Division of Gastroenterology EndogastroRio Clinic, 43/1101, Siqueira Campos Street, Rio de Janeiro, RJ, 22031-901, Brazil.
Post Graduation Program in Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Obes Surg. 2019 Aug;29(8):2600-2608. doi: 10.1007/s11695-019-03891-8.
Obesity is accompanied by adipose tissue remodeling characterized by increased production of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, leptin and resistin and reduced secretion of adiponectin, which favors inflammation, metabolic disorders, and cardiovascular diseases. Although intragastric balloon (IGB) can be considered safe and effective for weight loss, its effect on serum levels of these biomarkers has been evaluated only in a few studies, while no previous study evaluated its effect on circulating levels of resistin, TNF-α, and IL-6. The aim of this study was to evaluate the changes in serum levels of metabolic and inflammatory biomarkers in obese patients submitted to IGB treatment.
A prospective observational study involving 42 patients with obesity using IGB for 6 months. The patients were evaluated, on the day of insertion and withdrawal or adjustment of IGB, for the following: anthropometric measures and serum levels of adiponectin, leptin, resistin, TNF-α, IL-6, high-sensitivity C-reactive protein (hs-CRP), glucose, insulin, uric acid, triglycerides, and total cholesterol and fractions.
The body mass index decreased from 35.15 ± 0.41 to 29.50 ± 0.54 kg/m. There was a reduction (p < 0.05) in leptin, hs-CRP, glucose, insulin, HOMA-IR, and triglycerides, while the adiponectin/leptin ratio increased (p < 0.05). Moreover, weight loss presented (1) a positive association with the decrease in leptin, hs-CRP, glucose, insulin, HOMA-IR, uric acid, and total cholesterol and (2) a negative association with the reduction in adiponectin/leptin ratio.
The present study suggests that 6 months of IGB treatment in obese individuals reduce serum leptin and hs-CRP and improves insulin resistance and lipid profile which may decrease cardiovascular risk.
肥胖伴有脂肪组织重塑，其特征是肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-6、瘦素和抵抗素的产生增加，而脂联素的分泌减少，这有利于炎症、代谢紊乱和心血管疾病。虽然胃内球囊（IGB）可被认为是安全有效的减肥方法，但仅有少数研究评估了其对这些生物标志物血清水平的影响，而以前没有研究评估过它对抵抗素、TNF-α和 IL-6 循环水平的影响。本研究旨在评估肥胖患者接受 IGB 治疗后代谢和炎症生物标志物血清水平的变化。
一项前瞻性观察性研究，共纳入 42 例肥胖患者，使用 IGB 治疗 6 个月。患者在插入和取出或调整 IGB 当天接受以下评估：人体测量学指标和血清脂联素、瘦素、抵抗素、TNF-α、IL-6、高敏 C 反应蛋白（hs-CRP）、血糖、胰岛素、尿酸、甘油三酯和总胆固醇及各组分水平。
体重指数从 35.15±0.41kg/m2 降至 29.50±0.54kg/m2。瘦素、hs-CRP、血糖、胰岛素、HOMA-IR 和甘油三酯降低（p<0.05），而脂联素/瘦素比值升高（p<0.05）。此外，体重减轻与瘦素、hs-CRP、血糖、胰岛素、HOMA-IR、尿酸和总胆固醇降低呈正相关，与脂联素/瘦素比值降低呈负相关。
本研究表明，肥胖患者接受 6 个月的 IGB 治疗可降低血清瘦素和 hs-CRP，改善胰岛素抵抗和血脂谱，从而降低心血管风险。
