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Effects of Roux-en-Y gastric bypass on fasting and postprandial inflammation-related parameters in obese subjects with normal glucose tolerance and in obese subjects with type 2 diabetes.

Lindegaard KK, Jorgensen NB, Just R, Heegaard PM, Madsbad S - Diabetol Metab Syndr (2015)

Bottom Line: One week after surgery, circulating IL-6 and IL-8 were increased, while adiponectin and leptin were reduced compared with pre-surgical concentrations.One year after surgery, concentrations of IL-6, TGF-β, and leptin were significantly reduced compared to before surgery, while adiponectin was significantly increased.One year after RYGB, fasting concentrations of IL-6 and leptin were reduced, while no changes were observed in IL-8.

View Article: PubMed Central - PubMed

Affiliation: Zealand Pharma A/S, Smedeland 36, 2600 Glostrup, Denmark ; Innate Immunology Group, The National Veterinary Institute, DTU, 1870 Frederiksberg, Denmark.

ABSTRACT

Background: Obesity is characterized by low grade inflammation and an altered secretion of inflammatory cytokines from the adipose tissue. Weight loss has shown to reduce inflammation; however, changes in cytokine profiles during massive weight loss are not well described. The present study explored the hypothesis that Roux-en-Y gastric bypass (RYGB) reduces circulating levels of pro-inflammatory cytokines, while increasing anti-inflammatory cytokines in obese subjects with type 2 diabetes (T2D) and in obese normal glucose tolerant (NGT) subjects.

Methods: Thirteen obese subjects with T2D [weight; 129 ± 14 kg, glycated hemoglobin (HbA1c); 7.0 ± 0.9%, body mass index (BMI); 43.2 ± 5.3 kg/m(2), mean ± SD] and twelve matched obese NGT subjects [weight; 127 ± 15 kg, HbA1c; 5.5 ± 0.4%, BMI; 41.5 ± 4.8 kg/m(2), mean ± SD] were examined before, one week, three months, and one year after surgery. Interleukin (IL)-6, leptin, adiponectin, IL-8, transforming growth factor beta (TGF-β), and the incretin hormone glucagon-like peptide-1 (GLP-1) were measured in the fasting state and during a liquid meal. Insulin resistance was evaluated by HOMA-IR.

Results: Weight loss did not differ between the two groups. Before surgery, HbA1c was higher and HOMA-IR lower in T2D patients, however, converged to the values of NGT subjects one year after surgery. Circulating cytokine concentrations did not differ between the two groups at any time point. One week after surgery, circulating IL-6 and IL-8 were increased, while adiponectin and leptin were reduced compared with pre-surgical concentrations. Three months after surgery, IL-8 was increased, leptin was reduced, and no change was observed for IL-6, TGF-β, and adiponectin. One year after surgery, concentrations of IL-6, TGF-β, and leptin were significantly reduced compared to before surgery, while adiponectin was significantly increased.

Conclusions: One year after RYGB, fasting concentrations of IL-6 and leptin were reduced, while no changes were observed in IL-8. TGF-β was decreased and adiponectin increased in both T2D and NGT obese subjects. This study is the first to examine IL-8 and TGF-β in obese subject after RYGB. Resolution of inflammation could offer a potential explanation for the health improvement associated with major weight loss after bariatric surgery.

Trial registration: http://www.clinicaltrials.gov (NCT01579981).

No MeSH data available.


Related in: MedlinePlus

Trial profile. Numbers of subjects initially enrolled are depicted and subject disposition (number of T2D vs NGT subjects, subjects who were excluded or withdrawn, and subjects who were lost to follow up) is described.
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Fig1: Trial profile. Numbers of subjects initially enrolled are depicted and subject disposition (number of T2D vs NGT subjects, subjects who were excluded or withdrawn, and subjects who were lost to follow up) is described.

Mentions: Overview of enrolled patients is depicted in Figure 1. A total number of 30 patients were included in the study of which two were not operated and three subjects did not wish to participate following surgery. One subject with T2D could not be studied one week after RYGB because of anemia. One NGT subject was excluded from the three-month follow-up data set, due to excessively high fasting insulin and C-peptide concentrations, indicating a non-fasting state. One NGT subject was not examined at the one-year follow-up due to pregnancy (Figure 1). Before surgery, twelve subjects with T2D were treated with ≥ 1 oral antidiabetic medication, and one subject was diet-treated only. After RYGB, none of the T2D patients received any anti-diabetic medication.Figure 1


Effects of Roux-en-Y gastric bypass on fasting and postprandial inflammation-related parameters in obese subjects with normal glucose tolerance and in obese subjects with type 2 diabetes.

Lindegaard KK, Jorgensen NB, Just R, Heegaard PM, Madsbad S - Diabetol Metab Syndr (2015)

Trial profile. Numbers of subjects initially enrolled are depicted and subject disposition (number of T2D vs NGT subjects, subjects who were excluded or withdrawn, and subjects who were lost to follow up) is described.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4355543&req=5

Fig1: Trial profile. Numbers of subjects initially enrolled are depicted and subject disposition (number of T2D vs NGT subjects, subjects who were excluded or withdrawn, and subjects who were lost to follow up) is described.
Mentions: Overview of enrolled patients is depicted in Figure 1. A total number of 30 patients were included in the study of which two were not operated and three subjects did not wish to participate following surgery. One subject with T2D could not be studied one week after RYGB because of anemia. One NGT subject was excluded from the three-month follow-up data set, due to excessively high fasting insulin and C-peptide concentrations, indicating a non-fasting state. One NGT subject was not examined at the one-year follow-up due to pregnancy (Figure 1). Before surgery, twelve subjects with T2D were treated with ≥ 1 oral antidiabetic medication, and one subject was diet-treated only. After RYGB, none of the T2D patients received any anti-diabetic medication.Figure 1

Bottom Line: One week after surgery, circulating IL-6 and IL-8 were increased, while adiponectin and leptin were reduced compared with pre-surgical concentrations.One year after surgery, concentrations of IL-6, TGF-β, and leptin were significantly reduced compared to before surgery, while adiponectin was significantly increased.One year after RYGB, fasting concentrations of IL-6 and leptin were reduced, while no changes were observed in IL-8.

View Article: PubMed Central - PubMed

Affiliation: Zealand Pharma A/S, Smedeland 36, 2600 Glostrup, Denmark ; Innate Immunology Group, The National Veterinary Institute, DTU, 1870 Frederiksberg, Denmark.

ABSTRACT

Background: Obesity is characterized by low grade inflammation and an altered secretion of inflammatory cytokines from the adipose tissue. Weight loss has shown to reduce inflammation; however, changes in cytokine profiles during massive weight loss are not well described. The present study explored the hypothesis that Roux-en-Y gastric bypass (RYGB) reduces circulating levels of pro-inflammatory cytokines, while increasing anti-inflammatory cytokines in obese subjects with type 2 diabetes (T2D) and in obese normal glucose tolerant (NGT) subjects.

Methods: Thirteen obese subjects with T2D [weight; 129 ± 14 kg, glycated hemoglobin (HbA1c); 7.0 ± 0.9%, body mass index (BMI); 43.2 ± 5.3 kg/m(2), mean ± SD] and twelve matched obese NGT subjects [weight; 127 ± 15 kg, HbA1c; 5.5 ± 0.4%, BMI; 41.5 ± 4.8 kg/m(2), mean ± SD] were examined before, one week, three months, and one year after surgery. Interleukin (IL)-6, leptin, adiponectin, IL-8, transforming growth factor beta (TGF-β), and the incretin hormone glucagon-like peptide-1 (GLP-1) were measured in the fasting state and during a liquid meal. Insulin resistance was evaluated by HOMA-IR.

Results: Weight loss did not differ between the two groups. Before surgery, HbA1c was higher and HOMA-IR lower in T2D patients, however, converged to the values of NGT subjects one year after surgery. Circulating cytokine concentrations did not differ between the two groups at any time point. One week after surgery, circulating IL-6 and IL-8 were increased, while adiponectin and leptin were reduced compared with pre-surgical concentrations. Three months after surgery, IL-8 was increased, leptin was reduced, and no change was observed for IL-6, TGF-β, and adiponectin. One year after surgery, concentrations of IL-6, TGF-β, and leptin were significantly reduced compared to before surgery, while adiponectin was significantly increased.

Conclusions: One year after RYGB, fasting concentrations of IL-6 and leptin were reduced, while no changes were observed in IL-8. TGF-β was decreased and adiponectin increased in both T2D and NGT obese subjects. This study is the first to examine IL-8 and TGF-β in obese subject after RYGB. Resolution of inflammation could offer a potential explanation for the health improvement associated with major weight loss after bariatric surgery.

Trial registration: http://www.clinicaltrials.gov (NCT01579981).

No MeSH data available.


Related in: MedlinePlus