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Melania Manco, J. Manuel Fernandez-Real, Francesco Equitani, Joan Vendrell, Maria Elena Valera Mora, Giuseppe Nanni, Vincenzo Tondolo, Menotti Calvani, Wilfredo Ricart, Marco Castagneto, Geltrude Mingrone, Effect of Massive Weight Loss on Inflammatory Adipocytokines and the Innate Immune System in Morbidly Obese Women, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 2, 1 February 2007, Pages 483–490, https://doi.org/10.1210/jc.2006-0960
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Abstract
Context: Obesity may be regarded as a low-grade inflammatory state.
Objective: The aim of this study was to evaluate changes in pro-inflammatory adipocytokines and the innate immune system, cardiovascular risk, and insulin sensitivity after massive weight loss.
Design: This was a longitudinal study.
Setting: The study was conducted at Catholic University, Rome.
Subjects and Methods: There were 10 normoglucose-tolerant obese women evaluated before and 36 months after bilio-pancreatic diversion (BPD). Glucose sensitivity (M value) was estimated using the euglycemic-hyperinsulinemic clamp. Mannan-binding lectin (MBL), bactericidal/permeability increasing protein (BPI), α-defensins, soluble CD14 receptor (sCD14), C-reactive protein, adiponectin, leptin, visfatin, IL-6, and TNF-α were assayed.
Results: After massive weight loss (53% of excess body weight), leptin (P ≤ 0.0001), IL-6 (P ≤ 0.0001), α-defensins (P ≤ 0.001), and C-reactive protein (P ≤ 0.0001) decreased significantly. Adiponectin increased significantly (P ≤ 0.001). Of the nine subjects who lost more than 20% of body mass index, sCD14 (2.87 ± 0.5 to 2.55 ± 0.5; P = 0.016) and visfatin levels (12.20 ± 0.93 to 10.63 ± 1.93 ng/ml; P = 0.045) decreased significantly. No significant changes were observed in TNF-α, BPI, or MBL. Insulin sensitivity more than doubled after BPD (P ≤ 0.0001). sCD14 changes were significantly associated with body mass index (r0 = 0.80; P = 0.003) and M changes (r0 = −0.59; P = 0.03). MBL correlated with insulin sensitivity in obese (r0 = 0.93; P = 0.0001) and post-BPD women (r0 = 0.66; P = 0.038). Adiponectin correlated negatively with cardiovascular risk (r0 = −0.709; P = 0.02) and IL-6 (r0 = −0.634; P = 0.05). Multiple linear regression analysis showed that changes in sCD14 were also significantly related to changes in insulin sensitivity.
Conclusions: Surgically induced weight loss is capable of reversing low-grade inflammation, at least partially. The relationships between sCD14, MBL, BPI, and glucose sensitivity, and the role of TNF-α in obesity warrant further investigation.
