Campello Elena, Zabeo Eva, Radu Claudia M, Spiezia Luca, Foletto Mirto, Prevedello Luca, Gavasso Sabrina, Bulato Cristiana, Vettor Roberto, Simioni Paolo
Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine (DIMED), University of Padua, Via Ospedale Civile 105, 35100, Padua, Italy.
Week Surgery, Bariatric Unit, University of Padua, Padua, Italy.
Intern Emerg Med. 2016 Aug;11(5):695-702. doi: 10.1007/s11739-016-1397-7. Epub 2016 Feb 2.
A definitive relationship between adiposity and MP production is yet to be demonstrated. The aim of our study was to prospectively evaluate the levels of microparticles (MP) in a group of 20 III degree obese patients before and after weight loss. Plasma levels of annexin V-MP, endothelial-derived MP, platelet-derived MP (CD61+ and P-Selectin+), leukocyte-derived MP, tissue factor-bearing (TF+) and CD36+MP were prospectively measured in 20 patients with III degree obesity (BMI ≥ 40 kg/m(2)) before (T0) and 3 (T3) and 12 (T12) months after sleeve gastrectomy (SLG). Obese patients had lost 18 % of their body weight at T3 and 41 % at T12. We find that considering all MP, except for endothelial-derived MP, which had significantly decreased at T3, all MP subtypes had significantly decreased at T12. At T12, subjects showed a higher median level of all types of MP, except endothelial-derived MP, compared to T3, but without a statistically significant difference. The percentages of reduction of all the MP were significantly correlated with the percentage of reduction of BMI. The reductions of leukocyte-derived, TF+ and CD36+MP were significantly correlated with the reduction of leptin. Moreover, the reductions of leukocyte-derived and CD36+MP were significantly correlated with hs-CRP decrease. The decrease of BMI post-SLG in morbid obesity was matched with a decrease of circulating MP of endothelial, platelet, leukocyte origin, TF+ and CD36+. A trend of slight increase in all MP subtypes, except endothelial-derived, was detected 12 months after gastrectomy, indicating a possible underlying slow low-grade inflammatory/hypercoagulability state from adipose tissue before the potential overt weight gain.
肥胖与微颗粒(MP)产生之间的确切关系尚待证实。我们研究的目的是前瞻性评估一组20例III度肥胖患者在减肥前后的微颗粒(MP)水平。对20例III度肥胖患者(BMI≥40kg/m²)在袖状胃切除术(SLG)前(T0)、术后3个月(T3)和12个月(T12)前瞻性测量血浆中膜联蛋白V-MP、内皮源性MP、血小板源性MP(CD61+和P-选择素+)、白细胞源性MP、组织因子携带型(TF+)和CD36+MP的水平。肥胖患者在T3时体重减轻了18%,在T12时体重减轻了41%。我们发现,除内皮源性MP在T3时显著下降外,考虑所有MP时,所有MP亚型在T12时均显著下降。在T12时,与T3相比,除内皮源性MP外,所有类型MP的受试者中位数水平更高,但无统计学显著差异。所有MP的降低百分比与BMI的降低百分比显著相关。白细胞源性、TF+和CD36+MP的降低与瘦素的降低显著相关。此外,白细胞源性和CD36+MP的降低与hs-CRP的降低显著相关。病态肥胖患者SLG后BMI的降低与内皮、血小板、白细胞来源、TF+和CD36+循环MP的降低相匹配。胃切除术后12个月,除内皮源性外,所有MP亚型均有轻微增加趋势,表明在潜在明显体重增加之前,脂肪组织可能存在潜在的缓慢低度炎症/高凝状态。