C-Reactive protein level in morbidly obese patients before and after bariatric surgery

Abstract

Background: Human obesity is associated with a proinflammatory state and an elevated level of mediators, such as C-reactive protein (CRP). Objectives: To establish CRP levels as baseline preoperative values and then at 6 months after bariatric surgery, as well as to determine the changes in weight, body mass index (BMI), leukocytes, and glycemia. Materials and methods: An observational, analytical, retrospective, longitudinal, and open study was conducted. Serum CRP values were measured in 36 adults presenting with morbid obesity, and their baseline relation to weight, BMI, leukocytes, and glycemia was determined; the relation to the same parameters was established again, 6 months after bariatric surgery. Results: The mean and standard deviation of preoperative and postoperative CRP (mg/L) was 1.15 ± 0.86 and 0.34 ± 0.28, respectively with p < 0.0001; weight (kg) 112.10 ± 22.91 and 84.82 ± 17.11, p = 0.0443; BMI (kg/m 2 ) 42.48 ± 5.97 and 32.2 ± 4.79, p = 0.0988; glucose (mg/dL) 100.58 ± 17.82 and 87.11 ± 8.49, p < 0.0001, and leukocytes (× 10 3 /mm 3 ) 8.62 ± 1.69 and 6.99 ± 1.56, p = 0.3192.Baseline CRP only correlated with weight and BMI (p = 0.047 and p = 0.027 respectively) and there was no correlation between postoperative CRP and the evaluated parameters. Conclusions: Preoperative CRP had a significant lineal relation to weight and body mass index. Patients who underwent bariatric surgery had a significant decrease in CRP, weight, and fasting glucose at 6 months after surgery. Nivel de proteína C reactiva en pacientes con obesidad mórbida antes y después de cirugía bariátrica ResumenAntecedentes: La obesidad humana se asocia a un estado proinflamatorio reflejado en elevación de marcadores como la proteína C reactiva (PCR). Objetivos: Establecer los valores de PCR basales y a 6 meses de la cirugía bariátrica, así como los cambios en peso, índice de masa corporal (IMC), leucocitos y glucemia. Materiales y métodos: Se realizó un estudio observacional, analítico, retrospectivo, longitudinal y abierto. Se midieron los valores de PCR sérica y su relación con el peso, IMC, leucocitos y glucemia de manera basal y 6 meses posteriores a cirugía bariátrica en 36 adultos con obesidad mórbida. Resultados: La media ± desviación estándar de la PCR pre y posoperatorio (mg/l) fue 1.15 ± 0.86 y 0.34 ± 0.28, respectivamente, con p < 0.0001; peso (kg) 112.10 ± 22.91 y 84.82 ± 17.11, p = 0,0443; IMC (kg/m 2 ) 42.48 ± 5.97 y 32.2 ± 4.79, p = 0.0988; glucosa (mg/dl) 100.58 ± 17.82 y 87.11 ± 8.49, p < 0.0001, y leucocitos (× 10 3 /mm 3 ) 8.62 ± 1.69 y 6.99 ± 1.56, p = 0.3192.La PCR basal solo correlacionó con el peso e IMC (p = 0.047 y p = 0.027, respectivamente) y no hubo correlación entre la PCR posoperatoria y ninguno de los parámetros evaluados. Conclusiones: La PCR tiene una relación lineal significativa en el preoperatorio con el peso y el IMC. Los pacientes sometidos a cirugía bariátrica presentaron disminución significativa en la PCR, el peso y la glucemia en ayuno a los 6 meses posterior a la cirugía.

Intestinal barrier function in morbid obesity: results of a prospective study on the effect of sleeve gastrectomy

“…Obesity has been associated with low-grade intestinal and systemic inflammation. In line with previous studies [27] we found a significant correlation between BMI and hsCRP. Moreover, hsCRP and TNF-α plasma levels were significantly higher in morbidly obese subjects compared with the controls in our study.…”

Bariatric surgery in morbidly obese individuals affects plasma levels of protein C and thrombomodulin

“…Overall, several parameters determined in our patient cohort were comparable to already established results from bariatric surgery patients including a massive drop of BMI, change in lipid profile including a drop in LDL and an increase in HDL and a reduction in inflammatory markers IL-6 and CRP and the prothrombotic protein PAI-1 [ 20 , 21 ]. Similar drops in weight and CRP levels were also described in a Mexican cohort of bariatric surgery patients [ 22 ]. The overall amelioration of obesity was further met by a reduction in medication needed.…”

The immune remodel: Weight loss-mediated inflammatory changes to obesity

“…103 Following a three-month low-calorie diet in healthy, obese women stratified into insulinresistant and insulin-sensitive groups, CRP concentrations were higher in the resistant group and correlated with insulin response; CRP decreased in parallel with weight loss in both groups 104 CRP levels are significantly lower in calorierestricted individuals when compared to those consuming an ad libitum Western diet. 105 CRP is consistently reduced in short-term and more extended time frames in VSG, [106][107][108] RYGB, 109,110 and AGB. 110 Hence, CRP has become a clinical biomarker of meta-inflammation.…”