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Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding

International Journal of Obesity volume 27, pages 355–361 (2003)Cite this article

Abstract

OBJECTIVE: We measured markers of acute-phase response and immunological markers in morbid obese patients and in formerly morbid obese patients after a massive weight loss following adjustable gastric banding (GB).

SUBJECTS: A total of 49 morbid obese female patients with a body mass index (BMI) above 40 kg/m2 were investigated during a study period of 6 months. Of these, 24 patients received a gastric banding (GB) and lost a minimum of 20 kg in 1 y (GB group) and 25 patients maintained their weight (obese group). In sum, 13 normal weight subjects (BMI<24 kg/m2) were taken for controls.

METHOD: Plasma concentration of the acute-phase proteins, C-reactive protein (CRP), orosomucoid, complement factors C3 and C4 and white blood cell count, lymphocyte subsets and serum immunoglobulins were analyzed.

RESULTS: Acute-phase proteins were significantly lower in GB compared to morbid obese patients and remained significantly elevated in GB compared to controls. In addition, leukocytes, polymorphonuclear leukocytes and lymphocytes were significantly lower after GB and reached levels comparable to controls (except PMN). No difference in CD3 counts was observed in the three groups. CD4 increased and CD8 decreased in obese and GB patients when compared to controls whereas no statistical difference was found between obese and GB patients.

CONCLUSION: Our results confirm the positive effect of GB followed by a massive weight loss without apparent malnutrition. Subclinical chronical inflammation in morbid obese patients leads to irregularities in leukocyte and lymphocyte subsets. These alterations can be positively influenced by GB.

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References

  1. Burton BT, Foster WR . Health implications of obesity: an NIH consensus development conference. J Am Diet Assoc 1985; 11: 7–1121.

    Google Scholar 

  2. Seidell JC . Prevalence of obesity in Europe. Bibl Nutr Diet 1989; 44: 1–7.

    Google Scholar 

  3. Durazo-Arvizu RA, Goldbourt U, McGee DL . Body-mass index and mortality. N Engl J Med 2000; 342: 287–289.

    CAS  PubMed  Google Scholar 

  4. Jousilathi P, Tuomiletho J, Vartiainen E, Pekkanen J, Puska P . Body weight, cardiovascular risk factors, and coronary mortality. 15-year follow-up of middle-aged men and women in eastern Finland. Circulation 1996; 93: 1372–1379.

    Article  Google Scholar 

  5. Ridker PM . Inflammation, atherosclerosis, and cardiovascular risk: an epidemiologic view. Blood Coagul Fibrinolysis 1999; 10(Suppl 1): S9–S12.

    PubMed  Google Scholar 

  6. Ford ES . Body mass index, diabetes, and C-reactive protein among U.S. adults. Diabetes Care 1999; 22: 1971–1977.

    Article  CAS  PubMed  Google Scholar 

  7. Schmidt MI, Duncan BB, Sharett AR, Lindberg G, Savage PJ, Offenbacher S, Azambuja MI, Tracy RP, Heiss G . Markers of inflammation and prediction of diabetes mellitus in adults (Atherosclerosis Risk in Communities Study): a cohort study. Lancet 1999; 353: 1649–1652.

    Article  CAS  PubMed  Google Scholar 

  8. McMillan DE . Increased levels of acute-phase serum proteins in diabetes. Metabolism 1989; 38: 1042–1046.

    Article  CAS  PubMed  Google Scholar 

  9. Juhan-Vague I, Thompson SG, Jespersen J . Involvement of the hemostatic system in the insulin resistance syndrome: a study of 1500 patients with angina pectoris: the ECAT Angina pectoris Study Group. Atherioscler Thromb 1993; 13: 1865–1873.

    Article  CAS  Google Scholar 

  10. Haffner SM, Mykkanen L, Festa A, Burke JP, Stern MP . Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. Circulation 2000; 101: 975–980.

    Article  CAS  PubMed  Google Scholar 

  11. Pickup JC, Mattock MB, Chusney GD, Burt D . NIDDM as a disease of the innate immune system: association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia 1997; 40: 1286–1292.

    Article  CAS  PubMed  Google Scholar 

  12. Yudkin JS, Kumari M, Humphries SE, Hohamed-Ali V . Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis 2000; 148: 209–214.

    Article  CAS  PubMed  Google Scholar 

  13. Ferri C, Desideri G, Valenti M, Bellini C, Pasin M, Santucci A, DeMattia G . Early upregulation of endothelial adhesion molecules in obese hypertensive men. Hypertension 1999; 34(Pt 1): 568–573.

    Article  CAS  PubMed  Google Scholar 

  14. Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC . C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ 1996; 312: 1061–1065.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Haverkate F, Thompson SG, Pyke SD, Gallimore JR, Pepys MB . Production of C-reactive protein and risk of coronary events in stable and instable angina: European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Lancet 1997; 349: 462–466.

    Article  CAS  PubMed  Google Scholar 

  16. Kuller LH, Tracy RP, Shaten J, Meilahn EN, for the MRFIT group . Relation of C-reactive protein and coronary heart disease in the MRFIT nested case–control study. Am J Epidemiol 1996; 144: 537–547.

    Article  CAS  PubMed  Google Scholar 

  17. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH . Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336: 973–979.

    Article  CAS  PubMed  Google Scholar 

  18. Freedman DS, Joesoef MR, Barboriak JJ, Stallone DD, Byers T . Correlates of leukocyte counts in men. Ann Epidemiol 1996; 6: 74–82.

    Article  CAS  PubMed  Google Scholar 

  19. Brownell KD, Grennwood MRC, Stellar E, Shrager EE . The effect of repeated cycles of weight loss and regain in rats. Physiol Behav 1986; 38: 459–464.

    Article  CAS  PubMed  Google Scholar 

  20. Yang H, Peterson GM, Roth MP, Schoenfield LJ, Marks JW . Risk factors for gallstones during rapid weight loss. Digestive Dis Sci 1992; 37: 912–918.

    Article  CAS  Google Scholar 

  21. National Task Force on the Prevention and Treatment of Obesity. Weight Cycling. J Am Med Assoc 1994; 272: 1196–1202.

  22. Kuzmak LI . A review of seven years' experience with silicone gastric banding. Obes Surg 1991; 1: 403–408.

    Article  CAS  PubMed  Google Scholar 

  23. Miller K, Hell E . Laparoscopic adjustable gastric banding: a prospective 4-year follow-up study. Obes Surg 1999; 9: 183–187.

    Article  CAS  PubMed  Google Scholar 

  24. Luyckx FH, Sheen AJ, Desaive C, Dewe W, Gielen JE, Levebvre PJ . Effects of gastroplasty on body weight and related biological abnormalities in morbid obesity. Diabetes Metab 1998 Sep; 24(4): 356–361.

    Google Scholar 

  25. Favretti F, Cadiere GB, Segato G, Bruyns G, De Marchi F, Himpens J, Foletto M, Lise M . Laparoscopic adjustable silicone gastric banding: technique and results. Obes Surg 1995; 5: 364–337.

    Article  CAS  PubMed  Google Scholar 

  26. Field CJ, Gougeon R, Marliss EB . Changes in circulating leukocytes and mitogen responses during very-low-energy all-protein reducing diets. Am J Clin Nutr 1991; 54: 123–129.

    Article  CAS  PubMed  Google Scholar 

  27. Mc Murray RWQ, Bradsher RW, Steele RW, Pilkington NS . Effect of a prolonged modified fasting in obese persons on in vitro markers of immunity: lymphocyte function and serum effects on normal neutrophils. Am J Med Sci 1990; 299: 379–385.

    Article  CAS  Google Scholar 

  28. Tanaka S, Inoue S, Isoda F, Waseda M, Ishihara M, Yamakawa T, Sugiyama A, Takamura Y, Okuda K . Impaired immunity in obesity: suppressed but reversible lymphocyte responsiveness. Int J Obes Relat Metab Disord 1993; 17: 631–636.

    CAS  PubMed  Google Scholar 

  29. Nieman DC, Nehlsen-Cannarella SL, Henson DA, Butterworth DE, Fagoaga OR, Warren BJ, Rainwater MK . Immune response to obesity and moderate weight loss. Int J Obes Relat Metab Disord 1996; 20: 353–360.

    CAS  PubMed  Google Scholar 

  30. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr 1992; 55(Suppl): 615S–619S.

  31. Busetto L, Valente P, Pisent C, Segato G, de Marchi F, Favretti F, Lise M, Enzi G . Eating pattern in the first year following adjustable silicone gastric banding (ASGB) for morbid obesity. Int J Obes Relat Metab Disord 1996; 20: 539–546.

    CAS  PubMed  Google Scholar 

  32. Pepys MB . The acute phase response and c-reactive protein. In: Weatherall DJ, Ledingham JGG, Warrell DA (eds). Oxford textbook of medicine. Oxford University Press: New York, 1996.

    Google Scholar 

  33. Stallone DD . The influence of obesity and its treatment on the immune system. Nutr Rev 1994; 52: 37–50.

    CAS  PubMed  Google Scholar 

  34. Chandra RK, Kutty KM . Immunocompetence in obesity. Acta Paediatr Scand 1980; 69: 25–30.

    Article  CAS  PubMed  Google Scholar 

  35. Maki PA, Newberne PM . Dietary lipids and immune function. J Nutr 1992; 122: 610–614.

    Article  CAS  PubMed  Google Scholar 

  36. Good RA, Lorenz E . Nutrition and cellular immunity. Int J Immunopharmacol 1992; 14: 361–366.

    Article  CAS  PubMed  Google Scholar 

  37. Scanga CB, Verde TJ, Paolone AM, Andersen RE, Wadden TA . Effects of weight loss and exercise training on natural killer cell activity in obese women. Med Sci Sports Exerc 1998; 30: 1666–1671.

    Article  CAS  PubMed  Google Scholar 

  38. Cason J, Ainley CC, Wolstencroft RA, Norton KRW, Thompson RPH . Cell-mediated immunity in anorexia nervosa. Clin Exp Immunol 1986; 64: 370–375.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. Casper RC, Kirschner B, Sandstead HH, Jacob RA, Daus JM . An evaluation of trace minerals, vitamins and taste function in anorexia nervosa. Am J Clin Nutr 1980; 33: 1801–1808.

    Article  CAS  PubMed  Google Scholar 

  40. Pertschuk MJ, Crosby LO, Barot L, Mullen JL . Immunocompetence in anorexia nervosa. Am J Clin Nutr 1982; 35: 968–972.

    Article  CAS  PubMed  Google Scholar 

  41. Amstrong-Esther CA, Lacey JH, Crisp AH, Bryant TN . An investigation of the immune response in patients suffering from anorexia nervosa. Postgrad Med J 1978; 54: 395–400.

    Article  Google Scholar 

  42. Fink S, Eckert E, Mitchell J, Crosby R, Pomeroy C . T-lymphocyte subsets in patients with abnormal body weight: longitudinal studies in anorexia and obesity. Int J Eat Disord 1996; 20: 295–305.

    Article  CAS  PubMed  Google Scholar 

  43. Mili F, Flanders WD, Boring JR, Annest JL, Destefano F . The associations of race, cigarette smoking and smoking cessation to measures of the immune system in middle-aged men. Clin Immunol Immunopathol 1991; 59: 187–200.

    Article  CAS  PubMed  Google Scholar 

  44. Stallone DD, Stunkard AJ, Zweiman B, Wadden TA, Foster GD . Delayed-type hypersensitivity response in obese women following weight reduction. Clin Diagn Lab Immunol 1994; 2: 202–205.

    Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine V, Wilhelminenspital, Vienna, Austria

    U Hanusch-Enserer, E Cauza, M Spak & A Dunky

  2. Department of Surgery, Sozialmedizinisches Zentrum Ost, Vienna, Austria

    H R Rosen

  3. Immunology Outpatient Clinic, Vienna, Austria

    H Wolf & M M Eibl

  4. Department of Internal Medicine III, Hospital Lainz, Vienna, Austria

    R Prager

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  1. U Hanusch-Enserer
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  2. E Cauza
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Correspondence to M M Eibl.

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Hanusch-Enserer, U., Cauza, E., Spak, M. et al. Acute-phase response and immunological markers in morbid obese patients and patients following adjustable gastric banding. Int J Obes 27, 355–361 (2003). https://doi.org/10.1038/sj.ijo.0802240

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