A study of changes in glucose metabolism and inflammatory markers in morbidly obese patients undergoing bariatric surgery
Year: 2015
Type: dissertation
Abstract: Summary\nObesity is considered a worldwide pandemic. Morbidly obese patients are at risk of developing comorbidity such as diabetes mellitus type 2, hypertension and cardiovascular disease. The mechanisms behind the development of such complications in morbidly obese patients are still not fully understood, but low-grade inflammation and visceral adiposity are both involved. Effective treatment that leads to a significant weight loss can improve and/or repeal these comorbidities. \nIn this prospective study we have investigated what impact lifestyle intervention followed by bariatric surgery has on markers of glucose metabolism, inflammation and coagulation. 134 morbidly obese patients (who underwent lifestyle intervention followed by bariatric surgery) and 36 lean subjects (admitted for elective laparoscopic procedures) were included in 4 different studies. The morbidly obese patients were followed one year after surgery. The 36 lean subjects served as a control group.\nWe have shown that markers of low-grade inflammation such as the concentration of hs-CRP, C3 and C4 in serum were significantly higher in the morbidly obese group compared to the CG at admission. One year after bariatric surgery there was a significant reduction in C3 and C4 in the morbidly obese group and there was no longer a significant difference compared to the control group. The same was seen for several other important inflammatory markers. We found that there was a positive correlation between serum lipopolysaccharide and HbA1c. Through measuring bacterial DNA load and the volume of different adipose tissue compartments, we found that there was an increasing content of bacterial DNA with increasing proximity to the gut. We also found that monocyte activation measured by sCD14 is closely associated with obesity-related vascular dysfunction. \nFinally, in a group of non-diabetic morbidly obese patients we found that 11 out of 40 patients had insulin resistance at admission and that one year after surgery this was no longer present. \nThese findings indicate a central role of low-grade inflammation in development of comorbidity in morbidly obese patients, and underscore the position of the gut microbiota in this process.
Author: Torunn Kristin Nestvold
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1517472862