Effect of Massive Weight Loss on Inflammatory Adipocytokines and the Innate Immune System in Morbidly Obese Women

Melania Manco, J. Manuel Fernandez-Real, Francesco Equitani, Joan Vendrell, Maria Elena Valera Mora, Giuseppe Nanni, Vincenzo Tondolo, Menotti Calvani, Wilfredo Ricart, Marco Castagneto, Geltrude Mingrone
2007 Journal of Clinical Endocrinology and Metabolism  
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
more » ... reatic diversion (BPD). Glucose sensitivity (M value) was estimated using the euglycemic-hyperinsulinemic clamp. Mannan-binding lectin (MBL), bactericidal/permeability increasing protein (BPI), ␣-defensins, soluble CD14 receptor (sCD14), C-reactive protein, adiponectin, leptin, visfatin, IL-6, and TNF-␣ were assayed. Results: After massive weight loss (53% of excess body weight), leptin (P Յ 0.0001), IL-6 (P Յ 0.0001), ␣-defensins (P Յ 0.001), and C-re-active protein (P Յ 0.0001) decreased significantly. Adiponectin increased significantly (P Յ 0.001). Of the nine subjects who lost more than 20% of body mass index, sCD14 (2.87 Ϯ 0.5 to 2.55 Ϯ 0.5; P ϭ 0.016) and visfatin levels (12.20 Ϯ 0.93 to 10.63 Ϯ 1.93 ng/ml; P ϭ 0.045) decreased significantly. No significant changes were observed in TNF-␣, BPI, or MBL. Insulin sensitivity more than doubled after BPD (P Յ 0.0001). sCD14 changes were significantly associated with body mass index (r 0 ϭ 0.80; P ϭ 0.003) and M changes (r 0 ϭ Ϫ0.59; P ϭ 0.03). MBL correlated with insulin sensitivity in obese (r 0 ϭ 0.93; P ϭ 0.0001) and post-BPD women (r 0 ϭ 0.66; P ϭ 0.038). Adiponectin correlated negatively with cardiovascular risk (r 0 ϭ Ϫ0.709; P ϭ 0.02) and IL-6 (r 0 ϭ Ϫ0.634; P ϭ 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-␣ in obesity warrant further investigation. (J Clin Endocrinol Metab 92: [483][484][485][486][487][488][489][490] 2007)
doi:10.1210/jc.2006-0960 pmid:17105839 fatcat:o66zs22oovgyrl4jwfc6uw6s64