Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity

• Published in: International Journal of Obesity Vol. 40; no. 2; pp. 275 - 280
• Main Authors: Kelly, A S, Ryder, J R, Marlatt, K L, Rudser, K D, Jenkins, T, Inge, T H
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2016; Nature Publishing Group
• Subjects: 13/21; 631/250/127; 631/250/256; 692/699/2743/393; 692/700/565/545/2098; Adipokines - blood; Adiponectin; Adiponectin - blood; Adolescent; Adolescents; Adults; Arteriosclerosis; Atherosclerosis; Atherosclerosis - etiology; Atherosclerosis - physiopathology; Atherosclerosis - prevention & control; Biomarkers; Biomarkers - blood; Cardiovascular diseases; Care and treatment; Cholesterol; Cytokines; Diabetes; Diabetes mellitus (non-insulin dependent); Epidemiology; Female; Females; Gastrectomy; Gastric Bypass; Gastrointestinal surgery; Health Promotion and Disease Prevention; Hospitals; Humans; Inflammation; Inflammation - etiology; Inflammation - physiopathology; Inflammation - prevention & control; Insulin; Insulin Resistance; Interleukin 6; Interleukin-6 - blood; Internal Medicine; Laparoscopy; Leptin; Lipoproteins, LDL - blood; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Monocyte chemoattractant protein 1; Monocytes; Obesity; Obesity in adolescence; Obesity, Morbid - complications; Obesity, Morbid - epidemiology; Obesity, Morbid - physiopathology; Obesity, Morbid - surgery; original-article; Oxidation resistance; Oxidative Stress; Pediatric Obesity - complications; Pediatric Obesity - epidemiology; Pediatric Obesity - physiopathology; Pediatric Obesity - surgery; Pediatrics; Physiological aspects; Postoperative Period; Proteins; Public Health; Risk factors; Surgery; Teenagers; Time Factors; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-TNF; Tumor necrosis factor-α; United States - epidemiology; Weight control; Weight Loss; Minnesota; Minneapolis Minnesota; United States > US
• ISSN: 0307-0565; 1476-5497; 1476-5497
• DOI: 10.1038/ijo.2015.174

Background/Objectives: Inflammation, oxidative stress and dysregulation of adipokines are thought to be pathophysiological mechanisms linking obesity to the development of insulin resistance and atherosclerosis. In adults, bariatric surgery reduces inflammation and oxidative stress, and beneficially changes the levels of several adipokines, but little is known about the postsurgical changes among adolescents. Subjects/Methods: In two separate longitudinal cohorts we evaluated change from baseline of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), monocyte chemo-attractant protein-1 (MCP-1), oxidized low-density lipoprotein cholesterol (oxLDL), adiponectin, leptin and resistin up to 12 months following elective laparoscopic Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG) surgery in adolescents with severe obesity. Results: In cohort 1, which consisted of 39 adolescents (mean age 16.5±1.6 years; 29 females) undergoing either RYGB or VSG, IL-6 (baseline: 2.3±3.4 pg ml −1 vs 12 months: 0.8±0.6 pg ml −1 , P <0.01), leptin (baseline: 178±224 ng ml −1 vs 12 months: 41.4±31.9 ng ml −1 , P <0.001) and oxLDL (baseline: 41.6±11.6 U l −1 vs 12 months: 35.5±11.1 U l −1 , P =0.001) significantly decreased and adiponectin significantly increased (baseline: 5.4±2.4 μg ml −1 vs 12 months: 13.5±8.9 μg ml −1 , P <0.001). In cohort 2, which consisted of 13 adolescents (mean age 16.5±1.6 years; 10 females) undergoing RYGB, results were similar: IL-6 (baseline: 1.7±0.9 pg ml −1 vs 12 months: 0.4±0.9 pg ml −1 , P <0.05) and leptin (baseline: 92.9±31.3 ng ml −1 vs 12 months: 37.3±33.4 ng ml −1 , P <0.001) significantly decreased and adiponectin significantly increased (baseline: 6.1±2.9 μg ml −1 vs 12 months: 15.4±8.0 μg ml −1 , P <0.001). When the cohorts were combined to evaluate changes at 12 months, oxLDL also significantly decreased (baseline: 39.8±16.7 U l −1 vs 12 months: 32.7±11.9 U l −1 , P =0.03). Conclusions: Bariatric surgery produced robust improvements in markers of inflammation, oxidative stress and several adipokines among adolescents with severe obesity, suggesting potential reductions in risk for type 2 diabetes and cardiovascular disease.