Cited by 143Bariatric Surgery and OutcomesAdipokines, Inflammation, and Metabolic DiseasesMinimally Invasive Surgical Techniques

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Reduction in endotoxemia, oxidative and inflammatory stress, and insulin resistance after Roux-en-Y gastric bypass surgery in patients with morbid obesity and type 2 diabetes mellitus

Monte, Scott V., Caruana, Joseph A., Ghanim, Husam, Sia, Chang Ling, Korzeniewski, Kelly, Schentag, Jerome J., Dandona, Paresh·2012·Surgery

DOI 10.1016/j.surg.2011.09.038

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Abstract

Background Roux-en-Y gastric bypass (RYGB) results in profound weight loss and resolution of type 2 diabetes mellitus (T2DM). The mechanism of this remarkable transition remains poorly defined. It has been proposed that endotoxin (lipopolysaccharide [LPS]) sets inflammatory tone, triggers weight gain, and initiates T2DM. Because RYGB may diminish LPS from endogenous and exogenous sources, we hypothesized that LPS and the associated cascade of oxidative and inflammatory stress would diminish after RYGB.Methods Fifteen adults with morbid obesity and T2DM undergoing RYGB were studied. After an overnight fast, a baseline blood sample was collected the morning of surgery and at 180 days to assess changes in glycemia, insulin resistance, LPS, mononuclear cell nuclear factor (NF)-κB binding and mRNA expression of CD14, TLR-2, TLR-4, and markers of inflammatory stress.Results At 180 days after RYGB, subjects had a significant decrease in body mass index (52.1 ± 13.0 to 40.4 ± 11.1), plasma glucose (148 ± 8 to 101 ± 4 mg/dL), insulin (18.5 ± 2.2 mμU/mL to 8.6 ± 1.0 mμU/mL) and HOMA-IR (7.1 ± 1.1 to 2.1 ± 0.3). Plasma LPS significantly reduced by 20 ± 5% (0.567 ± 0.033 U/mL to 0.443 ± 0.022 E U/mL). NF-κB DNA binding decreased significantly by 21 ± 8%, whereas TLR-4, TLR-2, and CD-14 expression decreased significantly by 25 ± 9%, 42 ± 8%, and 27 ± 10%, respectively. Inflammatory mediators CRP, MMP-9, and MCP-1 decreased significantly by 47 ± 7% (10.7 ± 1.6 mg/L to 5.8 ± 1.0 mg/L), 15 ± 6% (492 ± 42 ng/mL to 356 ± 26 ng/mL) and 11 ± 4% (522 ± 35 ng/mL to 466 ± 35 ng/mL), respectively.Conclusion LPS, NF-κB DNA binding, TLR-4, TLR-2, and CD14 expression, CRP, MMP-9, and MCP-1 decreased significantly after RYGB. The mechanism underlying resolution of insulin resistance and T2DM after RYGB may be attributable, at least in part, to the reduction of endotoxemia and associated proinflammatory mediators.

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Impact of Bariatric Surgery on Adipose Tissue Biology
Osorio-Conles, Ó., Vidal, J., & de Hollanda, A. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10235516 · Cited by 34
Changes in Intestinal Permeability after Roux-en-Y Gastric Bypass
Savassi-Rocha, A. L., Diniz, M. T. C., Vilela, E. G., Diniz, M. D. F. H. S., Sanches, S. R. D. A., da Cunha, A. S., Ferrari, M. D. L. A., Tôrres, H. O. D. G., Maciente, B. A., Ataliba, G. S., et al. (2013) · Obesity Surgery · doi:10.1007/s11695-013-1084-y · Cited by 33
Metabolic Cytokines at Fasting and During Macronutrient Challenges: Influence of Obesity, Female Androgen Excess and Sex
Martínez-García, M. Á., Moncayo, S., Insenser, M. R., Álvarez‐Blasco, F., Luque‐Ramírez, M., & Escobar-Morreale, H. F. (2019) · Nutrients · doi:10.3390/nu11112566 · Cited by 32
Duodenojejunal Bypass Leads to Altered Gut Microbiota and Strengthened Epithelial Barriers in Rats
Yang, P., Yang, W., Nien, H., Chen, C., Lee, P., Yu, L. C., & Lin, M. (2015) · Obesity Surgery · doi:10.1007/s11695-015-1968-0 · Cited by 31
Chronic Endotoxemia in Subjects with Type-1 Diabetes Is Seen Much before the Onset of Microvascular Complications
Aravindhan, V., Mohan, V., Arunkumar, N., Sreedharan, S., & Babu, S. (2015) · PLoS ONE · doi:10.1371/journal.pone.0137618 · Cited by 31
“However, others have reported significantly elevated LBP levels under conditions of chronic inflammation like obesity [20], Type-2 diabetes [21] and non-alcoholic fatty-liver disease [22].”
Background
Decreased expression of the NLRP6 inflammasome is associated with increased intestinal permeability and inflammation in obesity with type 2 diabetes
Frühbeck, G., Gómez‐Ambrosi, J., Ramírez, B., Becerril, S., Rodrı́guez, A., Mentxaka, A., Valentí, V., Moncada, R., Reina, G., Baixauli, J., et al. (2024) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-024-05124-3 · Cited by 33
Dopaminergic Pathways in Obesity-Associated Inflammation
Leite, F., & Ribeiro, L. V. P. T. (2019) · Journal of Neuroimmune Pharmacology · doi:10.1007/s11481-019-09863-0 · Cited by 34
“…obesity induced by high fat diet (HFD), the expansion of visceral AT (VAT) has detrimental effects in intestinal barrier integrity favoring metabolic dysfunction and, although controversial, (Boutagy et al. 2016) metabolic endotoxemia (Kallio et al. 2015; Lassenius et al. 2011; Monte et al. 2012).”
Background
Sleeve Gastrectomy Alters Intestinal Permeability in Diet-Induced Obese Mice
Blanchard, C. L., Moreau, F., Chevalier, J., Ayer, A., Garçon, D., Arnaud, L., de Barros, J.-P. P., Gautier, T., Neunlist, M., Cariou, B., et al. (2017) · Obesity Surgery · doi:10.1007/s11695-017-2670-1 · Cited by 27
GLP-2 receptor signaling controls circulating bile acid levels but not glucose homeostasis in Gcgr mice and is dispensable for the metabolic benefits ensuing after vertical sleeve gastrectomy
Patel, A. R., Yusta, B., Matthews, D., Charron, M. J., Seeley, R. J., & Drucker, D. J. (2018) · Molecular Metabolism · doi:10.1016/j.molmet.2018.06.006 · Cited by 25
Gut microbiota in bariatric surgery
Gasmi, A., Bjørklund, G., Mujawdiya, P. K., Semenova, Y. M., Doşa, A., Piscopo, S., Pen, J. J., Benahmed, A. G., & Costea, D. O. (2022) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2022.2067116 · Cited by 29
“This is confirmed by the fact that post-RYGB improvement in metabolism was characterized by the reduced serum levels of LPS and high sensitivity C-reactive protein (Monte et al. 2012).”
Background
Change in gut microbiota is correlated with alterations in the surface molecule expression of monocytes after Roux-en-Y gastric bypass surgery in obese type 2 diabetic patients.
Chen, H., Qian, L., Lv, Q., Yu, J., Wu, W. H., & Qian, H. (2017) · PubMed Central · Cited by 25
Alterations of Serum Uric Acid Level and Gut Microbiota After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy in a Hyperuricemic Rat Model
Lu, C., Li, Y., Li, L., Kong, Y., Shi, T., Xiao, H. T., Cao, S., Zhu, H., Li, Z., & Zhou, Y. (2020) · Obesity Surgery · doi:10.1007/s11695-019-04328-y · Cited by 24
Lipids and bariatric procedures part 1 of 2: Scientific statement from the National Lipid Association, American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association: EXECUTIVE SUMMARY
Bays, H. E., Jones, P. H., Jacobson, T. A., Cohen, D. E., Orringer, C. E., Kothari, S. N., Azagury, D. E., Morton, J. M., Nguyen, N. T., Westman, E. C., et al. (2015) · Journal of clinical lipidology · doi:10.1016/j.jacl.2015.12.003 · Cited by 23
Roux‐en‐Y gastric bypass decreases endotoxemia and inflammatory stress in association with improvements in gut permeability in obese diabetic rats
Guo, Y. H., Liu, C., Liu, G., Huang, Z., & Zou, D. (2019) · Journal of Diabetes · doi:10.1111/1753-0407.12906 · Cited by 25
“We believe that colon tissue is superior for research on gut permeability due to the abundance of intestinal flora colonization.32 The present study showed a correlation between the improvement in metabolic endotoxemia and the strength of gut barrier function after RYGB.”
BackgroundInfluential
Gastrointestinal manifestations after Roux-en-Y gastric bypass surgery in individuals with and without type 2 diabetes
Härma, M., Adeshara, K. A., Istomin, N., Lehto, M. J., Blaut, M., Savolainen, M. J., Hörkkö, S., Groop, P., Koivukangas, V., & Hukkanen, J. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.10.021 · Cited by 22
Is intestinal permeability increased in obesity? A review including the effects of dietary, pharmacological and surgical interventions on permeability and the microbiome
Camilleri, M. (2022) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14899 · Cited by 22
“This assay has a sensitivity range of 0.1 to 1.0 EU/ml and a normal value range from 0.15 to 0.35 EU/ml.22 Expressing endotoxin concentrations in EU addresses the issue of different potencies of different endotoxins.”
BackgroundInfluential
Role of Gut Microbiome and Microbial Metabolites in Alleviating Insulin Resistance After Bariatric Surgery
Wang, M., Li, L., Chen, Y., Lian, G., Wang, J., Zhang, J., Shan, K., Shang, L., Tian, F., & Jing, C. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04974-7 · Cited by 22
“Meanwhile, the expression of inflammation-related receptors (CD14, TLR4, and TLR2), NF-κB DNA binding, and C-reactive protein (CRP) is significantly reduced after bariatric surgery [14, 46].”
Background
Single Cell RNA-Seq and Machine Learning Reveal Novel Subpopulations in Low-Grade Inflammatory Monocytes With Unique Regulatory Circuits
Lee, J., Geng, S., Li, S., & Li, L. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.627036 · Cited by 24
Intestinal expression of toll-like receptor gene changes early after gastric bypass surgery and association with type 2 diabetes remission
Sala, P., Torrinhas, R. S., Fonseca, D. C., Machado, N. M., Singer, J., Singer, P., Ravacci, G. R., Belarmino, G., Ferreira, B. D. A. M., Marques, M. Q., et al. (2020) · Nutrition · doi:10.1016/j.nut.2020.110885 · Cited by 21
Effects of Roux-en-Y Gastric Bypass or Diabetes Support and Education on Insulin Sensitivity and Insulin Secretion in Morbidly Obese Patients With Type 2 Diabetes
Khoo, C. M., Chen, J., Pamuklar, Z. N., & Torquati, A. (2013) · Annals of Surgery · doi:10.1097/sla.0b013e318294d19c · Cited by 21
Mediterranean diet and prudent diet are both associated with low circulating esterified 3-hydroxy fatty acids, a proxy of LPS burden, among older adults
André, P., de Barros, J.-P. P., Merle, B. M. J., Samieri, C., Helmer, C., Delcourt, C., & Féart, C. (2021) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqab126 · Cited by 20
Palmitate Potentiates Lipopolysaccharide-Induced IL-6 Production via Coordinated Acetylation of H3K9/H3K18, p300, and RNA Polymerase II
Kochumon, S., JACOB, T. K., Koshy, M., Al‐Rashed, F., Sindhu, S. T. A. K., Al‐Ozairi, E., Al‐Mulla, F., Rosen, E. D., & Ahmad, R. (2022) · The Journal of Immunology · doi:10.4049/jimmunol.2100928 · Cited by 19
Effects of Roux-en-Y Gastric Bypass on Fasting and Postprandial Levels of the Inflammatory Markers YKL-40 and MCP-1 in Patients with Type 2 Diabetes and Glucose Tolerant Subjects
Thomsen, S. B., Rathcke, C. N., Jørgensen, N. B., Madsbad, S., & Vestergaard, H. (2013) · Journal of Obesity · doi:10.1155/2013/361781 · Cited by 18
“recently documented that RYGB reduces the fasting plasma levels of LPS and other pro-inflammatory mediators in type 2 diabetes, and it is plausible that this reduction in the inflammatory state is responsible, at least in part, for the improvement of the glucose metabolism [27].”
BackgroundInfluential
The Immunophenotyping Changes of Peripheral CD4+ T Lymphocytes and Inflammatory Markers of Class III Obesity Subjects After Laparoscopic Gastric Sleeve Surgery – A Follow-Up Study
Rizk, N. M., Fadel, A., AlShammari, W., Younes, N., & Bashah, M. (2021) · Journal of Inflammation Research · doi:10.2147/jir.s282189 · Cited by 20
“The present study demonstrated a significant reduction of leptin after 12 weeks of LGS, observed after bariatric surgery in other studies such as gastric plication, bypass, and gastric sleeve.(20,22) The current study demonstrated dramatic weight loss after LGS, as previously reported.”
MethodResult
Postprandial Effect of a High-Fat Meal on Endotoxemia in Arab Women with and without Insulin-Resistance-Related Diseases
Aldisi, D. A., Al‐Daghri, N. M., Khan, N., Alfadda, A. A., Sallam, R. M., Alsaif, M. A., Sabico, S., Tripathi, G., & McTernan, P. G. (2015) · Nutrients · doi:10.3390/nu7085290 · Cited by 17
“Elevated endotoxin levels amongst Middle-Eastern patients with T2DM are also consistent across ethnic groups, such as Africans [29], Chinese [30], Caucasians [16,31], and South Asians [22,23].”
Background
Managing the manager: Gut microbes, stem cells and metabolism
Sérino, M., Blasco‐Baqué, V., Nicolas, S., & Burcelin, R. (2014) · Diabetes & Metabolism · doi:10.1016/j.diabet.2013.12.004 · Cited by 16
Inflammatory Cytokines, Redox Status, and Cardiovascular Diseases Risk after Weight Loss via Bariatric Surgery and Lifestyle Intervention
Abulmeaty, M. M. A., Ghneim, H. K., Alkhathaami, A., Al‐Numair, K. S., Zaben, M. A., Razak, S., & Al‐Sheikh, Y. A. (2023) · Medicina · doi:10.3390/medicina59040751 · Cited by 15
“Levels of MCP-1 were reduced significantly after procedures at different postoperative periods [23,24] and showed insignificant changes in another study [25].”
Result
Effects of gastric bypass bariatric surgery on gut microbiota in patients with morbid obesity
Amin, U., Huang, D. C., Dhir, A., Shindler, A. E., Franks, A. E., & Thomas, C. J. (2024) · Gut Microbes · doi:10.1080/19490976.2024.2427312 · Cited by 17
“175 LPS-induced TLR-4 activation pathway leads to increased adiposity, excess pro-inflammatory and ROS production, as well as vascular endothelial dysfunction, raising blood pressure in patients with obesity.”
Does chronic low-grade endotoxemia define susceptibility of obese humans to insulin resistance via dietary effects on gut microbiota?
Kemp, D. M. (2013) · Adipocyte · doi:10.4161/adip.24776 · Cited by 14
“More evidence linking chronic endotoxemia to insulin resistance and diabetes comes from a clinical study where Roux-en-Y gastric bypass (RYGB) resulted, as often cited, in profound weight loss in a majority of patients, accompanied by a high resolution rate of type 2 diabetes.(10) However, as many similar clinical stu…”
Result
Aspirin responsiveness changes in obese patients following bariatric surgery
Norgard, N. B., Monte, S. V., Fernandez, S. F., & Ma, Q. (2017) · Cardiovascular Therapeutics · doi:10.1111/1755-5922.12268 · Cited by 14
Bariatric surgery for diabetic comorbidities: A focus on hepatic, cardiac and renal fibrosis
Ding, H., Zhang, Y., Ma, X., Zhang, Z., Xu, Q., Liu, C., Li, B., Dong, S., Li, L., Zhu, J., et al. (2022) · Frontiers in Pharmacology · doi:10.3389/fphar.2022.1016635 · Cited by 16
“Bariatric surgery-induced reduction in CCL-2-related inflammation is associated with improved renal function and reduced renal fibrosis (Bueter et al., 2010; Monte et al., 2012; Fenske et al., 2013; Wu et al., 2014).”
Background
Use of the microbiome in the management of children with type 2 diabetes mellitus
Brar, P. C., & Kohn, B. (2019) · Current Opinion in Pediatrics · doi:10.1097/mop.0000000000000781 · Cited by 17
Effects of sleeve gastrectomy and rs9930506 FTO variants on angiopoietin/Tie-2 system in fat expansion and M1 macrophages recruitment in morbidly obese subjects
Figueroa‐Vega, N., Jordán, B., Pérez-Luque, E. L., Parra-Laporte, L., Garnelo-Cabañas, S., & Malacara, J. M. (2016) · Endocrine · doi:10.1007/s12020-016-1070-y · Cited by 13
Effect of surgically induced weight loss on biomarkers of endothelial dysfunction: a systematic review and meta-analysis
Seyyedi, J., & Alizadeh, S. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04710-1 · Cited by 12
Effects of meal composition on postprandial incretin, glucose and insulin responses after surgical and medical weight loss
Lee, C. J., Brown, T. T., Cheskin, L. J., Choi, P. P., Moran, T. H., Peterson, L., Matuk, R., & Steele, K. E. (2015) · Obesity Science & Practice · doi:10.1002/osp4.17 · Cited by 12
Roux-en-Y gastric bypass potentially improved intestinal permeability by regulating gut innate immunity in diet-induced obese mice
Jin, Z., Chen, K., Zhou, Z., Peng, W., & Liu, W. (2021) · Scientific Reports · doi:10.1038/s41598-021-94094-8 · Cited by 11
The Effect of Bariatric Surgery on Circulating Levels of Monocyte Chemoattractant Protein-1: A Systematic Review and Meta-Analysis
Jamialahmadi, T., Abbasifard, M., Reiner, Ž., Kesharwani, P., & Sahebkar, A. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11237021 · Cited by 11
“Salman 2021 [24] * * * * * * Rizk 2021 [25] * * * * * Morales 2021 [26] * * * * * * Yan 2021 [27] * * * * * * Bratti 2021 [28] * * * * * * * * Salman 2020 [29] * * * * * * Lambert 2018 [30] * * * * * * * * Alsharidah 2018 [31] * * * * Yadav 2017 [32] * * * * * * van der Wielen 2017 [33] * * * * * * Sams 2016 [34] * *…”
Background
Roux-en-Y Esophagojejunostomy Ameliorates Renal Function Through Reduction of Renal Inflammatory and Fibrotic Markers in Diabetic Nephropathy
Wang, C., He, B., Piao, D., & Han, P. (2015) · Obesity Surgery · doi:10.1007/s11695-015-1947-5 · Cited by 11
DNA Methylation Suppresses Liver Hamp Expression in Response to Iron Deficiency After Bariatric Surgery
Huang, Y., Zhang, H., Liu, H., Wang, X., Wang, C., 狄建忠, Bao, Y., Zhang, R., 贾伟平, Zhang, X., et al. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.10.005 · Cited by 11
ApoA-I mimetics favorably impact cyclooxygenase 2 and bioactive lipids that may contribute to cardiometabolic syndrome in chronic treated HIV
Δάσκου, Μ., Sharma, M. B., Mu, W., Heymans, R., Ritou, E., Rezek, V. K., Hamid, P., Kossyvakis, A., Roy, S. S., Grijalva, V. R., et al. (2021) · Metabolism · doi:10.1016/j.metabol.2021.154888 · Cited by 9
Bariatric Surgery Leads to a Reduction in Antibodies to Apolipoprotein A-1: a Prospective Cohort Study
Adam, S., Ho, J. H., Liu, Y., Siahmansur, T. J., Iqbal, Z., Pagano, S., Azmi, S., Dhage, S. S., Donn, R. P., Ammori, B. J., et al. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05738-7 · Cited by 9
Inhibition of inflammation may enhance nitric oxide availability in patients undergoing bariatric surgery for weight loss
Blum, A., Ginat‐Maimon, L., Yehuda, H., Geron, N., Ami, M. B., & Tamir, S. (2015) · Journal of Internal Medicine · doi:10.1111/joim.12379 · Cited by 9
Our Hidden Enemy: Ultra-Processed Foods, Inflammation, and the Battle for Heart Health
Sawalha, K., Tripathi, V., Alkhatib, D. A., Alalawi, L. H., Mahmood, A., & Alexander, T. J. (2023) · Cureus · doi:10.7759/cureus.47484 · Cited by 12
“However, we do know that AMPK activity was enhanced in the muscle and liver of germ-free mice, which played a huge role in weight loss by the process of enhanced fatty acid oxidation and energy expenditure [22].”
Background
Metabolic endotoxemia: possible causes and consequences
Beloglazov, V. A., Yatskov, I. A., Кумельский, Е. Д., & Polovinkina, V. V. (2021) · Obesity and metabolism · doi:10.14341/omet12750 · Cited by 8
The Evaluation of Serum Endocan, Interleukin-6, and CRP Levels Following Sleeve Gastrectomy
Sarıyıldız, G. T., Demir, C., Demir, M. E., Arslan, A., Banlı, O., & Dursun, A. D. (2023) · International Journal of General Medicine · doi:10.2147/ijgm.s436213 · Cited by 9
The possible role of antimicrobial proteins in obesity-associated immunologic alterations
Moreno‐Navarrete, J. M., & Fernández‐Real, J. M. (2014) · Expert Review of Clinical Immunology · doi:10.1586/1744666x.2014.911088 · Cited by 8
“Bariatric surgery- [36] or diet-induced weight loss [33] led to decreased plasma LPS in parallel with the improvement of obesity-associated metabolic disturbances.”
Background
Simulating the Post-gastric Bypass Intestinal Microenvironment Uncovers a Barrier-Stabilizing Role for FXR
Hankir, M. K., Langseder, T., Bankoglu, E. E., Ghoreishi, Y., Dischinger, U., Kurlbaum, M., Kroiß, M., Otto, C., le Roux, C. W., Arora, T., et al. (2020) · iScience · doi:10.1016/j.isci.2020.101777 · Cited by 8
Lipopolysaccharide and inflammatory cytokines levels decreased after sleeve gastrectomy in Chinese adults with obesity
Li, Y., Guan, W., Ma, S., Lin, S., Yang, N., Liu, R., Liang, H., & Zhou, H. (2019) · Endocrine Journal · doi:10.1507/endocrj.ej18-0446 · Cited by 10

Authors: Monte, S. V., Caruana, J. A., Ghanim, H., Sia, C. L., Korzeniewski, K., Schentag, J. J., & Dandona, P.
Affiliations: University at Buffalo, State University of New York (US)
Sisters of Charity Hospital (US)
Kaleida Health (US)
Corresponding author: Monte, Scott V.
ORCID: Monte, Scott V.
Ghanim, Husam
Schentag, Jerome J.
Dandona, Paresh
Venue: Surgery
Publisher: Elsevier BV
Published: 2012-04
Volume: 151
Issue: 4
Pages: 587-593
ISSN: 0039-6060 (ISSN-L)
DOI: 10.1016/j.surg.2011.09.038
OpenAlex: W1985684171
Cited by: 143
References: 31
Citations by year: 2026: 1 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 11 · 2021: 18 · 2020: 14 · 2019: 13 · 2018: 7 · 2017: 9 · 2016: 8 · 2015: 14 · 2014: 10 · 2013: 15 · 2012: 6
FWCI: 10.14
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Surgery (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r01dk069805-04)
National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK069805, R01DK075877)
Topics: Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
Keywords: Roux-en-Y gastric bypass, morbid obesity, type 2 diabetes, endotoxemia, lipopolysaccharide, insulin resistance, oxidative stress, inflammatory stress, NF-κB, Toll-like receptors, CD14, TLR4, TLR2, weight loss, bariatric surgery, C-reactive protein, MMP-9
MeSH terms: Adult, Anthropometry, Diabetes Mellitus, Type 2, Female, Humans, Inflammation, Insulin Resistance, Leukocytes, Mononuclear, Lipopolysaccharides, Male, Middle Aged, Obesity, Morbid, Gastric Bypass, NF-kappa B, Treatment Outcome, Oxidative Stress, Lipopolysaccharide Receptors, Endotoxemia, Toll-Like Receptor 4

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Reduction in endotoxemia, oxidative and inflammatory stress, and insulin resistance after Roux-en-Y gastric bypass surgery in patients with morbid obesity and type 2 diabetes mellitus

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