CRP reduction following gastric bypass surgery is most pronounced in insulin-sensitive subjects
Abstract
Objective Obesity is frequently associated with insulin resistance, dyslipidemia, hypertension and an increased risk of cardiovascular disease, reflected in elevated markers of inflammation, in particular C-reactive protein (CRP). To what extent the insulin resistance or the obesity per se contributes to increased CRP levels is unclear. In morbidly obese patients, gastric bypass surgery causes marked changes in body weight and improves metabolism, thereby providing informative material for studies on the regulation of inflammatory markers.Design Prospective, surgical intervention study of inflammatory markers in morbidly obese subjects.Subjects In total, 66 obese subjects with mean age 39 y and mean body mass index (BMI) 45 kg/m2 were studied prior to and 6 and 12 months following Roux-en-Y gastric bypass (RYGBP) surgery.Measurements Serum concentrations of high sensitivity CRP, serum amyloid A (SAA) and interleukin-6 (IL-6), as well as markers of glucose and lipid metabolism.Results Prior to surgery, CRP levels were elevated compared to the reference range of healthy, normal-weight subjects. CRP correlated with insulin sensitivity, as reflected by the homeostatic model assessment (HOMA) index, but not BMI, when corrected for age and gender. Surgery reduced BMI from 45 to 31 kg/m2 and lowered CRP, SAA and IL-6 levels by 82, 57 and 50%, respectively, at 12 months. The reduction in CRP was inversely related to HOMA at baseline independently of the change in body weight (r=-0.36, P=0.005). At 12 months, 140 and 40% reductions in CRP were seen in subjects with HOMA < 4 (insulin sensitive) and HOMA>9 (insulin resistant) despite similar reductions in BMI. Reductions in SAA and IL-6 tended to parallel the changes in CRP, but were less informative.Conclusion In morbidly obese subjects, gastric bypass surgery lowers energy intake, reduces inflammatory markers and improves insulin sensitivity. Despite a marked reduction in body weight, only a small effect on CRP levels was seen in insulin-resistant patients, indicating that flexibility of circulating CRP levels is primarily dependent upon insulin sensitivity rather than energy supply.
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Insulin-sensitive patients show earlier and more marked decreases in markers of inflammation than insulin-resistant patients following bariatric surgery.
“Also, insulin-sensitive patients show earlier and more marked decreases in markers of inflammation than patients who are insulin resistant following bariatric surgery.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [16]
Marked decreases in CRP are seen within 1 month following bariatric procedures, with more prominent reductions in insulin-sensitive patients.
“Marked decreases in CRP are seen within 1 month following bariatric procedures, with more prominent reductions seen in insulin-sensitive patients [16].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [16]
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- Authors
- Holdstock, C., Lind, L., Engstrom, B. E., Ohrvall, M., Sundbom, M., Larsson, A., & Karlsson, F. A.
- Affiliations
- Uppsala University Hospital (SE)
- Corresponding author
- Holdstock, C
- Venue
- International Journal of Obesity
- Published
- 2005-07-12
- Volume
- 29
- Issue
- 10
- Pages
- 1275-1280
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- OpenAlex
- W2051823822
- Cited by
- 73
- References
- 49
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 6 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 11 · 2017: 1 · 2016: 1 · 2015: 6 · 2013: 3 · 2012: 3
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- C-reactive protein, Roux-en-Y gastric bypass, morbid obesity, insulin resistance, insulin sensitivity, serum amyloid A, interleukin-6, inflammation, HOMA index, body mass index, weight loss, bariatric surgery
- MeSH terms
- Adult, Serum Amyloid A Protein, Blood Glucose, C-Reactive Protein, Female, Humans, Insulin Resistance, Male, Middle Aged, Obesity, Morbid, Prospective Studies, Sweden, Gastric Bypass, Biomarkers, Interleukin-6
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