Diabetes Program, Garvan Institute of Medical Research, Darlinghurst, Australia.
Diab Vasc Dis Res. 2013 Jan;10(1):40-8. doi: 10.1177/1479164112443375. Epub 2012 Apr 25.
Weight loss after bariatric surgery reduces cardiac risk and morbidity. We examined weight loss effects on arterial stiffness in morbidly obese subjects, in relation to cytokines, circulating and subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)-based immune cells and gene expression. Obese subjects with type 2 diabetes mellitus (T2D) or impaired glucose tolerance (n = 14, mean ± SEM body mass index 42.9 kg/m(2)) underwent 24 weeks' caloric restriction, with gastric banding at 12 weeks. Measures were: arterial augmentation index (AIx), insulin resistance, circulating cytokines, immune cell activation markers, and SAT and VAT cytokine gene expression. Weight loss reduced AIx by 20% (p = 0.007), with falls in s-selectin (p = 0.001) and inter-cellular adhesion molecule (p = 0.04). Improved AIx related to reduced surface expression of the interleukin (IL)-2 receptor on T-lymphocytes (TL-IL2R) and granulocyte adhesion markers (r = 0.59, 0.64, respectively, p < 0.04). Higher VAT expression of interferon-γ and monocyte chemoattractant protein-1 associated with a blunted AIx response. A model of TL-IL2R expression, waist, weight and insulin resistance explained 73% of the variance in AIx reduction (p = 0.005). In morbidly obese dysglycaemic subjects, modest weight loss reduces arterial stiffness, the magnitude of which relates to improved markers of inflammation.
减重手术可降低心脏风险和发病率。我们研究了肥胖患者体重减轻对动脉僵硬的影响，涉及细胞因子、循环和皮下脂肪组织（SAT）和内脏脂肪组织（VAT）中的免疫细胞和基因表达。患有 2 型糖尿病（T2D）或糖耐量受损的肥胖患者（n = 14，平均 ± SEM 体重指数 42.9 kg/m²）接受了 24 周的热量限制，在 12 周时进行胃束带手术。测量指标包括：动脉增强指数（AIx）、胰岛素抵抗、循环细胞因子、免疫细胞激活标志物，以及 SAT 和 VAT 细胞因子基因表达。体重减轻使 AIx 降低了 20%（p = 0.007），s 选择素（p = 0.001）和细胞间黏附分子（p = 0.04）下降。AIx 的改善与 T 淋巴细胞（TL）上白细胞介素（IL）-2 受体和粒细胞黏附标志物的表面表达减少相关（r = 0.59、0.64，分别为 p < 0.04）。VAT 中干扰素-γ和单核细胞趋化蛋白-1 的表达与 AIx 反应迟钝相关。TL-IL2R 表达、腰围、体重和胰岛素抵抗的模型解释了 AIx 降低的 73%（p = 0.005）。在患有代谢紊乱的肥胖患者中，适度的体重减轻可降低动脉僵硬程度，其程度与改善的炎症标志物相关。
