Federal University of São Paulo (UNIFESP), Brazil
Title: Roux-en-Y gastric bypass decreases pro-inflammatory and thrombotic biomarkers in individuals with extreme obesity
Bárbara Dal Molin Netto completed her graduation in Nutrition from Pontifical Catholic University of Paraná (PUC-PR) in 2006, Curitiba, Brazil. She received a Master’s degree from Federal University of Santa Catarina (UFSC), Florianopolis, Brazil, in the Post-Graduation Program in Clinical Nutrition. Currently, she is a senior doctoral student at Federal University of São Paulo (UNIFESP) in the Post-Graduation Program in Nutrition. Previously, she taught during 2 years at the department of Nutrition at Federal University of Paraná, Curitiba, Brazil. Her expertise includes bariatric surgery, nutritional management of obese individuals and its related chronic illnesses, such as diabetes, hypertension and heart diseases.
The low-grade inflammatory state in obesity leads to insulin resistance and endothelial dysfunction, all of which promote cardiovascular diseases in individuals with obesity. The purpose of this study was to evaluate the early effects of weight loss, achieved through bariatric surgery on the inflammatory and prothrombotic states. Additionally, our aim was to identify the role of hyperleptinemia on the prothrombotic state. Methods The sample was composed of 41 extremely obese patients who underwent Roux-en-Y gastric bypass (RYGB).Anthropometric and clinical data, and biochemical markers of inflammation were collected prior to, as well as 6 months post-RYGB.Results It was found that higher plasminogen activator inhibitor-1 (PAI-1) concentrations among extremely obese individuals with hyperleptinemia when compared with individuals without hyperleptinemia (p<0.01). In relation to the baseline, postsurgery BMI was reduced by 12.9 kg/m2, corresponding to 61.73% of excess weight loss.Also, were found decreased significantly in waist circumference from 126.23 to 101.24 cm, total cholesterol (p<0.01), LDL cholesterol (p=0.02), triglycerides (p<0.01) and glucose (p=0.01). In regards to pro-inflammatory biomarkers were observed a decrease on the PAI-1 of 55.886.02% (p<0.01), C reactive protein (CPR) 18.83.38% (p<0.01), intercellular adhesion molecule-1 (ICAM-1) 89.915.7% (p<0.01), leptin 27.863.22% (p<0.01) and resistin 69.295.8% (p<0.01). Indeed, we also observed significant decreases of the tumor necrosis factor alpha (TNF-α) and leptin/adiponectin ratio. Anti-inflammatory cytokines adiponectin and interleukin-10 (IL-10) were significantly increased [170.7182.50%,p<0.01;122.7155.05%,p=0.02].CRP levels were predictor of ICAM-1 (p=0.04) and changes in leptin concentrations were predictor decreased PAI-1 levels (p=0.03).Conclusions Our findings suggest that obesity per se is associated with a prothrombotic state and patients with hyperleptinemia have been major cardiovascular risk factors.Hence, the RYGB was effective in early reducing pro-inflammatory and thrombotic risk in individuals with extreme obesity.