Pre-operative and post-operative changes in CRP and other biomarkers sensitive to inflammatory status in patients with severe obesity undergoing laparoscopic sleeve gastrectomy

Randell, Edward; Twells, Laurie; Gregory, Deborah M.; Lester, Kendra; Daneshtalab, Noriko; Dillon, Carla; Pace, David; Smith, Chris; Boone, Darrell

doi:10.1016/j.clinbiochem.2017.10.010

Cited by 21 publications

(15 citation statements)

References 33 publications

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“…A previous study showed that the CRP on post-operative day 4 is the most reliable predictor of post-operative complications after gastrectomy for gastric cancer. 38,39 In accordance with the previous studies, our data also support the value of CRP in the diagnosis of infectious complications. Nevertheless, the ROC analysis further demonstrates that IL-6 yielded a better diagnostic value than CRP in predicting the infectious complications.…”

Section: Discussionsupporting

confidence: 92%

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Ding

et al. 2020

ANZ Journal of Surgery

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Background: This study aimed to investigate the value of inflammatory markers for the prediction of small bowel obstruction (SBO) following appendectomy. Methods: We included cases of acute appendicitis that underwent laparoscopic appendectomy (LA) in the Qingdao Municipal Hospital between January 2017 and January 2019. The cases were divided into an SBO group and a non-SBO group depending on whether patients had or did not have SBO, and patients were followed up for at least 1 year. The levels of interleukin (IL)-1β, IL-6 and tumour necrosis factor-alpha (TNF-α) in abdominal exudate and venous blood were examined using enzyme-linked immunosorbent assay. Results: After 1 year of follow-up, there were 985 cases in the non-SBO group and 16 cases in the SBO group. The levels of IL-1β, IL-6 and TNF-α in abdominal exudate on post-operative day 1 in the SBO group were 172.5 ± 14.7, 2167.3 ± 372.1 and 253.9 ± 12.9 pg/mL, respectively, which were significantly higher than that in the non-SBO group. The serum levels of IL-1β, IL-6, TNF-α and C-reactive protein (CRP) in the SBO group were significantly higher than that in the non-SBO group before surgery. Post-operatively, the inflammatory markers above decreased significantly and became similar with time in both groups. The logistic regression showed that the levels of peritoneal IL-6, preoperative serum CRP and perforated appendicitis were significant risk factors of SBO. The specificity and sensitivity of peritoneal IL-6 were 0.81 and 0.921, respectively. Conclusion: The IL-1β, IL-6, TNF-α and CRP in serum and abdominal exudate played an important role in SBO after LA. The peritoneal IL-6 was the most reliable prediction marker for SBO.

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Section: Discussionsupporting

confidence: 92%

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Ding

et al. 2020

ANZ Journal of Surgery

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“…However, the lack of change in platelet count in the diabetic subjects is consistent with residual inflammation consistent with the unaltered SPM levels. Systemic inflammation as manifested by elevated levels of hs-CRP has been demonstrated in obesity and in type 2 diabetes [24][25][26][27][28][29][30] . WBC and platelet counts are also markers of inflammation and both were elevated in the morbidly obese compared to the mildly obese in the current study.…”

Section: Discussionmentioning

confidence: 99%

The relationship between specialized pro-resolving lipid mediators, morbid obesity and weight loss after bariatric surgery

Schulte

Asbeutah

Benotti

et al. 2020

Sci Rep

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Obesity and diabetes are associated with chronic inflammation. Specialized pro-resolving lipid mediators (SPMs)—resolvins (Rv), protectins (PD) and maresins (MaR)—actively resolve inflammation. Bariatric surgery achieves remission of diabetes, but mechanisms are unclear. We measured SPMs and proinflammatory eicosanoid levels using liquid chromatography-tandem mass spectrometry in 29 morbidly obese subjects (13 with diabetes) and 15 nondiabetic, mildly obese subjects. Compared to the mildly obese, the morbidly obese had higher levels of SPMs—RvD3, RvD4 and PD1—and white blood cells (WBC) and platelets. Post-surgery, SPM and platelet levels decreased in morbidly obese nondiabetic subjects but not in diabetic subjects, suggesting continued inflammation. Despite similar weight reductions 1 year after surgery (44.6% vs. 46.6%), 8 diabetes remitters had significant reductions in WBC and platelet counts whereas five non-remitters did not. Remitters had a 58.2% decrease (p = 0.03) in 14-HDHA, a maresin pathway marker; non-remitters had an 875.7% increase in 14-HDHA but a 36.9% decrease in MaR1 to a median of 0. In conclusion, higher levels of RvD3, PD1 and their pathway marker, 17-HDHA, are markers of leukocyte activation and inflammation in morbid obesity and diabetes and diminish with weight loss in nondiabetic but not diabetic subjects, possibly representing sustained inflammation in the latter. Lack of diabetes remission after surgically-induced weight loss may be associated with reduced ability to produce MaR1 and sustained inflammation.

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“…The impact of bariatric surgery on the course of NAFLD in individuals with obesity has been extensively studied, and in the most recent IFSO consensus statement it is stated that bariatric surgery leads to the reversal or significant improvement of NAFLD and NASH [42]. In our patients with obesity, we observed a significant decrease of all biochemical and metabolic parameters assayed after bariatric surgery, clearly showing that LSG was effective in improving serum cytokine and the adipocytokine profile, thus ameliorating systemic inflammatory and metabolic status [43, 44]. We noted a statistically significant reduction of platelet count, as Johansson et al [45] also showed in 124 morbidly obese non-diabetic patients 12 months after Roux-en Y gastric bypass.…”

Section: Discussionmentioning

confidence: 63%

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

et al. 2019

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Background: Non-alcoholic fatty liver disease (NAFLD) has a high prevalence in obesity and its presence should be screened. Laparoscopic sleeve gastrectomy (LSG) is an effective treatment for obesity, but its effects on NAFLD are still to be firmly established. The diagnosis of non-alcoholic steatohepatitis (NASH) is currently performed by liver biopsy, a costly and invasive procedure. Squamous cell carcinoma antigen-IgM (SCCA-IgM) is a biomarker of viral hepatitis to hepatocellular carcinoma development and its role in NAFLD to NASH progression has not yet been investigated. Objective: The aim of this study was to evaluate SCCA-IgM as a non-invasive biomarker of NAFLD/NASH in patients with different degrees of metabolic-complicated obesity before and after LSG. Method: Fifty-six patients with obesity were studied before and 12 months after LSG; anthropometric, biochemical, clinical, and imaging data were collected. Results: At baseline steatosis was strongly associated with the glycaemic profile (p = 0.016) and was already present in prediabetic patients with obesity (82%). Only 3 patients had an SCCA-IgM level above the normal cut-off. SCCA-IgM titre did not change according to glycaemic profile or steatosis. Metabolic and inflammatory factors and transaminases significantly reduced after LSG-induced weight loss, except for SCCA-IgM. The ALT/AST ratio decreased post-LSG correlated with BMI (r = 0.297, p = 0.031), insulin (r = 0.354, p = 0.014), and triglycerides (r = 0.355, p = 0.009) reduction. Conclusions: Our results confirm the tight link between NAFLD and metabolic complications, suggesting prediabetes as a new risk factor of steatosis. SCCA-IgM does not seem to have a role in the identification and prognosis of NAFLD.

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Pre-operative and post-operative changes in CRP and other biomarkers sensitive to inflammatory status in patients with severe obesity undergoing laparoscopic sleeve gastrectomy

Cited by 21 publications

References 33 publications

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

Cytokines in abdominal exudate and serum predict small bowel obstruction following appendectomy

The relationship between specialized pro-resolving lipid mediators, morbid obesity and weight loss after bariatric surgery

SCCA-IgM as a Potential Biomarker of Non-Alcoholic Fatty Liver Disease in Patients with Obesity, Prediabetes and Diabetes Undergoing Sleeve Gastrectomy

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