Cited by 427Adipokines, Inflammation, and Metabolic DiseasesBariatric Surgery and OutcomesDiabetes, Cardiovascular Risks, and Lipoproteins

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Impact of Weight Loss on Inflammatory Proteins and Their Association With the Insulin Resistance Syndrome in Morbidly Obese Patients

Kopp, H.P., Kopp, C.W., Festa, A., Krzyzanowska, K., Kriwanek, S., Minar, E., Roka, R., Schernthaner, G.·2003·Arteriosclerosis, Thrombosis, and Vascular Biology

DOI 10.1161/01.atv.0000073313.16135.21

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Abstract

Objective— Obesity is closely linked to the insulin resistance syndrome (IRS), type 2 diabetes, and cardiovascular disease, the primary cause of morbidity and mortality in these patients. Elevated levels of C-reactive protein (CRP) and interleukin-6 (IL-6), indicating chronic subclinical inflammation, have been associated with features of the IRS and incident cardiovascular disease. Methods and Results— We studied the cross-sectional and longitudinal relation of CRP, IL-6, and tumor necrosis factor-α (TNF-α) with features of the IRS in 37 morbidly obese patients with different stages of glucose tolerance before and 14 months after gastric surgery. Weight loss after gastric surgery induced a significant shift from diabetes (37% vs 3%) to impaired glucose tolerance (40% vs 33%) and normal glucose tolerance (23% vs 64%). The baseline concentration of IL-6 was correlated with TNF-α ( r =0.59, P <0.01) and CRP ( r =0.44, P <0.05) levels. TNF-α, IL-6, and CRP were significantly correlated with insulin resistance estimated by the homeostatic model assessment ( r =0.48, P <0.05; r =0.56, P <0.01; and r =0.35, P <0.05, respectively). Concentrations of CRP and IL-6 decreased after weight loss (median, 8.6 and interquartile range, 2.7/14.5 vs 2.5 and 1.2/4.1 mg/L; P <0.006, and 5.13 and 2.72/12.15 vs 3.95 and 1.97/5.64 pg/mL, P <0.02, respectively), whereas serum levels of TNF-α remained unchanged (8.6 and 6.3/18.8 vs 11.7 and 5.8/17.2 pg/mL; NS.). Multiple regression analysis revealed that the decrease in insulin resistance remained independently and significantly correlated with the decrease in IL-6 concentrations ( P <0.01) and the decrease in body mass index with the decrease in CRP ( P <0.05), respectively. Conclusions— Weight loss in morbidly obese patients induces a significant decrease of CRP and IL-6 concentrations in association with an improvement of the IRS.

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Homeostasis model assessment: insulin resistance and ?-cell function from fasting plasma glucose and insulin concentrations in man
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Sorted by citations

Items 201–300 of 425

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Climent, E., Oliveras, A., Pedro‐Botet, J., Goday, A., & Benaiges, D. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10184049 · Cited by 31
“Moreover, as insulin sensitivity increases, C-reactive protein and interleukin-6 levels decrease, thus ameliorating adipocyte inflammation and in turn preventing vascular constriction [39].”
Background
Effects of Lifestyle Measures, Antiobesity Agents, and Bariatric Surgery on Serological Markers of Inflammation in Obese Patients
Τζιόμαλος, Κ., Dimitroula, H. V., Katsiki, N., Savopoulos, C. G., & Hatzitolios, A. I. (2010) · Mediators of Inflammation · doi:10.1155/2010/364957 · Cited by 28
“In addition, serum TNFα levels [172, 174] were not affected by gastric banding.”
BackgroundResultInfluential
Glycemic Index and Glycemic Load Estimates in the Dietary Approach of Polycystic Ovary Syndrome
Manta, A., Paschou, S. Α., Isari, G., Mavroeidi, I., Kalantaridou, S., & Peppa, Μ. (2023) · Nutrients · doi:10.3390/nu15153483 · Cited by 36
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Exercise-induced oxidative stress in overweight adolescent girls: roles of basal insulin resistance and inflammation and oxygen overconsumption
Youssef, H. A., Groussard, C., Pincemail, J., Moussa, E., Jacob, C. O., Lemoine, S., Zind, M., Jo, D., Cillard, J., Delamarche, P., et al. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.49 · Cited by 27
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“High circulating levels of TNF-α, IL-6, and leptin are recognized as markers of insulin resistance [10, 41, 42].”
Background
Impacto da perda de peso nas adipocitocinas, na proteína C-reativa e na sensibilidade à insulina em mulheres hipertensas com obesidade central
Borges, R. L., Ribeiro‐Filho, F. F., de Carvalho, K. M. B., & Zanella, M. T. (2007) · Arquivos Brasileiros de Cardiologia · doi:10.1590/s0066-782x2007001800010 · Cited by 27
Cardiovascular effects of the thiazolidinediones
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“present in patients with CAD as well as in patients with insulin resistance [29,30].”
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Type 2 diabetes in Singapore: the role of exercise training for its prevention and management.
Lim, J. G., Kang, H., & Stewart, K. J. (2004) · PubMed · Cited by 27
Bariatric surgery and nonalcoholic fatty liver disease
Bower, G., Athanasiou, T., Isla, A., Harling, L., Li, J. V., Holmes, E. C., Efthimiou, E., Darzi, A. W., & Ashrafian, H. (2015) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000000375 · Cited by 27
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“Another study [44] showed that, although the subjects’ body weights decreased by 32.”
Background
Association of C-reactive protein with the metabolic risk factors among young and middle-aged Koreans
Choi, E. Y., Park, E. H., Cheong, Y. S., Rheem, I., Park, S. G., & Yoo, S. (2006) · Metabolism · doi:10.1016/j.metabol.2005.11.002 · Cited by 26
“Findings from other studies that CRP levels decreased in response to weight loss [39-44] also support our results.”
Result
Alterations in adipocytokines and cGMP homeostasis in morbid obesity patients reverse after bariatric surgery
Felipo, V., Urios, A., García-Torres, M. L., Mlili, N. E., del Olmo, J. A., Civera, M., Ortega, J., Ferrandez, A., Martínez-Valls, J. F., Fernández, N. C., et al. (2013) · Obesity · doi:10.1002/oby.20008 · Cited by 25
“The changes in inflammatory markers observed are similar to those previously reported by other authors (25).”
Result
Changes in C-reactive protein during weight loss and the association with changes in anthropometric variables in men and women: LIFE Study
Yatsuya, H., Jeffery, R. W., Langer, S. L., Mitchell, N. R., Flood, A. P., Welsh, E. M., Jaeb, M. A., Laqua, P. S., Crowell, M. D., & Levy, R. L. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.200 · Cited by 26
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“Given that moderate weight loss alone is associated with improvement of fasting glucose/insulin and HbA1c concentrations (Kopp et al. 2003), it is inconclusive whether the improvement was a result of consuming a HP diet, weight loss, or a combined effect.”
Background
Lutein and Age-Related Ocular Disorders in the Older Adult
Renzi‐Hammond, L. M., & Johnson, E. J. (2007) · Journal of Nutrition for the Elderly · doi:10.1300/j052v26n03_07 · Cited by 24
Effect of Moderate-Intensity Exercise on Plasma C-Reactive Protein and Aortic Endothelial Function in Type 2 Diabetic Mice
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“In addition, db/db mice are obese, and there is also a close association between adiposity and CRP [13, 30].”
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The Relationship between BMI, Plasma Leptin, Insulin and Proinsulin Before and After Laparoscopic Adjustable Gastric Banding
Ram, E., Vishne, T. H., Maayan, R., Lerner, I., Weizman, A., Dreznik, Z., Bloch, K. O., Seror, D., & Vardi, P. (2005) · Obesity Surgery · doi:10.1381/096089205774859146 · Cited by 24
Stress-induced changes in the expression of monocytic β2-integrins: The impact of arousal of negative affect and adrenergic responses to the Anger Recall Interview
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“We and others have posited that the relation of state and trait measures of psychological distress to ACVD may be due, in part, to inflammation (Black, 2006; Kop et al., 2003; Suarez, 2003; Suarez et al., 2004b, 2006) and particularly the effects of stress on monocyte function.”
Background
The role of bariatric surgery in the treatment of diabetes
Tham, J. C., Howes, N., & le Roux, C. W. (2014) · Therapeutic Advances in Chronic Disease · doi:10.1177/2040622313513313 · Cited by 25
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“Obesity is also characterized by an inflammatory state, often reflected by elevated plasma C-reactive protein (CRP) levels [5], which fall with weight reduction [6,7].”
Background
Lifestyle Changes Followed by Bariatric Surgery Lower Inflammatory Markers and the Cardiovascular Risk Factors C3 and C4
Nestvold, T. K., Nielsen, E. W., Ludviksen, J. K., Fure, H., Landsem, A., & Lappegård, K. T. (2014) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2014.0099 · Cited by 23
Intrahepatic fat content correlates with soluble CD 163 in relation to weight loss induced by R oux‐en‐ Y gastric bypass
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“Massive weight loss in relation with RYGB is associated with improvement of the metabolic profile (24,26) and likewise, we found a reduction in the circulating inflammatory cytokines IL-6 and hs-CRP, decreased level of HOMA-IR, diabetes remission, and increased level of adiponectin after RYGB.”
Background
Comparison of Early and Late Changes in Immunoglobulins and Acute Phase Reactants after Laparoscopic Adjustable Gastric Banding in Patients with Morbid Obesity
SAKÇAK, İ., Avşar, M. F., Hamamcı, E. O., Bostanoğlu, S., Sonışık, M., Bostanoğlu, A., Erdem, N. Z., & Coşgun, E. (2010) · Obesity Surgery · doi:10.1007/s11695-009-0061-y · Cited by 23
“There are also some studies that have found no parallel decrease in inflammatory cytokines, despite weight loss in the early postoperative period after bariatric surgery [22, 23].”
Changes in C-Reactive Protein Predict Insulin Sensitivity in Severely Obese Individuals After Weight Loss Surgery
Gletsu-Miller, N. A., Lin, E., Khaitan, L., Lynch, S. A., Ramshaw, B., Raziano, R. M., Torres, W. E., Ziegler, T. R., Papanicolaou, D. A., & Smith, C. D. (2005) · Journal of Gastrointestinal Surgery · doi:10.1016/j.gassur.2005.07.035 · Cited by 23
Perioperative Optimization of Patients Undergoing Bariatric Surgery
Owers, C. E., Abbas, Y. H., Ackroyd, R., Barron, N., & Khan, M. A. (2012) · Journal of Obesity · doi:10.1155/2012/781546 · Cited by 22
“Thiamine stores are limited, is absorbed in the proximal small intestine and may become deficient after a combination of reduced intake, frequent vomiting, and malabsorption [29].”
Background
AMPK activation may suppress hepatic production of C-reactive protein by stimulating nitric oxide synthase
McCarty, M. F. (2004) · Medical Hypotheses · doi:10.1016/j.mehy.2004.01.044 · Cited by 22
“Finally, appropriate weight loss can lower CRP, presumably by decreasing the IL-6 production of hypertrophied insulin-resistant adipocytes [55–58].”
Background
Comparison of adipokine concentrations and markers of inflammation in obese versus lean dogs.
Eirmann, L., Freeman, L., Laflamme, D. P., Michel, K. E., & Satyaraj, E. (2009) · The journal of applied research in veterinary medicine · Cited by 22
Association of adipokines with insulin resistance and metabolic syndrome including obesity and diabetes
Gupta, A. K., Gupta, P., Singh, A. K., & Gupta, V. (2023) · GHM Open · doi:10.35772/ghmo.2023.01004 · Cited by 26
Sleep apnea modifies the long‐term impact of surgically induced weight loss on cardiac function and inflammation
Kardassis, D., Grote, L., Sjöström, L., Hedner, J. A., & Karason, K. (2013) · Obesity · doi:10.1002/oby.20115 · Cited by 21
“Short-term weight loss provides a benefit with respect to obesity-related OSA (12,13), inflammation (14) and cardiac dysfunction (15).”
Background
Non-Alcoholic Fatty Liver Disease and Its Association With Diabetes Mellitus
Padda, J., Khalid, K., Khedr, A., Tasnim, F., Al-Ewaidat, O. A., Cooper, A. C., & Jean-Charles, G. (2021) · Cureus · doi:10.7759/cureus.17321 · Cited by 24
“Moreover, once patients lose weight after bariatric surgery, IR gets improved, and it seems to correlate with improved Creactive protein and tumor necrosis factor-α [122].”
Background
Effect of oral magnesium supplement on cardiometabolic markers in people with prediabetes: a double blind randomized controlled clinical trial
Salehidoost, R., Boroujeni, G. T., Feizi, A., Aminorroaya, A., & Amini, M. (2022) · Scientific Reports · doi:10.1038/s41598-022-20277-6 · Cited by 22
Gender-specific differences of interaction between cadmium exposure and obesity on prediabetes in the NHANES 2007–2012 population
Jiang, F., Zhi, X., Xu, M., Li, B., & Zhang, Z. (2018) · Endocrine · doi:10.1007/s12020-018-1623-3 · Cited by 21
Effect of Bariatric Surgery on Cardiovascular Function and Heart Failure Outcomes
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“Circulating levels of CRP and IL-6 fall in parallel with improved insulin sensitivity almost immediately postoperatively, indicating that bariatric surgery has beneficial weight-independent effects.(71) A meta-analysis by Gloy et al(72) showed that diabetes remission occurred within days to weeks after bariatric surge…”
Background
Developmental programming of cardiovascular disorders: Focus on hypertension
MohanKumar, S. M. J., King, A., Shin, A. C., Sirivelu, M. P., MohanKumar, P. S., & Fink, G. D. (2007) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-007-9047-z · Cited by 21
“proinflammatory cytokines [61, 62], which results in an increase in their circulating levels.”
Myeloid cell-derived interleukin-6 induces vascular dysfunction and vascular and systemic inflammation
Knopp, T., Jung, R., Wild, J., Bochenek, M. L., Efentakis, P., Lehmann, A., Bieler, T., Garlapati, V. S., Richter, C., Molitor, M., et al. (2024) · European Heart Journal Open · doi:10.1093/ehjopen/oeae046 · Cited by 21
“This is of high clinical relevance, as elevated IL-6 levels in patients with CVD (as also seen for example in obesity 45 ) seem to predict a poorer outcome, 22,46 underlining the need for a better understanding of IL-6 in CVD.”
Background
Immune cell-mediated inflammation and the early improvements in glucose metabolism after gastric banding surgery
Samaras, K., Viardot, A., Botelho, N. K., Jenkins, A. J., & Lord, R. V. (2013) · Diabetologia · doi:10.1007/s00125-013-3033-7 · Cited by 20
High sensitivity C-reactive protein is associated with the metabolic syndrome independent to viral and bacterial pathogen burden
Ebrahimi, A., Nabipour, I., Vahdat, K., Jafari, S. M., Fouladvand, M., Assadi, M., Movahed, A., Obeidi, N., & Sanjdideh, Z. (2009) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2009.03.010 · Cited by 19
Gastric bypass–induced weight loss alters obesity-associated patterns of plasma pentraxin-3 and systemic inflammatory markers
Barazzoni, R., Palmisano, S., Cappellari, G. G., Giuricin, M., Moretti, E., Vinci, P., Semolic, A., Guarnieri, G., Zanetti, M., & de Manzini, N. (2015) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2015.04.013 · Cited by 19
“Weight loss induced by caloric restriction or bariatric surgery may limit these alterations ((7-12)), and these effects may contribute to the positive effect of weight loss to reduce obesityassociated morbidity.”
Background
The decrease in serum IL-18 levels after bariatric surgery in morbidly obese women is a time-dependent event
Botella-Carretero, J. I., Álvarez‐Blasco, F., Martínez-García, M. Á., Luque‐Ramírez, M., Millán, J. L. S., & Escobar-Morreale, H. F. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9202-3 · Cited by 19
The effect of weight loss and dietary fatty acids on inflammation
Devaraj, S., Kasim-Karakas, S. E., & Jialal, I. (2006) · Current Atherosclerosis Reports · doi:10.1007/s11883-006-0023-y · Cited by 19
“Subjects in the study by Laimer et al. [15] had a BMI of 42 kg/m 2 at baseline, subjects in the study by Kopp et al. [ 14 ] had a BMI of 49 ± 7 kg/m 2 at baseline, and subjects in the study by Hanusch-Enserer et al. [16] had a BMI of 50 ± 10 kg/m 2 at baseline.”
BackgroundInfluential
Molecular Basis of Irisin Regulating the Effects of Exercise on Insulin Resistance
Lin, J., Liu, X., Zhou, Y., Zhu, B., Wang, Y., Cui, W., Peng, Y., Wang, B., Chen, Z., & Zhao, R. (2022) · Applied Sciences · doi:10.3390/app12125837 · Cited by 22
Oxidative balance score inversely associated with the prevalence and incidence of metabolic syndrome: analysis of two studies of the Korean population
Park, H.-M., Han, T.-H., Kwon, Y., & Lee, J. (2023) · Frontiers in Nutrition · doi:10.3389/fnut.2023.1226107 · Cited by 18
“Both insulin resistance and chronic systemic inflammation are key factors in MetS (8).”
Background
Transcriptome responses in blood reveal distinct biological pathways associated with arsenic exposure through drinking water in rural settings of Punjab, Pakistan
Rehman, M. Y. A., van Herwijnen, M. H. M., Krauskopf, J., Farooqi, A., Kleinjans, J. C. S., Malik, R. N., & Briedé, J. J. (2019) · Environment International · doi:10.1016/j.envint.2019.105403 · Cited by 18
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 Influence of Obesity and Weight Loss on the Bioregulation of Innate/Inflammatory Responses: Macrophages and Immunometabolism
Gálvez, I., Navarro, M. D. C., Martín-Cordero, L., Otero, E., Hinchado, M. D., & Ortega, E. (2022) · Nutrients · doi:10.3390/nu14030612 · Cited by 21
Bariatric Surgery in Patients with Type 2 Diabetes: A Viable Option
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Correlation between Obesity and Inflammation in Cardiovascular Diseases—Evaluation of Leptin and Inflammatory Cytokines
Erusan, R. R., Devarajan, N., Manohar, G., & Malathi, R. (2012) · Open Journal of Endocrine and Metabolic Diseases · doi:10.4236/ojemd.2012.22002 · Cited by 17
Decrease in microvesicle-associated tissue factor activity in morbidly obese patients after bariatric surgery
Ay, L., Thaler, J., Brix, J., Schernthaner, G.-H., Ay, C., Pabinger, I., & Schernthaner, G.-H. (2015) · International Journal of Obesity · doi:10.1038/ijo.2015.246 · Cited by 17
Self-citation
Therapy Insight: weight-loss surgery and major cardiovascular risk factors
Blackburn, G. L., & Mun, E. C. (2005) · Nature Clinical Practice Cardiovascular Medicine · doi:10.1038/ncpcardio0349 · Cited by 17
“Weight-loss surgery in morbidly obese individuals produces significant decreases in concentrations of inflammatory indicators (C-reactive protein and interleukin-6)”
Background
Modeling the dynamics of glucose, insulin, and free fatty acids with time delay: The impact of bariatric surgery on type 2 diabetes mellitus
Murillo, A. L., Li, J. X., & Castillo‐Chávez, C. (2019) · Mathematical Biosciences & Engineering · doi:10.3934/mbe.2019288 · Cited by 17
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The Neuro‐Endocrinal Regulation in Vitiligo
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Authors: Kopp, H. P., Kopp, C. W., Festa, A., Krzyzanowska, K., Kriwanek, S., Minar, E., Roka, R., & Schernthaner, G.
Affiliations: Vienna General Hospital (AT)
From the Department of Medicine 1 (H.P.K., A.F., K.K., G.S.), Rudolfstiftung Hospital; the Department of Medicine 2 (C.W.K., E.M.), General Hospital of Vienna; and the Department of Surgery 1 and Ludwig Boltzmann Institute for Endocrine Surgery (S.K., R.K.), Rudolfstiftung Hospital, Vienna, Austria.
ORCID: Kopp, C.W.
Festa, A.
Roka, R.
Schernthaner, G.
Venue: Arteriosclerosis, Thrombosis, and Vascular Biology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-06
Volume: 23
Issue: 6
Pages: 1042-1047
ISSN: 1079-5642 (ISSN-L)
1524-4636
DOI: 10.1161/01.atv.0000073313.16135.21
OpenAlex: W2102170193
Cited by: 427
References: 45
Citations by year: 2026: 9 · 2025: 8 · 2024: 10 · 2023: 14 · 2022: 9 · 2021: 10 · 2020: 10 · 2019: 13 · 2018: 17 · 2017: 10 · 2016: 6 · 2015: 24 · 2014: 24 · 2013: 25 · 2012: 15
FWCI: 20.21
Type: journal article
Language: en
Open access: closed
Locations: Arteriosclerosis Thrombosis and Vascular Biology (publishedVersion)
PubMed (publishedVersion)
Funders: Universität Wien
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: morbid obesity, weight loss, metabolic syndrome, C-reactive protein, interleukin-6, TNF-α, chronic inflammation, gastric bypass, bariatric surgery, impaired glucose tolerance, type 2 diabetes, HOMA, body mass index, glucose tolerance, cardiovascular risk factors, adipokines, adipose tissue inflammation, hepatic insulin resistance
MeSH terms: Adult, Blood Glucose, C-Reactive Protein, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Fibrinogen, Humans, Inflammation, Insulin, Insulin Resistance, Lipids, Longitudinal Studies, Male, Middle Aged, Obesity, Morbid, Tumor Necrosis Factor-alpha, Gastroplasty, Weight Loss, Interleukin-6, Body Mass Index

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Impact of Weight Loss on Inflammatory Proteins and Their Association With the Insulin Resistance Syndrome in Morbidly Obese Patients

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