Solá Eva, Jover Ana, López-Ruiz Antonio, Jarabo María, Vayá Amparo, Morillas Carlos, Gómez-Balaguer Marcelino, Hernández-Mijares Antonio
Endocrinology Service, Doctor Peset University Hospital, Av. Gaspar Aguilar 90, 46017, Valencia, Spain.
Obes Surg. 2009 May;19(5):571-6. doi: 10.1007/s11695-008-9772-8. Epub 2008 Dec 3.
Obesity has been associated with a chronic activation of the acute-phase response. The aims of our study were to investigate whether levels of inflammatory cytokines are higher in obese patients, to evaluate their relationship with metabolic syndrome, and to analyze the effect of moderate weight loss upon their levels.
Sixty-seven severe or morbid obese patients were compared with 67 controls. Patients were submitted to a 4-week very low calorie diet followed by a low calorie diet for 2 months. Exclusion criteria were organic disease, ischemic heart disease or stroke, diabetes mellitus, hyperlipidemia, and hypertension. An evaluation was performed before and after the diet, in which fibrinogen, blood count, high-sensitive C-reactive protein (CRP), interleukin 6 (IL-6), and tumoral necrosis factor alpha (TNF-alpha) were measured. The Student t test was employed to compare differences between the groups and Pearson correlation coefficients were calculated.
Obese patients showed higher levels of CRP (P < 0.001), IL-6 (P < 0.001), TNF-alpha (P < 0.001), leukocyte (P = 0.001), and neutrophil count (P < 0.001) than controls. In obese patients, inflammatory parameters were significantly correlated with anthropometric parameters and did not differ between obese subjects with or without metabolic syndrome. Moderate weight loss (excess weight loss 19.6%) was achieved through dieting, but no change was observed in any inflammatory parameter.
Obesity is associated to a chronic inflammatory state that seems to be due to an increased secretion of cytokines, and this state is not related to the presence of metabolic syndrome. Moderate weight loss does not ameliorate this inflammatory state in the short term.
肥胖与急性期反应的慢性激活有关。我们研究的目的是调查肥胖患者体内炎症细胞因子水平是否更高，评估它们与代谢综合征的关系，并分析适度体重减轻对其水平的影响。
将67例重度或病态肥胖患者与67例对照者进行比较。患者先接受为期4周的极低热量饮食，随后接受为期2个月的低热量饮食。排除标准为器质性疾病、缺血性心脏病或中风、糖尿病、高脂血症和高血压。在饮食前后进行评估，测量纤维蛋白原、血细胞计数、高敏C反应蛋白（CRP）、白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）。采用Student t检验比较组间差异，并计算Pearson相关系数。
肥胖患者的CRP（P < 0.001）、IL-6（P < 0.001）、TNF-α（P < 0.001）、白细胞（P = 0.001）和中性粒细胞计数（P < 0.001）水平高于对照组。在肥胖患者中，炎症参数与人体测量参数显著相关，且在有或无代谢综合征的肥胖受试者之间无差异。通过节食实现了适度体重减轻（超重减轻19.6%），但未观察到任何炎症参数的变化。
肥胖与一种慢性炎症状态相关，这种状态似乎是由于细胞因子分泌增加所致，且这种状态与代谢综合征的存在无关。短期内适度体重减轻并不能改善这种炎症状态。
