TY - JOUR
T1 - Effect of massive weight loss on inflammatory adipocytokines and the innate immune system in morbidly obese women
AU - Manco, Melania
AU - Fernandez-Real, J. Manuel
AU - Equitani, Francesco
AU - Vendrell, Joan
AU - Mora, Maria Elena Valera
AU - Nanni, Giuseppe
AU - Tondolo, Vincenzo
AU - Calvani, Menotti
AU - Ricart, Wilfredo
AU - Castagneto, Marco
AU - Mingrone, Geltrude
PY - 2007/2
Y1 - 2007/2
N2 - Context: Obesity may be regarded as a low-grade inflammatory state. Objective: The aim of this study was to evaluate changes in proinflammatory adipocytokines and the innate immune system, cardiovascular risk, and insulin sensitivity after massive weight loss. Design: This was a longitudinal study. Setting: The study was conducted at Catholic University, Rome. Subjects and Methods: There were 10 normoglucose-tolerant obese women evaluated before and 36 months after bilio-pancreatic diversion (BPD). Glucose sensitivity (M value) was estimated using the euglycemic-hyperinsulinemic clamp. Mannan-binding lectin (MBL), bactericidal/permeability increasing protein (BPI), α-defensins, soluble CD14 receptor (sCD14), C-reactive protein, adiponectin, leptin, visfatin, IL-6, and TNF-α were assayed. Results: After massive weight loss (53% of excess body weight), leptin (P le; 0.0001), IL-6 (P ≤ 0.0001), α-defensins (P ≤ 0.001), and C-reactive protein (P ≤ 0.0001) decreased significantly. Adiponectin increased significantly (P ≤ 0.001). Of the nine subjects who lost more than 20% of body mass index, sCD14 (2.87 ± 0.5 to 2.55 ± 0.5; P = 0.016) and visfatin levels (12.20 ± 0.93 to 10.63 ± 1.93 ng/ml; P = 0.045) decreased significantly. No significant changes were observed in TNF-α, BPI, or MBL. Insulin sensitivity more than doubled after BPD (P ≤ 0.0001). sCD14 changes were significantly associated with body mass index (r0 = 0.80; P = 0.003) and M changes (r0 = -0.59; P = 0.03). MBL correlated with insulin sensitivity in obese (r0 = 0.93; P = 0.0001) and post-BPD women (r0 = 0.66; P = 0.038). Adiponectin correlated negatively with cardiovascular risk (r0 = -0.709; P = 0.02) and IL-6 (r0 = -0.634; P = 0.05). Multiple linear regression analysis showed that changes in sCD14 were also significantly related to changes in insulin sensitivity. Conclusions: Surgically induced weight loss is capable of reversing low-grade inflammation, at least partially. The relationships between sCD14, MBL, BPI, and glucose sensitivity, and the role of TNF-α in obesity warrant further investigation.
AB - Context: Obesity may be regarded as a low-grade inflammatory state. Objective: The aim of this study was to evaluate changes in proinflammatory adipocytokines and the innate immune system, cardiovascular risk, and insulin sensitivity after massive weight loss. Design: This was a longitudinal study. Setting: The study was conducted at Catholic University, Rome. Subjects and Methods: There were 10 normoglucose-tolerant obese women evaluated before and 36 months after bilio-pancreatic diversion (BPD). Glucose sensitivity (M value) was estimated using the euglycemic-hyperinsulinemic clamp. Mannan-binding lectin (MBL), bactericidal/permeability increasing protein (BPI), α-defensins, soluble CD14 receptor (sCD14), C-reactive protein, adiponectin, leptin, visfatin, IL-6, and TNF-α were assayed. Results: After massive weight loss (53% of excess body weight), leptin (P le; 0.0001), IL-6 (P ≤ 0.0001), α-defensins (P ≤ 0.001), and C-reactive protein (P ≤ 0.0001) decreased significantly. Adiponectin increased significantly (P ≤ 0.001). Of the nine subjects who lost more than 20% of body mass index, sCD14 (2.87 ± 0.5 to 2.55 ± 0.5; P = 0.016) and visfatin levels (12.20 ± 0.93 to 10.63 ± 1.93 ng/ml; P = 0.045) decreased significantly. No significant changes were observed in TNF-α, BPI, or MBL. Insulin sensitivity more than doubled after BPD (P ≤ 0.0001). sCD14 changes were significantly associated with body mass index (r0 = 0.80; P = 0.003) and M changes (r0 = -0.59; P = 0.03). MBL correlated with insulin sensitivity in obese (r0 = 0.93; P = 0.0001) and post-BPD women (r0 = 0.66; P = 0.038). Adiponectin correlated negatively with cardiovascular risk (r0 = -0.709; P = 0.02) and IL-6 (r0 = -0.634; P = 0.05). Multiple linear regression analysis showed that changes in sCD14 were also significantly related to changes in insulin sensitivity. Conclusions: Surgically induced weight loss is capable of reversing low-grade inflammation, at least partially. The relationships between sCD14, MBL, BPI, and glucose sensitivity, and the role of TNF-α in obesity warrant further investigation.
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U2 - 10.1210/jc.2006-0960
DO - 10.1210/jc.2006-0960
M3 - Article
C2 - 17105839
AN - SCOPUS:33846941566
VL - 92
SP - 483
EP - 490
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 2
ER -