title: Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea.
abstract: Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation.
  
  
  
  We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery.
  
  
  
  Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (r = 0.27, p = 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (p = 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (r = 0.43, p = 0.04) and with improved HOMA score (r = 0.37, p = 0.03).
  
  
  
  Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation.
authors.affiliation: Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Tirado
authors.affiliation: Pneumology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Masdeu
authors.affiliation: Pneumology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Ciber de Enfermedades Respiratorias-Ciberes, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Vigil
authors.affiliation: Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Rigla
authors.affiliation: Surgery Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Alexis
authors.initials: A
authors.lastname: Luna
authors.affiliation: Surgery Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Rebasa
authors.affiliation: Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Pareja
authors.affiliation: Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Hurtado
authors.affiliation: Endocrinology and Nutrition Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, c/ Parc Taulí no 1, 08208, Sabadell, Barcelona, Spain. acaixas@tauli.cat.
authors.forename: Assumpta
authors.identifier: 0000-0001-8472-9189
authors.initials: A
authors.lastname: Caixàs
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D050110:Bariatric Surgery; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D051547:Heme Oxygenase-1 / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000601:surgery; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; C508600:IL6 protein, human; D007328:Insulin; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D051547:Heme Oxygenase-1
keywords: Bariatric surgery; Heme oxygenase-1; Inflammation; Insulin resistance; OSA