title: Weight loss induced by very low calorie diet is associated with a more beneficial systemic inflammatory profile than by Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Weight loss interventions such as Roux-en-Y gastric bypass (RYGB) and very low calorie diets (VLCD) lead to improvement of glucose metabolism in obese individuals with type-2 diabetes. Weight loss can also positively influence the unfavorable inflammatory profile associated with obesity. However, a direct comparison of the effect of VLCD and RYGB on systemic inflammation is lacking.
  
  
  METHODS
  Systemic inflammation was investigated in age- and BMI-matched morbidly obese T2DM women by determining the number and activation- or memory status of peripheral blood leukocytes by flow cytometry, in addition to measuring circulating levels of cytokines and CRP. Systemic inflammation was assessed one month before and three months after RYGB (n=15) or VLCD (n=12). An age matched group of lean women (n=12) was studied as control group.
  
  
  RESULTS
  Three months after the intervention, CRP and leptin levels were reduced whereas adiponectin levels were increased both by RYGB and VLCD. TNF-α levels were increased by RYGB, but reduced by VLCD. IL-2 and IL-6 levels were reduced and IL-4 levels were increased by VLCD but not affected by RYGB. The number of activated peripheral cytotoxic T (CD8+CD25+) and B (CD19+CD38+) cells was significantly higher after RYGB than after VLCD.
  
  
  CONCLUSIONS
  In conclusion, RYGB and VLCD have differential effects on the activation status of peripheral leukocytes and levels of cytokines in obese women with T2DM, despite comparable weight loss three months after the intervention. VLCD seems to have more favorable effects on the inflammatory profile as compared to RYGB.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Mirjam A
authors.initials: MA
authors.lastname: Lips
authors.affiliation: Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jan Bert
authors.initials: JB
authors.lastname: van Klinken
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Hanno
authors.initials: H
authors.lastname: Pijl
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
authors.forename: Ignace
authors.initials: I
authors.lastname: Janssen
authors.affiliation: Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands; Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Ko
authors.initials: K
authors.lastname: Willems van Dijk
authors.affiliation: Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Frits
authors.initials: F
authors.lastname: Koning
authors.affiliation: Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: V.J.A.van_Harmelen@lumc.nl.
authors.forename: Vanessa
authors.initials: V
authors.lastname: van Harmelen
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D031204:Caloric Restriction; D016207:Cytokines / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D018655:Lymphocyte Count; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D001786:Blood Glucose; D016207:Cytokines; D007328:Insulin; D020738:Leptin; D002097:C-Reactive Protein
keywords: Cytokines; Interleukins; Lymphocytes; Systemic inflammation