title: Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity.
abstract: OBJECTIVE
  Inflammation, oxidative stress and dysregulation of adipokines are thought to be pathophysiological mechanisms linking obesity to the development of insulin resistance and atherosclerosis. In adults, bariatric surgery reduces inflammation and oxidative stress, and beneficially changes the levels of several adipokines, but little is known about the postsurgical changes among adolescents.
  
  
  METHODS
  In two separate longitudinal cohorts we evaluated change from baseline of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemo-attractant protein-1 (MCP-1), oxidized low-density lipoprotein cholesterol (oxLDL), adiponectin, leptin and resistin up to 12 months following elective laparoscopic Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG) surgery in adolescents with severe obesity.
  
  
  RESULTS
  In cohort 1, which consisted of 39 adolescents (mean age 16.5±1.6 years; 29 females) undergoing either RYGB or VSG, IL-6 (baseline: 2.3±3.4 pg ml(-1) vs 12 months: 0.8±0.6 pg ml(-1), P<0.01), leptin (baseline: 178±224 ng ml(-1) vs 12 months: 41.4±31.9 ng ml(-1), P<0.001) and oxLDL (baseline: 41.6±11.6 U l(-1) vs 12 months: 35.5±11.1 U l(-1), P=0.001) significantly decreased and adiponectin significantly increased (baseline: 5.4±2.4 μg ml(-1) vs 12 months: 13.5±8.9 μg ml(-1), P<0.001). In cohort 2, which consisted of 13 adolescents (mean age 16.5±1.6 years; 10 females) undergoing RYGB, results were similar: IL-6 (baseline: 1.7±0.9 pg ml(-1) vs 12 months: 0.4±0.9 pg ml(-1), P<0.05) and leptin (baseline: 92.9±31.3 ng ml(-1) vs 12 months: 37.3±33.4 ng ml(-1), P<0.001) significantly decreased and adiponectin significantly increased (baseline: 6.1±2.9 μg ml(-1) vs 12 months: 15.4±8.0 μg ml(-1), P<0.001). When the cohorts were combined to evaluate changes at 12 months, oxLDL also significantly decreased (baseline: 39.8±16.7 U l(-1) vs 12 months: 32.7±11.9 U l(-1), P=0.03).
  
  
  CONCLUSIONS
  Bariatric surgery produced robust improvements in markers of inflammation, oxidative stress and several adipokines among adolescents with severe obesity, suggesting potential reductions in risk for type 2 diabetes and cardiovascular disease.
authors: Department of Pediatrics, University of Minnesota Medical School and University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.|Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
authors: A S
authors: AS
authors: Kelly
authors: Department of Pediatrics, University of Minnesota Medical School and University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.|Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
authors: J R
authors: JR
authors: Ryder
authors: Department of Pediatrics, University of Minnesota Medical School and University of Minnesota Masonic Children's Hospital, Minneapolis, MN, USA.|School of Kinesiology, University of Minnesota, Minneapolis, MN, USA.
authors: K L
authors: KL
authors: Marlatt
authors: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors: K D
authors: KD
authors: Rudser
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors: T
authors: T
authors: Jenkins
authors: Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors: T H
authors: TH
authors: Inge
mesh_terms: D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D018384:Oxidative Stress; D063766:Pediatric Obesity / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
chemical_list: C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D008077:Lipoproteins, LDL; D014409:Tumor Necrosis Factor-alpha