title: CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment.
abstract: OBJECTIVE
  The aim of this study was to evaluate the concentrations of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the degree of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy.
  
  
  METHODS
  The study included 33 patients (25 females and 8 males; mean age 46 years) with body mass index (BMI) values of >40 kg/m(2). Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before (baseline data) and three weeks after the treatment. The control group consisted of 20 healthy volunteers (15 females and 5 males) with a mean age of 39 years and BMI values of ≤24.9 kg/m(2).
  
  
  RESULTS
  In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a decreased level of high density lipoprotein (HDL)-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4% reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concentration of CRP, but no change in TNF-α or IL-6. HOMA-IR was significantly reduced.
  
  
  CONCLUSIONS
  The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients.
authors.affiliation: Department of Pathophysiology, Faculty of Pharmacy, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz PL 85-094, Poland; Clinic of Balneology and Physical Medicine, Faculty of Health Science, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz PL 85-094, Poland.
authors.forename: Danuta
authors.initials: D
authors.lastname: Rość
authors.forename: Przemysław
authors.initials: P
authors.lastname: Adamczyk
authors.forename: Joanna
authors.initials: J
authors.lastname: Boinska
authors.forename: Robert
authors.initials: R
authors.lastname: Szafkowski
authors.forename: Irena
authors.initials: I
authors.lastname: Ponikowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Stankowska
authors.forename: Barbara
authors.initials: B
authors.lastname: Góralczyk
authors.forename: Barbara
authors.initials: B
authors.lastname: Ruszkowska-Ciastek
mesh_terms: D017667:Adipocytes / Q000378:metabolism; D000328:Adult; D000368:Aged; D001452:Balneology / Q000379:methods; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism*; D031204:Caloric Restriction; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D004038:Diet, Reducing; D005260:Female; D006706:Homeostasis; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000378:metabolism*; D015431:Weight Loss; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; C508600:IL6 protein, human; D015850:Interleukin-6; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: C-reactive protein (CRP); Homeostasis model assessment-insulin resistance (HOMA-IR); Interleukin-6 (IL-6); Morbid obesity; Pro-inflammatory cytokines; Tumor necrosis factor-α (TNF-α)