Bariatric Surgery Unit, Department of Surgery, General University Hospital Elche, Alicante, Spain.
Obes Surg. 2013 Jun;23(6):764-9. doi: 10.1007/s11695-013-0865-7.
C-Reactive protein (CRP) has been associated with the macro- and microvascular effects of hypertension and diabetes mellitus. Referring to serum cortisol, it has been proposed to contribute to the pathogenesis of metabolic syndrome, and it has been demonstrated that weight loss normalizes cortisol levels and improves insulin resistance. The aims of this study were to analyze CRP and cortisol levels pre- and postoperatively in morbidly obese patients undergoing a laparoscopic sleeve gastrectomy and to correlate them with weight loss and parameters associated with cardiovascular risk.
A prospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and May 2011 was performed.
A total of 40 patients were included in the study. CRP levels decreased significantly 12 months after surgery (median reduction of 8.9 mg/l; p = 0.001). Serum cortisol levels decreased significantly 6 months after surgery (median reduction of 34.9 μg/dl; p = 0.001). CRP values reached the normal range (<5 mg/l) 1 year after surgery. Referring to cortisol, a significant association was observed with the cardiovascular risk predictor (triglyceride/high-density lipoprotein cholesterol ratio) from the 6th month after surgery onward (Pearson correlation coefficient, 0.559; p = 0.008).
CRP levels are increased preoperatively and in the postoperative course up to 1 year after surgery. Serum cortisol levels remain elevated until the 6th month after surgery. From this moment onward, serum cortisol is associated with the cardiovascular risk predictor reflecting the cardiovascular risk decreasement during the weight loss.
C 反应蛋白（CRP）与高血压和糖尿病的大血管和微血管效应有关。关于血清皮质醇，它被认为有助于代谢综合征的发病机制，并且已经证明体重减轻可以使皮质醇水平正常化并改善胰岛素抵抗。本研究的目的是分析接受腹腔镜袖状胃切除术的病态肥胖患者术前和术后的 CRP 和皮质醇水平，并将其与体重减轻和与心血管风险相关的参数相关联。
对 2007 年 10 月至 2011 年 5 月期间接受腹腔镜袖状胃切除术作为减肥手术的所有病态肥胖患者进行了前瞻性研究。
共纳入 40 例患者。术后 12 个月 CRP 水平显著降低（中位数降低 8.9mg/l；p=0.001）。术后 6 个月血清皮质醇水平显著降低（中位数降低 34.9μg/dl；p=0.001）。术后 1 年 CRP 值达到正常范围（<5mg/l）。关于皮质醇，从术后 6 个月开始观察到与心血管风险预测因子（甘油三酯/高密度脂蛋白胆固醇比值）有显著相关性（皮尔逊相关系数为 0.559；p=0.008）。
术前和术后 CRP 水平升高，术后 1 年内持续升高。血清皮质醇水平在术后 6 个月内仍保持升高。从这一刻起，血清皮质醇与心血管风险预测因子相关，反映了减肥期间心血管风险的降低。
