Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Department of Endocrinology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu 225001, China.
Endocr J. 2019 Apr 25;66(4):337-347. doi: 10.1507/endocrj.EJ18-0446. Epub 2019 Feb 22.
Obesity is linked to a low-grade systemic inflammation and lipopolysaccharide (LPS) is a key factor. Sleeve gastrectomy (SG) can significantly cause weight loss, but few reports have looked into the changes of LPS and inflammatory cytokines after surgery. To explore the potential short-term impact of SG on LPS and inflammatory cytokines and their relationship to early metabolic changes in obesity. 30 Chinese adults with obesity (BMI 39.37 ± 8.22 kg/m, 25 female) receiving SG were included in this study. Fasting blood samples were collected at baseline and 30 days after SG. Serum LPS markedly reduced from 336.50 (73.54, 500) pg/mL to 5.00 (5.00, 5.24) pg/mL at 1 month after SG (p < 0.05). There was a significant decrease in plasma IL-6, IL-8, and serum CRP after SG (all p < 0.05). Insulin resistance improved remarkably after surgery as displayed by reductions in fasting insulin level (FINS, p < 0.001), and HOMA-IR (p < 0.001). In addition, visceral fat area (VFA) decreased from 209.70 ± 39.96 cm to 193.28 ± 43.68 cm after SG (p < 0.001). LPS was positively correlated with FINS (r = 0.391, p = 0.033) and HOMA-IR (r = 0.38, p = 0.038) before SG. Meanwhile, VFA was positively associated with CRP (r = 0.388, p = 0.034) before surgery. When assessing 30-days postoperative changes, a positive correlation was found between the variations of LPS, IL-8 and the reduction of VFA. After multivariate analyses, only the reduced IL-8 level was independently associated with the reduction of VFA (p = 0.015). In conclusion, SG can significantly relieve the inflammation in obesity in the short term and LPS might be an earlier predictor of inflammatory changes after surgery.
肥胖与低度全身炎症有关，脂多糖（LPS）是一个关键因素。袖状胃切除术（SG）可以显著减轻体重，但很少有报道研究手术后 LPS 和炎症细胞因子的变化。本研究旨在探讨 SG 对 LPS 和炎症细胞因子的潜在短期影响及其与肥胖早期代谢变化的关系。30 名中国肥胖成年人（BMI 39.37±8.22kg/m，25 名女性）接受了 SG，本研究纳入了这些患者。在基线和 SG 后 30 天采集空腹血样。SG 后 1 个月，血清 LPS 从 336.50（73.54，500）pg/mL 显著降低至 5.00（5.00，5.24）pg/mL（p<0.05）。SG 后血浆 IL-6、IL-8 和血清 CRP 显著下降（均 p<0.05）。SG 后空腹胰岛素水平（FINS，p<0.001）和 HOMA-IR（p<0.001）显著改善，提示胰岛素抵抗明显改善。此外，SG 后内脏脂肪面积（VFA）从 209.70±39.96cm 降至 193.28±43.68cm（p<0.001）。SG 前 LPS 与 FINS（r=0.391，p=0.033）和 HOMA-IR（r=0.38，p=0.038）呈正相关。同时，术前 VFA 与 CRP 呈正相关（r=0.388，p=0.034）。评估术后 30 天的变化时，发现 LPS、IL-8 的变化与 VFA 的减少呈正相关。多元分析后，仅 IL-8 水平的降低与 VFA 的减少独立相关（p=0.015）。总之，SG 可显著减轻肥胖患者的短期炎症，LPS 可能是术后炎症变化的早期预测因子。
