Abstracts
2002 Digestive Disease Week

# 100992 Abstract ID: 100992 The Effects of Weight Loss after Bariatric Surgery on Plasma Concentrations of Leptin, Acute Phase Proteins and Soluble TNF-a Receptors
Francois Dielen, M'Hamed Hadfoune, Wim Buurman, Jan-Willem Greve, Maastricht, Netherlands

Introduction: Obesity is demonstrated to be associated with an enhanced inflammatory state. This inflammatory state is suggested to be a cause for the development of obesity related morbidity. It was hypothesized that a decrease in body weight in morbid obese subjects would lead to a reduction of the inflammatory state in these subjects. Methods: 27 morbidly obese patients (5 male, 21 female, age 38.2 ? 9.1) underwent bariatric surgery. Preoperative (preop) as well as on 3, 6,12 and 24 months postoperative (postop) blood was taken and BMI measured. Plasma concentrations of leptin, soluble TNF-a receptors (TNFR55 and TNFR75) and acute phase proteins (lipopolysaccharide binding protein (LBP), a1-acid glycoprotein (AGP) and CRP) were measured. Results: After surgery, BMI decreased significantly (P<0.001) from 46.7 ? 5.8 kg/m2 preop to 40.7 ? 5.7 at 3, 37.5 ? 5.7 at 6, 33.7 ? 5.3 at 12 and 33.0 ? 4.8 at 24 months postop. In line, leptin concentrations decreased significantly from 92.5 ng/ml ? 31.8 ng/ml preop to 52.5 ? 27.3 at 3, 49.8 ? 28.0 at 6, 38.0 ? 25.8 at 12 and 53.9 ? 35.7 at 24 months postop. Surprisingly, the acute phase protein LBP did not change significantly up to 12 months postop. However, at 24 months postop LBP was significantly decreased (78.9 ? 39.4 µg/ml) compared to preop values (134.7 ? 98.2). Also, CRP levels did not change up to 6 months postop. Thereafter, CRP decreased significantly (P<0.05) compared to preop values. AGP was significantly decreased at 6, 12 and 24 months postop (P<0.05) compared to preop data. TNFR55 remained elevated up to 12 months postop and significantly decreased at 24 months postop compared to preop data, whereas TNFR75 remained elevated up to 24 months postop. Conclusions: This study demonstrates that after bariatric surgery BMI and leptin significantly decrease. However, levels of the acute phase proteins LBP and CRP and both TNF-a receptors remain at least elevated up to 6 months postop, suggesting an ongoing inflammatory state in these obese subjects. However, two years after bariatric surgery, this inflammatory state is strongly reduced.