IL-8 was increased, leptin was reduced, and no change was observed for IL-6, TGF-β, and adiponectin. One year after surgery, concentrations of IL-6, TGF-β, and leptin were significantly reduced compared to before surgery, while adiponectin was significantly increased.
  
  
  CONCLUSIONS
  One year after RYGB, fasting concentrations of IL-6 and leptin were reduced, while no changes were observed in IL-8. TGF-β was decreased and adiponectin increased in both T2D and NGT obese subjects. This study is the first to examine IL-8 and TGF-β in obese subject after RYGB. Resolution of inflammation could offer a potential explanation for the health improvement associated with major weight loss after bariatric surgery.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov (NCT01579981).
authors.affiliation: Zealand Pharma A/S, Smedeland 36, 2600 Glostrup, Denmark ; Innate Immunology Group, The National Veterinary Institute, DTU, 1870 Frederiksberg, Denmark.
authors.forename: Kirsten Katrine
authors.initials: KK
authors.lastname: Lindegaard
authors.affiliation: Department of Endocrinology, Hvidovre Hospital, Kettegård Alle 30, 2650 Hvidovre, Denmark.
authors.forename: Nils Bruun
authors.initials: NB
authors.lastname: Jorgensen
authors.affiliation: Zealand Pharma A/S, Smedeland 36, 2600 Glostrup, Denmark.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Just
authors.affiliation: Innate Immunology Group, The National Veterinary Institute, DTU, 1870 Frederiksberg, Denmark.
authors.forename: Peter Mh
authors.initials: PM
authors.lastname: Heegaard
authors.affiliation: Department of Endocrinology, Hvidovre Hospital, Kettegård Alle 30, 2650 Hvidovre, Denmark.
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
keywords: Glucose tolerant subjects; Inflammatory cytokines; RYGB; Type 2 diabetes; Weight loss