Schernthaner Gerit-Holger, Kopp Hans-Peter, Kriwanek Stefan, Krzyzanowska Katarzyna, Satler Miriam, Koppensteiner Renate, Schernthaner Guntram
Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Vienna, Austria.
Obes Surg. 2006 Jun;16(6):709-15. doi: 10.1381/096089206777346763.
Morbid obesity is associated with insulin resistance (IR), chronic inflammation and premature atherosclerosis. Since vascular inflammation may contribute to the increased risk of cardiovascular morbidity and mortality of these patients, we studied circulating Interleukin-18 (L-18) and monocyte-chemoattractant-protein-1 (MCP-1) levels in 37 patients with morbid obesity before and after significant weight loss induced by bariatric surgery and their preoperative and postoperative associations with C-reactive protein (CRP) and IR-associated factors.
High sensitivity assays were used to measure concentrations of fasting CRP, IL-18 and MCP-1. Differences between patients before and after bariatric surgery were analyzed by Student's paired t-test. To investigate the associations of the observed reductions of values, delta of parameters were calculated and preoperative, postoperative and delta data were tested by univariate and multivariate linear regression.
After a mean follow-up period of 26.5 months and a massive weight loss of 35 kg induced by bariatric surgery, circulating IL-18 levels decreased by 37% (P<0.001) and circulating MCP-1 levels by 47% (P<0.001). Multiple linear regression of delta values of IL-18 showed that only 2-hour glucose (P=0.008) remained independently and significantly associated with IL-18, whereas multiple linear regression analysis of delta values of MCP-1 revealed that only delta of HOMA-IR (P<0.001) remained independently and significantly associated with MCP-1, respectively.
Because both biomarkers have been shown to play an important role in the development and progression of atherosclerosis, the observations presented in this study could be of clinical relevance for morbidly obese patients undergoing bariatric surgery.
病态肥胖与胰岛素抵抗（IR）、慢性炎症和过早发生的动脉粥样硬化相关。由于血管炎症可能导致这些患者心血管疾病发病率和死亡率增加，我们研究了37例病态肥胖患者在接受减肥手术后显著体重减轻前后循环白细胞介素-18（IL-18）和单核细胞趋化蛋白-1（MCP-1）水平，以及它们术前和术后与C反应蛋白（CRP）和IR相关因素的关联。
采用高灵敏度检测法测量空腹CRP、IL-18和MCP-1的浓度。通过学生配对t检验分析减肥手术前后患者的差异。为了研究观察到的值的降低之间的关联，计算参数的变化量，并通过单变量和多变量线性回归对术前、术后和变化量数据进行测试。
在平均26.5个月的随访期以及减肥手术导致体重大幅减轻35 kg后，循环IL-18水平下降了37%（P<0.001），循环MCP-1水平下降了47%（P<0.001）。IL-18变化量的多变量线性回归显示，只有2小时血糖（P=0.008）与IL-18保持独立且显著相关，而MCP-1变化量的多变量线性回归分析显示，只有HOMA-IR的变化量（P<0.001）分别与MCP-1保持独立且显著相关。
由于这两种生物标志物已被证明在动脉粥样硬化的发生和发展中起重要作用，本研究中的观察结果可能对接受减肥手术的病态肥胖患者具有临床意义。
