High levels of CRP in morbid obesity: the central role of adipose tissue and lessons for clinical practice before and after bariatric surgery

Abstract Background Obesity, characterized by low-grade inflammation both in blood and white adipose tissue (WAT) is associated with increased C-reactive protein (CRP), a well-known acute phase protein. The aim of this study was to determine factors associated with high levels of CRP in obesity. Methods In 674 obese patients candidates to bariatric surgery (mean body mass index [BMI] = 47.4±7.4 kg/m²), we examined the relationships between CRP and a series of bioclinical markers and histologic features of subcutaneous and omental WAT (scWAT) and liver. We also compared the same parameters after separating patients with “high” inflammation (HI, CRP≥20 mg/L, n = 52) and with “low” inflammation (LI, CRP