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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

Postprandial cytokine and GLP-1 response in the whole study population. Postprandial response of (a) IL-6, (b) adiponectin, (c) leptin, and (d) GLP-1 in the whole study population before (Pre-RYGB) (N = 21), one week (N = 20), three months (N = 20), and one year (N = 20) after Roux-en-Y gastric bypass in the whole study population. Data are presented as mean ± SEM.
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Fig3: Postprandial cytokine and GLP-1 response in the whole study population. Postprandial response of (a) IL-6, (b) adiponectin, (c) leptin, and (d) GLP-1 in the whole study population before (Pre-RYGB) (N = 21), one week (N = 20), three months (N = 20), and one year (N = 20) after Roux-en-Y gastric bypass in the whole study population. Data are presented as mean ± SEM.

Mentions: The postprandial responses of cytokines and GLP-1 are presented in Figure 3a-d and depicted as total AUC in Table 3. Total AUC for the different cytokines in T2D patients and NGT subjects did not differ significantly at any study time-point and the two groups will be analyzed as one group. An increase in total AUC for IL-6 was observed one week after surgery followed by a decrease to preoperative response levels after three months and after one year (Figure 3a). Total AUC for adiponectin was significantly increased one year after surgery compared with both before, one week, and three months after surgery (P < 0.0001) (Figure 3b). At all post-operative follow-ups, a significant reduction in leptin was observed with no significant differences between the responses after surgery (Figure 3c) (P < 0.0001). Postprandial GLP-1 responses were markedly increased at all three post-surgical follow-ups (Figure 3d) (P < 0.0001). Correlation analysis revealed no associations between the postprandial GLP-1 response and postprandial inflammatory cytokine responses before or after RYGB surgery (data not shown).Figure 3


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)

Postprandial cytokine and GLP-1 response in the whole study population. Postprandial response of (a) IL-6, (b) adiponectin, (c) leptin, and (d) GLP-1 in the whole study population before (Pre-RYGB) (N = 21), one week (N = 20), three months (N = 20), and one year (N = 20) after Roux-en-Y gastric bypass in the whole study population. Data are presented as mean ± SEM.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Postprandial cytokine and GLP-1 response in the whole study population. Postprandial response of (a) IL-6, (b) adiponectin, (c) leptin, and (d) GLP-1 in the whole study population before (Pre-RYGB) (N = 21), one week (N = 20), three months (N = 20), and one year (N = 20) after Roux-en-Y gastric bypass in the whole study population. Data are presented as mean ± SEM.
Mentions: The postprandial responses of cytokines and GLP-1 are presented in Figure 3a-d and depicted as total AUC in Table 3. Total AUC for the different cytokines in T2D patients and NGT subjects did not differ significantly at any study time-point and the two groups will be analyzed as one group. An increase in total AUC for IL-6 was observed one week after surgery followed by a decrease to preoperative response levels after three months and after one year (Figure 3a). Total AUC for adiponectin was significantly increased one year after surgery compared with both before, one week, and three months after surgery (P < 0.0001) (Figure 3b). At all post-operative follow-ups, a significant reduction in leptin was observed with no significant differences between the responses after surgery (Figure 3c) (P < 0.0001). Postprandial GLP-1 responses were markedly increased at all three post-surgical follow-ups (Figure 3d) (P < 0.0001). Correlation analysis revealed no associations between the postprandial GLP-1 response and postprandial inflammatory cytokine responses before or after RYGB surgery (data not shown).Figure 3

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