Sachan Astha, Singh Archna, Shukla Sakshi, Aggarwal Sandeep, Mir Ishfaq, Yadav Rakhee
Department of Biochemistry, 3rd Floor, Main Teaching Block, All India Institute of Medical Sciences, New Delhi, 110029, India.
Department of Surgical Disciplines, 1st Floor, CMET, All India Institute of Medical Sciences, New Delhi, 110029, India.
Metabol Open. 2021 Nov 1;13:100147. doi: 10.1016/j.metop.2021.100147. eCollection 2022 Mar.
Bariatric surgery has emerged as a promising treatment for improving adipose tissue dysfunction in obesity, but the mechanisms for such amelioration are still not known. This study comprehensively explores a panel of adipo-cytokines in individuals with obesity undergoing bariatric surgery, in conjunction with markers of insulin resistance, at three time points i.e., pre-op, immediate post-op and 6 months post-surgery.
It is a case-control prospective study among obese individuals undergoing bariatric surgery (BMI ≥35 kg/m2, n=30) and non-obese subjects (BMI <25 kg/m2, n=30), comparing the levels of serum adiponectin, resistin, C-Reactive Protein (CRP), Interleukin (IL)-6 and 8, Monocyte chemoattractant protein (MCP)-1 and Tumor necrosis factor (TNF)-α between them. The same were followed at immediate and 6-month post-op periods in the former group. The serum markers were correlated with the markers of Insulin resistance like HOMA-IR, HOMA-β and QUICKI.
A significant increase in adiponectin was seen after weight loss in obese group (17.54 ± 1.31 μg/mL at baseline vs 68.76 ± 1.84 μg/mL at 6- month post-surgery). CRP being an acute phase protein showed significant higher levels at immediate post-op period but declined even below its baseline at 6 months after surgery (33.34 ± 16.85 μg/mL at baseline vs 59.85 ± 23.12 μg/mL at immediate post-op vs 9.66 ± 1.84 μg/mL at 6 months post-operatively). Few inconsistencies were observed in the trajectories of IL-6 and TNF-α, while other pro-inflammatory markers indicated resolution after surgery.
Bariatric surgery alleviated the systemic inflammation, correlating with improved insulin resistance in individuals with obesity.
减肥手术已成为改善肥胖症患者脂肪组织功能障碍的一种有前景的治疗方法，但其改善机制仍不清楚。本研究全面探讨了接受减肥手术的肥胖个体在术前、术后即刻和术后6个月这三个时间点的一组脂肪细胞因子，以及胰岛素抵抗标志物。
这是一项病例对照前瞻性研究，研究对象为接受减肥手术的肥胖个体（BMI≥35kg/m²，n = 30）和非肥胖个体（BMI<25kg/m²，n = 30），比较他们之间血清脂联素、抵抗素、C反应蛋白（CRP）、白细胞介素（IL）-6和8、单核细胞趋化蛋白（MCP）-1和肿瘤坏死因子（TNF）-α的水平。前一组在术后即刻和术后6个月进行随访。血清标志物与胰岛素抵抗标志物如HOMA-IR、HOMA-β和QUICKI相关。
肥胖组体重减轻后脂联素显著增加（基线时为17.54±1.31μg/mL，术后6个月为68.76±1.84μg/mL）。CRP作为一种急性期蛋白，在术后即刻水平显著升高，但在术后6个月甚至降至基线水平以下（基线时为33.34±16.85μg/mL，术后即刻为59.85±23.12μg/mL，术后6个月为9.66±1.84μg/mL）。在IL-6和TNF-α的变化轨迹中观察到一些不一致之处，而其他促炎标志物表明术后炎症得到缓解。
减肥手术减轻了全身炎症，这与肥胖个体胰岛素抵抗的改善相关。
