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Clinical Studies and Practice

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

International Journal of Obesity volume 40, pages 275–280 (2016)Cite this article

Subjects

Abstract

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.

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Acknowledgements

Funding for the cohort 1 project was provided by the National Institutes of Health: Teen-LABS Grant number U01 DK072493/UM1 DK072493 (awarded to THI) and the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8 UL1TR000077. Funding for the cohort 2 project was provided by the National Institute of Diabetes, Digestive, and Kidney, National Institutes of Health through Grants R03DK068228 (awarded to THI) and the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant 8 UL1 TR000077. Support also came from National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000114. JRR was supported by a training grant from the NIH/NIDDK (T32-DK083250). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding to perform the biomarker assays was provided by the University of Minnesota, Department of Pediatrics. We thank Dr Angela Mortari and Mr Michael Ehrhardt for performing the assays.

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Authors and Affiliations

  1. Department of Pediatrics, University of Minnesota Medical School and University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA

    A S Kelly, J R Ryder & K L Marlatt

  2. Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA

    A S Kelly

  3. Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA

    J R Ryder

  4. School of Kinesiology, University of Minnesota, Minneapolis, MN, USA

    K L Marlatt

  5. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    K D Rudser

  6. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    T Jenkins & T H Inge

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Correspondence to A S Kelly.

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Competing interests

ASK is a consultant for Novo Nordisk Pharmaceuticals and Takeda Pharmaceuticals as well as serves as the signatory author for a clinical trial sponsored by Novo Nordisk but does not accept personal or professional payment for his services. THI has served as consultant to NPS Pharma and Sanofi (not pertaining to this work) and has obtained grant support from Ethicon Endosurgery (not pertaining to this work). The remaining authors declare no conflict of interest.

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Kelly, A., Ryder, J., Marlatt, K. et al. Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity. Int J Obes 40, 275–280 (2016). https://doi.org/10.1038/ijo.2015.174

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