Opstad Trine B, Farup Per G, Rootwelt Helge, Aaseth Jan O
Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, 0240 Oslo, Norway; Faculty of Medicine, University of Oslo, 0315 Oslo, Norway.
Department of Research, Innlandet Hospital Trust, PB 104, N-2381 Brumunddal, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, N-7491 Trondheim, Norway.
Nutr Metab Cardiovasc Dis. 2022 Dec;32(12):2858-2864. doi: 10.1016/j.numecd.2022.09.009. Epub 2022 Sep 22.
Obesity is associated with chronic inflammation and oxidative stress. Weight loss after bariatric surgery improves the inflammatory state and risk of cardiovascular disease. Improvement in metabolic dysfunction might be associated with changes in the activity of sirtuin 1 (SIRT1) and we aimed to investigate the effect of bariatric surgery on its circulating levels.
This is a sub-study of a prospective cohort study, including 110 subjects with morbid obesity. The surgical procedure was either laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Blood was sampled at inclusion and six and 12 months after surgery. SIRT1 was measured in EDTA plasma with an enzyme-linked immunosorbent assay. The mean age in the population was 43 years, 80% were women and mean body mass index (BMI) was 38.8 kg/m. RYGB and SG were performed in 89 and 21 subjects, respectively. SIRT1 concentration was significantly reduced from baseline to six and 12 months after surgery, with mean values (SD) 156.8 (82.6), 119.5 (65.6) and 94.9 (45.6) ng/mL, respectively, (p ≤ 0.002, all), accompanied by significant reductions in C-reactive protein (CRP), BMI and triglycerides from inclusion (p < 0.001, all). Type of surgery did not differently modify SIRT1 levels (p = 0.09). CRP and triglycerides were both positively predictive of SIRT1 levels (p ≤ 0.001, both).
SIRT1 concentration was significantly lower six and 12 months after bariatric surgery. CRP and triglycerides independently predicted SIRT1 levels, suggesting that reduction in SIRT1 levels might not intrinsically be related to weight reduction, but to improvement in metaflammation.
肥胖与慢性炎症和氧化应激相关。减肥手术后体重减轻可改善炎症状态及心血管疾病风险。代谢功能障碍的改善可能与沉默调节蛋白1（SIRT1）活性的变化有关，我们旨在研究减肥手术对其循环水平的影响。
这是一项前瞻性队列研究的子研究，纳入110例病态肥胖受试者。手术方式为腹腔镜Roux-en-Y胃旁路术（RYGB）或袖状胃切除术（SG）。在入组时以及术后6个月和12个月采集血液样本。采用酶联免疫吸附测定法在乙二胺四乙酸（EDTA）血浆中检测SIRT1。研究人群的平均年龄为43岁，80%为女性，平均体重指数（BMI）为38.8kg/m²。分别对89例和21例受试者进行了RYGB和SG手术。SIRT1浓度从基线到术后6个月和12个月显著降低，平均值（标准差）分别为156.8（82.6）、119.5（65.6）和94.9（45.6）ng/mL（均p≤0.002），同时C反应蛋白（CRP）、BMI和甘油三酯从入组时起显著降低（均p<0.001）。手术方式对SIRT1水平的影响无差异（p=0.09）。CRP和甘油三酯均为SIRT1水平的阳性预测指标（均p≤0.001）。
减肥手术后6个月和12个月，SIRT1浓度显著降低。CRP和甘油三酯独立预测SIRT1水平，提示SIRT1水平降低可能并非本质上与体重减轻有关，而是与代谢炎症的改善有关。
