Elevated GlycA in severe obesity is normalized by bariatric surgery

Abstract

Chronic inflammation drives many obesity-associated conditions including atherosclerosis. GlycA, a marker of systemic inflammation with lower intra-individual variability than high sensitivity C-reactive protein, is independently associated with incident cardiovascular events and mortality. Although GlycA is elevated in obesity, correlations with anthropometric measures are modest and the effect of body weight loss on GlycA is untested. Obese (body mass index [BMI] 44.6 ± 6.6 kg/m ), non-diabetic women (33.7 ± 8.2 years) undergoing Roux-en-Y gastric bypass (n = 23) or sleeve gastrectomy (n = 31) were prospectively studied at baseline, 6 and 12 months postprocedure. Women with normal BMI (n = 14) served as controls. Bariatric surgery significantly reduced GlycA by 6 months (451 ± 47 μmol/L vs. 383 ± 50 μmol/L; P < 0.001) with further reduction at 12 months (348 ± 41 μmol/L; P < 0.001) and no difference between procedures. At 12 months, despite 41% of surgical subjects maintaining BMI >30 kg/m , GlycA levels did not differ between surgical and control subjects (P = 0.13). Increased high density lipoprotein particle size was strongly associated with reduced GlycA (r = -0.49; P < 0.001) and was found to mediate up to 43% of its body weight-loss-associated fall. This is the first study to demonstrate that surgical body weight loss markedly reduces levels of GlycA.

Title: Human Serum/Plasma Glycoprotein Analysis by 1H-NMR, an Emerging Method of Inflammatory Assessment

“…The variable GlycB has been shown to be associated to these parameters but less strongly. However, this has been reported in so few studies [83,97,109,159] that firm conclusions cannot be drawn until more studies are performed.…”

“…The most typical forms of bariatric surgery are Roux-en-Y gastric bypass and sleeve gastrectomy, both of which lead to substantial weight loss. Manmadhan et al saw that postoperative changes in GlycA were very positively associated with changes in body weight, high sensitive CRP (hsCRP), and glycated haemoglobin (HbA1c), and inversely with changes in the mean particle size of high-density lipoprotein (HDL) and adiponectin [159].…”

“…These associations raise some open questions. The first is that the two markers may follow distinct inflammatory pathways because some studies have reported different behavior between GlycA and hsCRP [159]. The second is that GlycA may integrate more multiple inflammatory pathways by capturing the global signal of several proteins and, therefore, better captures the degree of systemic inflammation.…”

Bariatric surgery decreases oxidative stress and protein glycosylation in patients with morbid obesity

“…This might also mean that they are associated with increased risk of atherosclerosis, as they increase with AIP. 12 Meanwhile, regarding atheroprotective function, the concentration of linkages of the glycoproteins studied is negatively correlated with PON1. 38 There were only two patients in our study with AIP ≤ 0.21.…”

“…11 Recently, some authors have reported a relationship between GlycA and severe obesity, and a decrease in both after BS. 12 However, less is known about the relationship that may exist between glycoproteins and OS in morbid obesity, and their evolution after BS.…”