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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
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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“In addition, intranuclear binding of nuclear factor kappa B, a major proinflammatory transcription factor, also fell.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [15]
In the citing paper
“This observation was also noted in 2012, 6 months after a Roux-en-Y gastric bypass (RYGB) procedure [15], where a reduction in plasma concentrations of endotoxin was observed.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [15]
In the citing paper
“Substantial decreases in the expression of toll-like receptors, TLR-4 and TLR-2 (the respective receptors for endotoxin and Gram-positive bacterial products), occurred in mononuclear cells.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [15]
In the citing paper
“Concomitant reductions in plasma concentrations of matrix metallopeptidase (MMP)-9 and C-reactive protein (CRP) were seen and there was also a reduction in the expression of CD14, the marker of activated monocytes.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [15]
In the citing paper
“In addition, there was a parallel reduction in fasting glucose and insulin concentrations, reflected in reduced Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), an index of insulin resistance.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [15]
In the citing paper
“Beyond gastrointestinal derived signals and feeding behavior alteration, contributing factors include the reductions in endotoxemia/inflammation and insulin resistance after bariatric surgery [15].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [15]
Citations
Cites
Bariatric Surgery: A Systematic Review and Meta-analysis
Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., Fahrbach, K., & Schoelles, K. (2004) · JAMA · doi:10.1001/jama.292.14.1724 · Cited by 6,800
Metabolic Endotoxemia Initiates Obesity and Insulin Resistance
Cani, P. D., Amar, J., Iglesias, M. A., Poggi, M., Knauf, C., Bastelica, D., Neyrinck, A. M., Fava, F., Tuohy, K. M., Chabo, C., et al. (2007) · Diabetes · doi:10.2337/db06-1491 · Cited by 6,638
Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery
Sjöström, L., Lindroos, A.-K., Peltonen, M., Torgerson, J., Bouchard, C., Carlsson, B., Dahlgren, S., Larsson, B., Narbro, K., Sjöström, C. D., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa035622 · Cited by 4,457
Inflammation, stress, and diabetes
Wellen, K. E., & Hotamisligil, G. S. (2005) · Journal of Clinical Investigation · doi:10.1172/jci25102 · Cited by 4,143
Pories, W. J., Swanson, M. S., MacDonald, K. G., Long, S. B., Morris, P. G., Brown, B. M., Barakat, H. A., deRamon, R. A., Israel, G., Dolezal, J. M., et al. (1995) · Annals of Surgery · doi:10.1097/00000658-199509000-00011 · Cited by 2,293
Andrews, N. C., & Faller, D. V. (1991) · Nucleic Acids Research · doi:10.1093/nar/19.9.2499 · Cited by 2,292
Inflammation: the link between insulin resistance, obesity and diabetes
Dandona, P. (2004) · Trends in Immunology · doi:10.1016/j.it.2003.10.013 · Cited by 2,170
Self-citationToll-like Receptor-4 Mediates Lipopolysaccharide-induced Signal Transduction
Chow, J. C., Young, D. W., Golenbock, D. T., Christ, W. J., & Gusovsky, F. (1999) · Journal of Biological Chemistry · doi:10.1074/jbc.274.16.10689 · Cited by 1,924
Human gut microbiota in obesity and after gastric bypass
Zhang, H., DiBaise, J. K., Zuccolo, A., Kudrna, D., Braidotti, M., Yu, Y., Parameswaran, P., Crowell, M. D., Wing, R., Rittmann, B. E., et al. (2009) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0812600106 · Cited by 1,880
Dandona, P., Aljada, A., Chaudhuri, A., Mohanty, P., & Garg, R. (2005) · Circulation · doi:10.1161/01.cir.0000158483.13093.9d · Cited by 1,263
Pickup, J. C., Mattock, M. B., Chusney, G. D., & Burt, D. J. (1997) · Diabetologia · doi:10.1007/s001250050822 · Cited by 1,246
Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus
Schauer, P. R., Burguera, B., Ikramuddin, S., Cottam, D., Gourash, W., Hamad, G., Eid, G. M., Mattar, S., Ramanathan, R., Barinas-Mitchel, E., et al. (2003) · Annals of Surgery · doi:10.1097/01.sla.0000089851.41115.1b · Cited by 1,183
Tripathy, D., Mohanty, P., Dhindsa, S., Syed, T., Ghanim, H., Aljada, A., & Dandona, P. (2003) · Diabetes · doi:10.2337/diabetes.52.12.2882 · Cited by 667
Circulating Mononuclear Cells in the Obese Are in a Proinflammatory State
Ghanim, H., Aljada, A., Hofmeyer, D., Syed, T., Mohanty, P., & Dandona, P. (2004) · Circulation · doi:10.1161/01.cir.0000142055.53122.fa · Cited by 611
Gastric Bypass for Obesity: Mechanisms of Weight Loss and Diabetes Resolution
Cummings, D. E., Overduin, J., & Foster-Schubert, K. E. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-0433 · Cited by 503
Ghanim, H., Abuaysheh, S., Sia, C. L., Korzeniewski, K., Chaudhuri, A., Fernandez-Real, J. M., & Dandona, P. (2009) · Diabetes Care · doi:10.2337/dc09-0979 · Cited by 494
Self-citationPYY modulation of cortical and hypothalamic brain areas predicts feeding behaviour in humans
Batterham, R. L., Ffytche, D. H., Rosenthal, J., Zelaya, F. O., Barker, G. J., Withers, D. J., & Williams, S. (2007) · Nature · doi:10.1038/nature06212 · Cited by 489
Gastric Bypass vs Sleeve Gastrectomy for Type 2 Diabetes Mellitus
Lee, W. (2011) · Archives of Surgery · doi:10.1001/archsurg.2010.326 · Cited by 436
Falkén, Y., Hellström, P. M., Holst, J. J., & Näslund, E. B. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2876 · Cited by 315
Deopurkar, R., Ghanim, H., Friedman, J., Abuaysheh, S., Sia, C. L., Mohanty, P., Viswanathan, P., Chaudhuri, A., & Dandona, P. (2010) · Diabetes Care · doi:10.2337/dc09-1630 · Cited by 256
Remission of Type 2 Diabetes After Gastric Bypass and Banding
Pournaras, D. J., Osborne, A., Hawkins, S. C., Vincent, R. P., Mahon, D., Ewings, P., Ghatei, M. A., Bloom, S. R., Welbourn, R., & le Roux, C. W. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181efc49a · Cited by 226
Roux‐en‐Y Gastric Bypass Improves Liver Histology in Patients with Non‐Alcoholic Fatty Liver Disease
Clark, J. M., Al-Khuraishi, A., Solga, S. F., Alli, P. M., Diehl, A. M., & Magnuson, T. H. (2005) · Obesity Research · doi:10.1038/oby.2005.140 · Cited by 187
Is weight reduction an effective therapy for nonalcoholic fatty liver?
Wang, R. T., Koretz, R. L., & Yee, H. F. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00449-2 · Cited by 146
Effects of Bilio-Pancreatic Diversion on Diabetic Complications
Iaconelli, A., Panunzi, S., Gaetano, A. D., Manco, M., Guidone, C., Leccesi, L., Gniuli, D., Nanni, G., Castagneto, M., Ghirlanda, G., et al. (2011) · Diabetes Care · doi:10.2337/dc10-1761 · Cited by 141
Changes in neurohormonal gut peptides following bariatric surgery
Ochner, C. N., Gibson, C. D., Shanik, M. H., Goel, V., & Geliebter, A. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.132 · Cited by 137
Crook, M. A., Tutt, P., & Pickup, J. C. (1993) · Diabetes Care · doi:10.2337/diacare.16.1.57 · Cited by 133
Campos, G. M. (2011) · Archives of Surgery · doi:10.1001/archsurg.2010.316 · Cited by 72
Deopurkar, R., Ghanim, G., Friedman, & Abuaysheh (2010) · Diabetes Care · Cited by 71
Appetite control after weight loss: what is the role of bloodborne peptides?
Doucet, É., & Cameron, J. D. (2007) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h07-019 · Cited by 52
Neurohormonal pathways regulating food intake and changes after Roux-en-Y gastric bypass
Orlando, F. A., Gonçalves, C. G., George, Z. M., Halverson, J. D., Cunningham, P. R., & Meguid, M. M. (2005) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2005.05.009 · Cited by 13
Roux en Y Gastric Bypass by Single-Incision Mini-Laparotomy: Outcomes in 3,300 Consecutive Patients
Caruana, J. A., McCabe, M. N., Smith, A. D., Stawiasz, K. A., Kabakov, E., & Kabakov, J. M. (2011) · Obesity Surgery · doi:10.1007/s11695-011-0394-1 · Cited by 12
Cited by
Sorted by citations
Chait, A., & den Hartigh, L. J. (2020) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.00022 · Cited by 1,529
“Such metabolic endotoxemia is reduced following antibiotic treatment (681) or RYGB surgery-induced weight loss (627).”
BackgroundHuman gut microbiome: Hopes, threats and promises
Cani, P. D. (2018) · Gut · doi:10.1136/gutjnl-2018-316723 · Cited by 1,386
Systemic Effects of Inflammation on Health during Chronic HIV Infection
Deeks, S. G., Tracy, R. P., & Douek, D. C. (2013) · Immunity · doi:10.1016/j.immuni.2013.10.001 · Cited by 910
“…pancreatitis, graft-versus-host disease, excessive alcohol consumption, and obesity and diabetes, and might even contribute to aging (Lassenius et al., 2011; Monte et al., 2012; Nalle and Turner, 2012; Pussinen et al., 2007, 2011; Sandler et al., 2011a; Tran and Greenwood-Van Meerveld, 2013).”
How Probiotics Affect the Microbiota
Wieërs, G., Belkhir, L., Enaud, R., Leclercq, S., de Foy, J.-M. P., Dequenne, I., de Timary, P., & Cani, P. D. (2020) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2019.00454 · Cited by 557
“Importantly, this finding was later confirmed in several large human cohorts (Amar et al., 2008; Gummesson et al., 2011; Lassenius et al., 2011; Laugerette et al., 2011; Monte et al., 2011; Pussinen et al., 2011; Horton et al., 2014; Jayashree et al., 2014; Radilla-Vazquez et al., 2016; Gomes et al., 2017).”
ResultMetabolic endotoxemia with obesity: Is it real and is it relevant?
Boutagy, N. E., McMillan, R. P., Frisard, M. I., & Hulver, M. W. (2016) · Biochimie · doi:10.1016/j.biochi.2015.06.020 · Cited by 413
Metadata
- 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.
- Venue
- Surgery
- Publisher
- Elsevier BV
- Published
- 2012-04
- Volume
- 151
- Issue
- 4
- Pages
- 587-593
- ISSN
- 0039-6060 (ISSN-L)
- 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
- 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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