title: Effects of depressive symptoms on clinical outcomes, inflammatory markers and quality of life after a significant weight loss in a bariatric surgery sample.
abstract: BACKGROUND
  Obesity is linked to a low-grade chronic systemic inflammation that improves after weight loss. Depressive disorder has been suggested to be associated with systemic inflammation up regulation.
  
  
  OBJECTIVE
  We aimed to explore whether, after a significant weight loss, the presence of depressive symptoms was associated with differences in terms of inflammatory markers and quality of life.
  
  
  METHODS
  Sixty patients (78.3%♀, age 46.4 ± 9.9) who underwent bariatric surgery, with a minimum follow up of 18 months, were evaluated. For the screening of depression, the Beck Depression Inventory (BDI) was administered.
  
  
  RESULTS
  Ten subjects (16.6%) had a positive screening for depressive disorder. The percentage of patients with weight regain was greater among subjects with symptoms of depression (70% vs. 32%; p = 0.024), although no differences were seen regarding BMI prior to surgery and current BMI. Acute phase reactants were higher among subjects with symptoms of depression: platelets (319 ± 15 x 10^12/L vs. 232 ± 47 x 10 ^ 12/L; p = 0.001), erythrocyte sedimentation rate (24.7 ± 11.3 mm vs.17 ± 10 mm; p = 0.03), fibrinogen (486 ± 107 mg/dL vs. 406 ± 66 mg/dL; p = 0.003), ferritin (106 ± 180 ng/ml vs. 34 ± 44 ng/ml; p = 0.014) and ultrasensitive C-reactive protein (0.96 ± 1.84 mg/dL vs. 0.24 ± 0.26 mg/dL; p = 0.008). All domains of quality of life were significantly lower in the depressive group.
  
  
  CONCLUSIONS
  Despite a significant weight loss, inflammatory markers are greater and quality of life lower when associated with depressive symptoms.
authors.affiliation: Endocrinology and Nutrition Department. Hospital Son Llàtzer. Palma de Mallorca, Spain. University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma (IdISPa). Palma de Mallorca. jnicolauramis@gmail.com.
authors.forename: Joana
authors.initials: J
authors.lastname: Nicolau
authors.forename: Rafael
authors.initials: R
authors.lastname: Simó
authors.forename: Pilar
authors.initials: P
authors.lastname: Sanchís
authors.forename: Luisa
authors.initials: L
authors.lastname: Ayala
authors.forename: Regina
authors.initials: R
authors.lastname: Fortuny
authors.forename: Rosmeri
authors.initials: R
authors.lastname: Rivera
authors.forename: Lluís
authors.initials: L
authors.lastname: Masmiquel
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D015415:Biomarkers / Q000097:blood; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology / Q000601:surgery; D009767:Obesity, Morbid / Q000601:surgery; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D015415:Biomarkers
keywords: Obesity. Depression.  Bariatric surgery.  Acute phase  reactants. Quality  of life.