Lifestyle changes followed by bariatric surgery lower inflammatory markers and the cardiovascular risk factors C3 and C4. Markers of chronic inflammation and obesity: a prospective study on the reversibility of this association in middle-aged women undergoing weight loss by surgical intervention Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function: A randomized controlled trial. Changes in inflammatory markers after sleeve gastrectomy in patients with impaired glucose homeostasis and type 2 diabetes. Postprandial variations of plasma inflammatory markers in abdominally obese men. Little evidence of systemic and adipose tissue inflammation in overweight individuals† A Prospective Randomized Study Comparing Patients with Morbid Obesity Submitted to Sleeve Gastrectomy With or Without Omentectomy Effects of acute ingestion of different fats on oxidative stress and inflammation in overweight and obese adults Effects of bariatric surgery on inflammatory, functional and structural markers of coronary atherosclerosis. Leisure-time physical activity and reduced plasma levels of obesity-related inflammatory markers. Inhibition of C-Reactive Protein in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy Obesity, inflammatory markers, and endometrial cancer risk: a prospective case–control study The implication of obesity and central fat on markers of chronic inflammation: The ATTICA study. Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial. Evaluation of the biochemical, inflammatory and oxidative profile of obese patients given clinical treatment and bariatric surgery. The effect of bariatric surgery on adipocytokines, renal parameters and other cardiovascular risk factors in severe and very severe obesity: 1-year follow-up.
BACKGROUND Morbidly obese patients are at risk of developing insulin resistance and cardiovascular disease . Low- grade systemic inflammation is an important factor for this development . We evaluated the effect of bariatric surgery on markers of inflammation , coagulation and glucose metabolism . METHODS Ninety-seven morbidly obese patients and 17 lean subjects ( control group ) participated .  Anthropometric measurements  as well as  fasting blood sample s  were obtained at first admission , prior to surgery , and 1 year after surgery . RESULTS At admission , the morbidly obese group had significantly elevated levels of the complement components C3 and C4 compared to the lean control group ( P<0.0001 ) . Levels of C3 and C4 dropped significantly in the morbidly obese group over time ( P<0.0001 ) , and , 1 year after the operation , levels were comparable to those of the control group . The same changes were seen for markers of inflammation ( high-sensitivity C-reactive protein , tumor necrosis factor-α , interferon-γ , interleukin-1 receptor antagonist , IL-6 , and IL-13 ) , coagulation ( fibrinogen and plasminogen activator inhibitor-1 ) , and glucose metabolism ( leptin and insulin ) . There was a positive correlation between changes in C3 and body mass index , weight , coagulation parameters , inflammatory parameters , and leptin , respectively . CONCLUSIONS Bariatric surgery in morbidly obese patients  reduced weight effectively . Even more importantly , the increased levels of several risk factors associated with diabetes and cardiovascular co-morbidity normalized 1 year after surgery Background : Human adipose tissue expresses and releases proinflammatory cytokines and these measures of chronic inflammation have recently been associated with obesity . Hypothesis : To test whether the proinflammatory state is reversible in subjects undergoing weight loss by surgical measures .Subjects and Methods : Twenty morbidly obese women participated in this prospect i ve study . Subjects were examined for fat mass , high-sensitive C-reactive protein ( hs-CRP ) , interleukin 6 ( IL-6 ) and tumor necrosis factor-alpha ( TNF-α ) before and 1 y after Swedish adjustable gastric b and ing . Results : Anthropometric measures displayed a significant reduction of the body mass index ( BMI ) from 41.6±5.4 to 30.8±6.1 kg/m2 and the fat mass from 53.9±10.3 to 29.8±12.1 kg ( mean±s.d . ) . Hs-CRP levels decreased significantly from 1.33±1.21 mg/dl in pre-gastric b and ing subjects to 0.40±0.61 mg/dl in post-gastric b and ing subjects , respectively . IL-6 and TNF-α levels did not differ significantly between pre- and post-gastric b and ing subjects . Conclusions : We speculate that in these patients the marked reduction in C-reactive protein might be beneficial in reducing their cardiovascular risk and is not solely mediated by IL-6 and TNF-α Introduction Morbid obesity and obstructive sleep apnea ( OSA ) interact at an inflammatory level . Bariatric surgery reduces inflammatory responses associated with obesity . Heme oxygenase-1 ( HO-1 ) is an enzyme with anti-inflammatory properties , which might be increased in morbid obesity or OSA . We studied morbidly obese patients with OSA to determine : ( a ) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and ( b ) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation . Material and Methods We analyzed the homeostasis model insulin resistance index ( HOMA ) and plasma concentrations of HO-1 , tumor necrosis factor alpha , interleukin-6 , interleukin-1-beta , C reactive protein ( CRP ) , and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery  and 12 months after surgery . Results Before surgery , HO-1 plasma concentrations were similar in three groups of patients with mild , moderate , and severe OSA , and correlated with HOMA ( r = 0.27 , p = 0.02 ) . Twelve months after surgery , low- grade inflammation and insulin resistance had decreased in all the groups , but HO-1 plasma concentration had decreased only in the severe OSA group ( p = 0.02 ) . In this group , the reduction in HO-1 correlated with a reduction in CRP concentrations ( r = 0.43 , p = 0.04 ) and with improved HOMA score ( r = 0.37 , p = 0.03 ) . Conclusions Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA , and this decrease is associated with decreases in insulin resistance and in inflammation BACKGROUND AND AIMS Obesity and physical inactivity are both associated with low- grade inflammation and endothelial dysfunction .  Bariatric surgery improves markers of inflammation and endothelial function , but it is unknown if physical training after bariatric surgery can improve these markers even further . Therefore , we aim ed to investigate the effects of Roux-en-Y gastric bypass ( RYGB ) followed by physical training on markers of low- grade inflammation and endothelial function . METHODS Sixty patients approved for RYGB underwent examinations pre-surgery , 6 , 12 , and 24 months post-surgery . Six months post-surgery , they were r and omized 1:1 to an intervention group or a control group . The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks . Fasting blood sample s were analyzed for concentrations of interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , intercellular adhesion molecule 1 ( ICAM-1 ) , tissue-type plasminogen activator antigen ( t-PA : Ag ) and von Willebr and factor ( vWF ) . RESULTS RYGB markedly improved markers of inflammation ( IL-6 , CRP ) ( p < 0.001 ) and endothelial function ( ICAM-1 , t-PA : Ag , vWF ) ( p < 0.05 ) , and the improvements were sustained 24 months post-surgery ( p < 0.01 ) , except for the effects on vWF . We found no correlations between the changes in weight or BMI and the changes in markers of inflammation and endothelial function , except that the change in vWF was found to be inversely correlated with the changes in weight and BMI . We observed no effects of supervised physical training on markers on inflammation or endothelial function ( p>0.1 for all ) . CONCLUSIONS RYGB causes substantial and sustained favorable effects on markers of inflammation and endothelial function .  Supervised physical training after RYGB did not cause additional improvements BACKGROUND Bariatric surgery is an effective treatment for morbid obesity . Obesity and type 2 diabetes are associated with chronic inflammation . There is lack of data examining the effects of sleeve gastrectomy ( SG ) on inflammatory biomarkers . Our aim was to study the effects of SG on specific cytokines associated with obesity including interleukin-6 ( IL-6 ) , interleukin-10 ( IL-10 ) , leptin , adiponectin , and C-reactive protein ( CRP ) preoperatively , 1 and 6 months after surgery . METHODS A nonr and omized prospect i ve study comprising of 22 participants with impaired glucose homeostasis and type 2 diabetes undergoing SG ( body mass index 50.1 kg/m(2 ) , glycated hemoglobin [ HbA1c ] 53 mmol/mol ) .  Serial measurements of IL-6 , IL-10 , leptin , adiponectin , and CRP  were performed during oral glucose tolerance testing preoperatively , 1 and 6 months postoperatively . RESULTS We observed significant improvements at 1 and 6 months in leptin ( P≤.001 ) and CRP ( P = .003 ) after SG . We also observed a significant reduction in IL-6 at 6 months ( P = .001 ) . No statistically significant differences were observed for adiponectin and IL-10 . CONCLUSION This study is the first to examine the detailed changes in the inflammatory cytokines after SG . Our study shows significant improvements in the inflammatory biomarkers after SG in patients with impaired glucose homeostasis and type 2 diabetes OBJECTIVE Abdominal obesity is associated with a fasting proinflammatory condition . However , not much is known of the potential variations in circulating inflammatory markers after food intake . The purpose of the present study was to examine postpr and ial changes in plasma tumor necrosis factor (TNF)-alpha , interleukin (IL)-6 , and C-reactive protein ( CRP ) concentrations in men and their potential associations with fat distribution and metabolic profile variables . RESEARCH METHODS AND PROCEDURES Thirty-eight men were given a high-fat meal in the morning after an overnight fast , and TNF-alpha , IL-6 , and CRP levels were measured in plasma at 0 , 4 , and 8 hours after the meal . Physical and metabolic profiles were also assessed for each participant . RESULTS We observed a substantial increase in circulating IL-6 levels ( p < 0.0001 ) after the meal . Although postpr and ial variations in circulating TNF-alpha levels across time failed to reach statistical significance ( p = 0.02 ) , we noted a significant decrease in plasma TNF-alpha concentrations 4 hours ( -10 % , p < 0.001 vs. 0 hours ) after food intake . Plasma CRP levels were not affected by the fat load . We also noted that insulin-sensitive individuals displayed a less pronounced inflammatory response after food intake than insulin-resistant subjects . DISCUSSION Results of the present study show that consumption of a high-fat meal leads to an increase in plasma IL-6 concentrations and transient decrease in circulating TNF-alpha levels in overweight men . Our results suggest a possible role of insulin resistance in the modulation of the postpr and ial inflammatory response , which could , in turn , contribute to worsen the state of insulin resistance Context : The effect of weight loss by diet alone or diet in conjunction with exercise on low- grade inflammation in non-obese ( overweight ) individuals is not known . Objective : Test the hypothesis that 24 weeks of moderate calorie restriction ( CR ; 25 % ) by diet only or with aerobic exercise would reduce markers of systemic inflammation and attenuate inflammation gene expression in subcutaneous adipose tissue . Design : R and omized controlled trial . Setting : Institutional Research Center . Participants : Thirty-five overweight ( body mass index : 27.8 ± 0.7 kg/m2 ) but otherwise healthy participants ( 16M/19F ) completed the study . Intervention : Participants were r and omized to either CR ( 25 % reduction in energy intake , n = 12 ) , caloric restriction + exercise ( CR + EX : 12.5 % reduction in energy intake + 12.5 % increase in exercise energy expenditure , n = 12 ) , or control ( healthy weight-maintenance diet , n = 11 ) for 6 months . Main outcome measures : Fasting serum markers of inflammation [ leptin , highly sensitive C-reactive protein ( hsCRP ) , interleukin-6 ( IL-6 ) , tumor necrosis factor-alpha ( TNF-α ) , adiponectin ] and inflammation-related genes [ CD68 , IL-6 , TNF-α , macrophage migration inhibitory factor ( MIF ) , monocyte chemoattractant protein-1 ( MCP-1 ) , adiponectin , plasminogen activator inhibitor-1 ( PAI-1 ) ] in subcutaneous adipose tissue . Results : CR and CR + EX lost similar amounts of body weight ( –10 ± 1 % ) , fat mass ( –24 ± 3 % ) , visceral fat ( –27 ± 3 % ) , and had increased insulin sensitivity ( CR : 40 ± 20 % , CR + EX : 66 ± 22 % ) . Leptin was significantly decreased from baseline ( p < 0.001 ) in both groups however TNF-α and IL-6 were not changed . hsCRP was decreased in CR + EX . There was no change in the expression of genes involved in macrophage infiltration ( CD68 , MIF MCP-1 , PAI-1 ) or inflammation ( IL-6 , TNF-α , adiponectin ) in either CR or CR + EX . Conclusion : A 10 % weight loss with a 25 % CR diet alone or with exercise did not impact markers of systemic inflammation or the expression of inflammation-related adipose genes in overweight individuals Background Increased visceral adipose tissue is a risk factor for the metabolic complications associated with obesity and promotes a low- grade chronic inflammatory process . Resection of the great omentum in patients su bmi tted to a bariatric procedure has been proposed for the amelioration of metabolic alterations and the maximization of weight loss . The aim of the present study was to investigate the impact of omentectomy performed in patients with morbid obesity undergoing sleeve gastrectomy ( SG ) on metabolic profile , adipokine secretion , inflammatory status , and weight loss . Methods Thirty-one obese patients were r and omized into two groups : SG alone or with omentectomy . Adiponectin , omentin , interleukin-6 ( IL-6 ) , tumor necrosis factor-α ( TNF-α ) , high-sensitivity C-reactive protein ( hs-CRP ) , blood lipids , fasting glucose , insulin , and insulin resistance were measured before surgery and at 7 days , and 1 , 3 and 12 months after surgery . Results During the 1-year follow-up , body mass index ( BMI ) decreased markedly and comparably in both groups ( p < 0.001 ) . Insulin , IL-6 , and hs-CRP levels decreased significantly compared to baseline ( p < 0.05 ) in both groups with no significant difference between groups . Adiponectin and high-density lipoprotein cholesterol levels were significantly and similarly increased compared to baseline ( p < 0.001 ) in both groups . Omentin levels increased significantly ( p < 0.05 ) in the control group and decreased in the omentectomy group 1 year postoperatively . There was no significant change in TNF-α levels in either group . Conclusions The theoretical advantages of omentectomy in regard to weight loss and obesity-related abnormalities are not confirmed in this prospect i ve study . Furthermore , omentectomy does not induce important changes in the inflammatory status in patients undergoing SG Background Studies show that obese individuals have prolonged elevations in postpr and ial lipemia and an exacerbated inflammatory response to high fat meals , which can increase risk for cardiovascular diseases . As epidemiological studies indicate an association between type of fat and circulating inflammatory markers , the purpose of this study was to investigate the acute effect of different fat sources on inflammation and oxidative stress in overweight and obese individuals . Methods Eleven overweight and obese subjects consumed three high fat milkshakes rich in monounsaturated fat ( MFA ) , saturated fat ( SFA ) , or long-chain omega 3 polyunsaturated fat ( O3FA ) in r and om order . Blood sample s collected at baseline , 1 , 2 , 4 , and 6 hours postpr and ial were analyzed for markers of inflammation ( soluble intercellular adhesion molecule-1 ( ICAM-1 ) , vascular cell adhesion molecule-1 ( VCAM-1 ) , tumor necrosis factor- α ( TNF-α ) , and C-reactive protein ( CRP ) ) , oxidative stress ( 8-epi-prostagl and in-F2α ( 8-epi ) and nuclear factor-κB ( NF-κB ) ) , and metabolic factors ( glucose , insulin , non-esterified free fatty acids , and triglycerides ( TG ) ) . Results O3FA enhanced NF-kB activation compared to SFA , but did not increase any inflammatory factors measured . Conversely , SFA led to higher ICAM-1 levels than MFA ( p = 0.051 ) , while MFA increased TG more than SFA ( p < 0.05 ) . CRP increased while TNF-α and 8-epi decreased with no difference between treatments . Conclusions While most of the inflammatory factors measured had modest or no change following the meal , ICAM-1 and NF-κB responded differently by meal type . These results are provocative and suggest that type of fat in meals may differentially influence postpr and ial inflammation and endothelial activation This study was design ed to assess the effects of bariatric weight loss surgery on structural , functional , and inflammatory markers of coronary atherosclerosis . Obesity is a worldwide epidemic and an independent risk factor for coronary atherosclerosis . It remains unclear whether surgically induced weight loss reduces cardiovascular risk . This prospect i ve study enrolled 50 consecutive subjects with morbid obesity who underwent Roux-en-Y gastric bypass surgery ( GBS ) after failed attempts at medical weight loss . Subjects were recruited through a comprehensive weight loss center affiliated with an academic tertiary care hospital . All subjects had body mass indexes > or = 40 kg/m(2 ) or body mass indexes of 35 to 40 kg/m(2 ) with > or = 2 co-morbid obesity-related conditions . Markers of coronary atherosclerosis , including brachial artery flow-mediated dilation , carotid intima-media thickness , and high-sensitivity C-reactive protein , were measured before GBS and 6 , 12 , and 24 months after GBS . There were statistically significant improvements in all measured markers of coronary atherosclerosis after GBS . The mean body mass index decreased from 47 to 29.5 kg/m(2 ) at 24 months ( p < 0.001 ) , the mean carotid intima-media thickness regressed from 0.84 to 0.50 mm at 24 months ( p < 0.001 ) , mean flow-mediated dilation improved from 6.0 % to 14.9 % at 24 months ( p < 0.05 ) , and mean high-sensitivity C-reactive protein decreased from 1.23 to 0.65 mg/dl at 6 months ( p < 0.001 ) and to 0.35 mg/dl at 24 months ( p < 0.001 ) . In conclusion , GBS results in significant improvements in inflammatory , structural , and functional markers of coronary atherosclerosis OBJECTIVE This study investigated the relationship between physical activity and the obesity-related inflammatory markers C-reactive protein , interleukin-6 , and soluble tumor necrosis factor receptors ( sTNF-Rs ) 1 and 2 . Furthermore , we examined the relationship between physical activity and insulin sensitivity ( insulin , C-peptide , and hemoglobin A(1c ) levels ) and whether inflammatory markers mediate this association . RESEARCH METHODS AND PROCEDURES Biomarkers were measured in 405 healthy men and 454 healthy women from two large ongoing prospect i ve studies . Information about physical activity and other variables was assessed by question naires . RESULTS After adjustment for other predictors of inflammation , physical activity was inversely associated with plasma levels of sTNF-R1 , sTNF-R2 , interleukin-6 , and C-reactive protein ( p = 0.07 , p = 0.004 , p = 0.04 , and p = 0.009 ) . After further adjustment for BMI and leptin , as a surrogate for fat mass , most of these associations were no longer significant . Physical activity was also inversely related to insulin and C-peptide levels ( p = 0.008 and p < 0.001 ) ; however , in contrast to BMI and leptin , levels of inflammatory markers explained only very little of this inverse relationship . DISCUSSION These results suggest that frequent physical activity is associated with lower systemic inflammation and improved insulin sensitivity . These associations can partially be explained by a lower degree of obesity in physically active subjects . Although inflammatory markers may mediate obesity-dependent effects of physical activity on inflammatory related diseases such as type 2 diabetes or coronary heart disease , our study suggests that they do not directly account for the beneficial effects of physical activity on insulin resistance Background Obesity is considered a low- grade chronic inflammatory condition as reflected by increased C-reactive protein ( CRP ) levels . Inflammation is emerging as a predictor of cardiovascular disease and it may be a precursor of the metabolic syndrome . Bariatric surgery is commonly performed as a treatment for morbid obesity offering significant reductions in premature myocardial infa rct ion . Laparoscopic sleeve gastrectomy ( LSG ) is a relatively new bariatric procedure that is currently used as a definitive procedure for weight loss . The aim of this study is to assess the impact of sleeve gastrectomy on CRP levels . Methods This study is part of an ongoing , prospect i ve , cohort study to evaluate LSG impact on iron indices . CRP levels were compared preoperatively and 6 months after surgery . Similarly , demographics including body mass index and excess weight were also compared at these same study points . Data were analyzed using Student paired t test and Pearson product moment correlation analysis . Results Twenty-nine morbidly obese patients were included . There was significant decrease in body mass index ( BMI ) between the preoperative and 6-month period ( 50.9 ± 13.2 and 35.1 ± 6.85 , respectively ; P < 0.001 ) . Also CRP levels were statistically significantly lower at 6 months after surgery ( preoperative 12.3 ± 7.53 mg/L and postoperative 5.6 ± 4.2 mg/L. P < 0.0001 ) . The significant weight loss as reflected by change in BMI was correlated with the difference between preoperative and postoperative CRP levels . Conclusions Massive weight loss in morbidly obese patients induced by LSG causes a significant decrease in CRP levels , which could reduce the risk of cardiovascular diseases in these patients Obesity , a major risk factor for endometrial cancer , is a low- grade inflammatory state characterized by elevated concentrations of cytokines and acute phase reactants . The current study had two aims : first to investigate the associations of  C-reactive protein ( CRP ) , interleukin 6 ( IL6 ) , and IL1 receptor antagonist ( IL1Ra ) with endometrial cancer risk and second to examine to which extent these markers can influence the association between obesity and endometrial cancer . We conducted a case – control study , nested within the European Prospect i ve Investigation into Cancer and Nutrition , which comprised 305 incident cases of endometrial cancer and 574 matched controls .  CRP , IL6 , and IL1Ra  were measured in prospect ively collected blood specimens by immunoassays . Data were analyzed using conditional logistic regression . All statistical tests were two-sided , and P values < 0.05 were considered statistically significant . We observed a significant increase in risk of endometrial cancer with elevated levels of CRP ( odds ratio ( OR ) for top versus bottom quartile : 1.58 , 95 % confidence interval ( CI ) : 1.03–2.41 , Ptrend=0.02 ) , IL6 ( OR for top versus bottom quartile : 1.66 , 95 % CI : 1.08–2.54 , Ptrend=0.008 ) , and IL1Ra ( OR for top versus bottom quartile : 1.82 , 95 % CI : 1.22–2.73 , Ptrend=0.004 ) . After adjustment for body mass index ( BMI ) , the estimates were strongly reduced and became non-significant . The association between BMI and endometrial cancer was also substantially attenuated ( ∼10–20 % ) after adjustment for inflammatory markers , even when the effects of C-peptide or estrone had already been taken into account . We provided epidemiological evidence that chronic inflammation might mediate the association between obesity and endometrial cancer and that endometrial carcinogenesis could be promoted by an inflammatory milieu OBJECTIVE We evaluated the association of obesity with various markers of chronic inflammation , in a population -based sample of 3,042 adults . METHODS During 2001 - 2002 , we r and omly enrolled 1,514 men ( 18 - 87 years old ) and 1,528 women ( 18 - 89 years old ) , from the Attica area , Greece ; the sampling was stratified by the age-sex distribution of the region ( census 2001 ) . Among several variables , we also measured various inflammatory markers ( C-reactive protein , tumor necrosis factor alpha , amyloid A , white blood cells and interleukin-6 ) and anthropometric variables ( weight , height , waist and hip circumferences ) . Central fat was defined as waist-to-hip ratio > or=0.95 in men and > or=0.8 in women , while obesity as body mass index ( BMI ) > 29.9 kg/m(2 ) . RESULTS Central fat prevailed in 36 % of men and 43 % of women ( p<0.001 ) , while obesity prevailed in 20 % of men and 15 % of women , respectively . Compared to participants with normal body fat distribution , those with central fat exhibited 53 % higher C-reactive protein levels , 30 % higher tumor necrosis factor , alpha levels , 26 % higher amyloid A levels , 17 % higher white blood cell counts and 42 % higher interleukin-6 levels ( all p<0.05 ) . We observed that all inflammation markers were related to BMI ( index for obesity ) , waist and to waist-to-hip ratio ( indices for central fat ) , in both genders . Moreover , the models that included waist or waist-to-hip ratio as independent variable had higher explanatory ability ( i.e. R(2 ) ) than the models included BMI , especially in women , even after adjusting for age and various other potential confounders . CONCLUSION Our results suggest a relationship between central adiposity and inflammation process , irrespective of age and other potential confounders . This association was more prominent than the relationship between total obesity and inflammation . It could be hypothesized that a disproportionate accumulation of visceral fat mass could be partially associated with increased coronary risk , through inflammation process BACKGROUND Persistent , low- grade inflammation is an independent predictor of several chronic diseases and all-cause mortality . OBJECTIVE The intention of this study was to determine the independent and combined effects of diet-induced weight loss and exercise on markers of chronic inflammation . DESIGN Three hundred sixteen community-dwelling , older ( > or = 60 y ) , overweight or obese [ body mass index ( in kg/m2 ) > or = 28 ] , sedentary men and women with radiographic evidence of knee osteoarthritis were r and omly assigned to four 18-mo treatments : healthy lifestyle control , diet-induced weight loss , exercise , and diet plus exercise . The exercise intervention consisted of combined weight training and walking for 1 h 3 times/wk . The weight-loss intervention consisted of a weekly session with a registered dietitian to provide education and support for lowering energy intake . RESULTS The diet-induced weight-loss intervention result ed in significantly greater reductions in concentrations of C-reactive protein ( P = 0.01 ) , interleukin 6 ( P = 0.009 ) , and soluble tumor necrosis factor alpha receptor 1 ( P = 0.007 ) than did no weight-loss treatment . Changes in soluble tumor necrosis factor alpha receptor 1 but not in C-reactive protein or interleukin 6 correlated with changes in body weight .  Exercise training did not have a significant effect on these inflammatory biomarkers , and there was no significant interaction between weight loss and exercise training . CONCLUSIONS These findings provide evidence from a r and omized controlled trial that a dietary intervention design ed to elicit weight loss reduces overall inflammation in older , obese persons . Additional studies are needed to assess the effects of different modes and intensities of exercise on inflammation BACKGROUND We investigated the biochemical and inflammatory parameters as well as biomarkers of oxidative stress in morbidly obese patients before and after bariatric surgery and clinical treatment .  METHODS This study was conducted using 60 individuals ( 10 men and 50 women ) distributed into 3 groups :  the control group , 20 non-diabetic obese patients given clinical treatment , the bariatric group , 20 non-diabetic obese patients given a Roux-en-Y bypass gastroplasty , and the bariatric diabetic group , 20 diabetic obese patients given a Roux-en-Y bypass gastroplasty .  Measurements were made before and 1 , 3 , 6 , and 12months after surgery and clinical treatment . RESULTS We showed a significant decrease in body weight , body mass index ( BMI ) and waist circumference , accompanied by a decrease in the lipid profile and glucose and glycated hemoglobin concentrations in the groups that received bariatric surgery . The concentrations of lipid peroxidation , carbonyl protein and NPSH , as well as superoxide dismutase ( SOD ) and catalase ( CAT ) activity , significantly decreased in both groups after surgery . The concentrations of inteleukin-6 , inteleukin-1 , TNF-α and resistin were also significantly lower , while adiponectin concentrations significantly increased 12months after bariatric surgery . No significant alterations were observed in the biochemical , inflammatory or oxidative parameters of the control group . CONCLUSIONS Our findings demonstrate a decrease in body mass and a subsequent improvement in biochemical , metabolic and anthropometric parameters in patients given bariatric surgery .  This may contribute to the reduction of oxidative damage in these patients and consequently a reduction in the risk of the development and progression of multiple co-morbidities associated with obesity AIMS To evaluate the effect of weight loss after bariatric surgery ( BS )  on peripheral adipocytokines , renal parameters and other cardiovascular risk factors ( CVRFs ) . METHODS A total of 70 ( 41 women ) extremely obese adults were prospect ively studied before and 12 months after surgery . CONTROLS 24 ( 15 women ) normal-weight adults .  Anthropometric , biochemical and renal parameters were recorded . RESULTS Presurgery , adiponectin ( ADPN ) was lower , whereas leptin , insulin resistance , C-reactive protein , creatinine clearance and albuminuria were higher in patients than controls ( P<0.001 ) . All parameters improved postsurgery . Changes in ADPN correlated negatively with leptin , insulin resistance , albumin , C-reactive protein , and creatinine clearance . Multiple regression analysis : using changes in ADPN as the dependent variable , only changes in insulin resistance ( P=0.005 ) and albumin ( P=0.019 ) were significant independent determinants for changes in ADPN . No statistical differences were found in relation to the degree of obesity . CONCLUSION Patients changed to obesity type I after surgery . This implies a substantial improvement of CVRFs including ADPN , creatinine clearance and albuminuria . Changes in plasma ADPN correlated negatively with insulin resistance and with albuminemia but not with renal parameters . The lack of differences between different degrees of obesity suggests that the relationship between weight and CVRFs no longer exists when obesity becomes very extreme
Bariatric surgery  significantly lowered inflammatory factors ; however , baseline BMI , follow-up duration and type of surgery could impact the extent of observed effects
Obesity is one of the main causes of inflammation .
Previous studies have reported inconclusive results regarding the effect of bariatric surgery on inflammatory markers .
This systematic review and meta- analysis is aim ed at describing the effect of bariatric surgery on C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) , tumor necrosis factor-α ( TNF-α ) .