Sams Valerie G, Blackledge Camille, Wijayatunga Nadeeja, Barlow Patrick, Mancini Matthew, Mancini Gregory, Moustaid-Moussa Naima
Department of Surgery, University of Tennessee Medical Center, Knoxville, TN, USA.
San Antonio Military Medical Center, 26 Campedn Circle, San Antonio, TX, 78209, USA.
Surg Endosc. 2016 Aug;30(8):3499-504. doi: 10.1007/s00464-015-4638-3. Epub 2015 Oct 30.
Obese patients are predisposed to developing insulin resistance and associated metabolic diseases such as diabetes and cardiovascular disease. The objective of this study was to determine the effect of bariatric surgery on adipose-derived inflammatory cytokines (adipokines), which play a key role in insulin resistance and obesity. We hypothesized that there is a significant increase in serum and tissue anti-inflammatory adiponectin with a decrease in circulating pro-inflammatory TNF-α and MCP-1, leading to reduced inflammation post-bariatric surgery.
In this study, we investigated the effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic gastric band on serum and tissue levels of adiponectin and serum levels of MCP-1 and TNF-α. Samples of serum and adipose tissue were collected at the time of surgery, 2 weeks and 6 months postoperatively. Adipokine levels were assayed by ELISA kits.
A significant increase in adiponectin levels 2 weeks after surgery was observed in the subcutaneous adipose tissue in both groups combined. Serum adiponectin in LRYGB patients showed an increasing trend, while MCP-1 showed a decreasing trend post-surgery. There was no difference in TNF-α among the groups. The number of patients enrolled did not allow for statistical power to be reached.
Our results show significant and rapid increases in subcutaneous adipose adiponectin as early as 2 weeks post-bariatric surgery demonstrating reduced inflammation and possibly reduced insulin resistance. Future studies are warranted in larger cohorts with additional measurements of insulin sensitivity and inflammation.
肥胖患者易患胰岛素抵抗及相关代谢疾病，如糖尿病和心血管疾病。本研究的目的是确定减肥手术对脂肪源性炎症细胞因子（脂肪因子）的影响，这些因子在胰岛素抵抗和肥胖中起关键作用。我们假设减肥手术后血清和组织中的抗炎性脂联素会显著增加，而循环中的促炎性肿瘤坏死因子-α（TNF-α）和单核细胞趋化蛋白-1（MCP-1）会减少，从而导致炎症减轻。
在本研究中，我们调查了腹腔镜Roux-en-Y胃旁路术（LRYGB）和腹腔镜胃束带术对脂联素的血清和组织水平以及MCP-1和TNF-α血清水平的影响。在手术时、术后2周和6个月采集血清和脂肪组织样本。使用酶联免疫吸附测定（ELISA）试剂盒检测脂肪因子水平。
两组患者皮下脂肪组织在术后2周时脂联素水平均显著升高。LRYGB患者术后血清脂联素呈上升趋势，而MCP-1呈下降趋势。各组间TNF-α无差异。入组患者数量未达到统计学效力。
我们的结果显示，减肥手术后仅2周，皮下脂肪组织中的脂联素就显著且迅速增加，这表明炎症减轻，胰岛素抵抗可能也有所降低。未来有必要在更大的队列中进行进一步研究，并额外测量胰岛素敏感性和炎症指标。
