Clinical and adipocytokine changes after bariatric surgery in morbidly obese women

Authors

  • Teresa Auguet,

    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    2. Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
    Search for more papers by this author
  • Ximena Terra,

    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    Search for more papers by this author
  • Mercè Hernández,

    1. Servei de Cirurgia, Hospital Sant Joan de Reus, Tarragona, Spain
    Search for more papers by this author
  • Fàtima Sabench,

    1. Servei de Cirurgia, Hospital Sant Joan de Reus, Tarragona, Spain
    Search for more papers by this author
  • Jose Antonio Porras,

    1. Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
    Search for more papers by this author
  • Josep Maria Orellana-Gavaldà,

    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    Search for more papers by this author
  • Jordi Llutart,

    1. Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
    Search for more papers by this author
  • Esther Guiu-Jurado,

    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    Search for more papers by this author
  • Alba Berlanga,

    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    Search for more papers by this author
  • Salomé Martinez,

    1. Servei Anatomia Patològica, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
    Search for more papers by this author
  • Carmen Aguilar,

    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    Search for more papers by this author
  • Daniel Del Castillo,

    1. Servei de Cirurgia, Hospital Sant Joan de Reus, Tarragona, Spain
    Search for more papers by this author
  • Cristóbal Richart

    Corresponding author
    1. Grup d'Estudi de Malalties Metabòliques Associades a Insulin Resistència (GEMMAIR), Departament de Medicina i Cirurgia, Universitat Rovira i Virgili (URV), Tarragona, Spain
    2. Servei Medicina Interna, Hospital Universitari Joan XXIII Tarragona, Tarragona, Spain
    Search for more papers by this author

  • Funding agencies: Ministerio de Ciencia e Innovación of the government of Spain (grant number SAF 2008-02278, to C.R.), the Fondo de Investigación Sanitaria (grant number PS09/01778, to T.A.), Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR 2009 SGR 959 to C.R.), Grup de Recerca en Medicina Aplicada URV (2010PFR-URV-B2-14 to C.R.), Fundación Biociencia.

  • Disclosures: The authors have no conflict of interests to declare.

Abstract

Objective

Recent studies report the effect of bariatric surgery on glycaemia control and prevention of type-2-diabetes in obese patients. This study is about the pathophysiological mechanisms associated to these changes.

Design and Methods

Circulating levels of receptors of tumor necrosis factor (TNF-RI, TNF-RII), visfatin, high molecular weight (HMW) adiponectin, and C reactive protein (CRP) in 30 morbidly obese women (body mass index, BMI>40 kg/m2) and 60 normal-weight controls (BMI>25 kg/m2) were analyzed. Morbidly obese were studied at three time-points: before surgery (baseline), and 6 and 12 months after.

Results

After surgery, the levels of TNF-RI, TNF-RII, visfatin, and CRP were significantly lower than its baseline levels, whereas HMW adiponectin was higher. Fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA2-IR) levels were markedly lower postoperatively. High density lipoproteins (HDL) moderately increased, and triglyceride levels had sharply decreased. The study of the predictive value of variables indicated that preoperative levels of TNF-RI and visfatin correlated positively with levels of glucose, insulin, glycosylated hemoglobin A1c, and HOMA2-IR postoperatively, whereas adiponectin levels correlated negatively. Baseline CRP levels negatively linked to HDL and TNF-RII positively to triglyceride.

Conclusions

The preoperative profile with high levels of proinflammatory adipocytokines is linked to smaller improvements in glucose homeostasis and lipid factors. The use of a range of biomarkers may predict the level of metabolic changes following bariatric surgery.

Ancillary