Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea
Introduction Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We stu...
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| Veröffentlicht in: | Obesity surgery 2017-09, Vol.27 (9), p.2338-2346 |
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| container_title | Obesity surgery |
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| creator | Tirado, Raquel Masdeu, Maria José Vigil, Laura Rigla, Mercedes Luna, Alexis Rebasa, Pere Pareja, Rocío Hurtado, Marta Caixàs, Assumpta |
| description | Introduction
Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation.
Material and Methods
We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery.
Results
Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (
r
= 0.27,
p
= 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (
p
= 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (
r
= 0.43,
p
= 0.04) and with improved HOMA score (
r
= 0.37,
p
= 0.03).
Conclusions
Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation. |
| doi_str_mv | 10.1007/s11695-017-2635-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1876498174</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1930049511</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-7aaab7199f31a1d85f80b69461dd183e3de0903a8baa1b66e631c43ff9c4e3fb3</originalsourceid><addsrcrecordid>eNp1kcFu1DAQhi0EokvhAbggS1w4NOCxs459bCugKxWtROFsTZJJcZU4i-0Ae-fB8WoLQkicrJn5_M9IH2PPQbwGIZo3CUDbdSWgqaRW66p-wFbQCFOJWpqHbCWsFpWxUp2wJyndCSFBS_mYnUgjjbJSrNjPzbTDLvN54BcYPeboO36zxFuKez4HfkUT8e2P_S0FTFTBGd-EYcRpwuzncMYx9KWTltEH_pGSTxlDR7xUH-bY-p5v29LNe_7d5y-lSDkuXfbfiN-MRDt-vguET9mjAcdEz-7fU_b53dtPl1fV9fb95vL8uupUI3PVIGLbgLWDAoTerAcjWm1rDX0PRpHqSVih0LSI0GpNWkFXq2GwXU1qaNUpe3XM3cX560Ipu8mnjsYRA81LcmAaXVsDTV3Ql_-gd_MSQ7nOgVVC1HYNUCg4Ul2cU4o0uF30E8a9A-EOitxRkSuK3EGROyS_uE9e2on6Pz9-OymAPAKpjEIR8dfq_6b-AoPKnFE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1930049511</pqid></control><display><type>article</type><title>Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Tirado, Raquel ; Masdeu, Maria José ; Vigil, Laura ; Rigla, Mercedes ; Luna, Alexis ; Rebasa, Pere ; Pareja, Rocío ; Hurtado, Marta ; Caixàs, Assumpta</creator><creatorcontrib>Tirado, Raquel ; Masdeu, Maria José ; Vigil, Laura ; Rigla, Mercedes ; Luna, Alexis ; Rebasa, Pere ; Pareja, Rocío ; Hurtado, Marta ; Caixàs, Assumpta</creatorcontrib><description>Introduction
Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation.
Material and Methods
We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery.
Results
Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (
r
= 0.27,
p
= 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (
p
= 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (
r
= 0.43,
p
= 0.04) and with improved HOMA score (
r
= 0.37,
p
= 0.03).
Conclusions
Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-017-2635-4</identifier><identifier>PMID: 28283920</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adiponectin - blood ; Adult ; Bariatric Surgery ; C-Reactive Protein - metabolism ; Female ; Gastrointestinal surgery ; Heme Oxygenase-1 - blood ; Humans ; Inflammation - blood ; Inflammation - complications ; Inflammation - metabolism ; Inflammation - surgery ; Insulin - blood ; Insulin resistance ; Insulin Resistance - physiology ; Interleukin-6 - blood ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Obesity, Morbid - complications ; Obesity, Morbid - metabolism ; Obesity, Morbid - surgery ; Original Contributions ; Polysomnography ; Sleep apnea ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - metabolism ; Sleep Apnea, Obstructive - surgery ; Surgery ; Surgical outcomes ; Tumor Necrosis Factor-alpha - blood ; Weight control</subject><ispartof>Obesity surgery, 2017-09, Vol.27 (9), p.2338-2346</ispartof><rights>Springer Science+Business Media New York 2017</rights><rights>Obesity Surgery is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-7aaab7199f31a1d85f80b69461dd183e3de0903a8baa1b66e631c43ff9c4e3fb3</citedby><cites>FETCH-LOGICAL-c372t-7aaab7199f31a1d85f80b69461dd183e3de0903a8baa1b66e631c43ff9c4e3fb3</cites><orcidid>0000-0001-8472-9189</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-017-2635-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-017-2635-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28283920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tirado, Raquel</creatorcontrib><creatorcontrib>Masdeu, Maria José</creatorcontrib><creatorcontrib>Vigil, Laura</creatorcontrib><creatorcontrib>Rigla, Mercedes</creatorcontrib><creatorcontrib>Luna, Alexis</creatorcontrib><creatorcontrib>Rebasa, Pere</creatorcontrib><creatorcontrib>Pareja, Rocío</creatorcontrib><creatorcontrib>Hurtado, Marta</creatorcontrib><creatorcontrib>Caixàs, Assumpta</creatorcontrib><title>Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Introduction
Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation.
Material and Methods
We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery.
Results
Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (
r
= 0.27,
p
= 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (
p
= 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (
r
= 0.43,
p
= 0.04) and with improved HOMA score (
r
= 0.37,
p
= 0.03).
Conclusions
Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation.</description><subject>Adiponectin - blood</subject><subject>Adult</subject><subject>Bariatric Surgery</subject><subject>C-Reactive Protein - metabolism</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>Heme Oxygenase-1 - blood</subject><subject>Humans</subject><subject>Inflammation - blood</subject><subject>Inflammation - complications</subject><subject>Inflammation - metabolism</subject><subject>Inflammation - surgery</subject><subject>Insulin - blood</subject><subject>Insulin resistance</subject><subject>Insulin Resistance - physiology</subject><subject>Interleukin-6 - blood</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - metabolism</subject><subject>Obesity, Morbid - surgery</subject><subject>Original Contributions</subject><subject>Polysomnography</subject><subject>Sleep apnea</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - metabolism</subject><subject>Sleep Apnea, Obstructive - surgery</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Tumor Necrosis Factor-alpha - blood</subject><subject>Weight control</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kcFu1DAQhi0EokvhAbggS1w4NOCxs459bCugKxWtROFsTZJJcZU4i-0Ae-fB8WoLQkicrJn5_M9IH2PPQbwGIZo3CUDbdSWgqaRW66p-wFbQCFOJWpqHbCWsFpWxUp2wJyndCSFBS_mYnUgjjbJSrNjPzbTDLvN54BcYPeboO36zxFuKez4HfkUT8e2P_S0FTFTBGd-EYcRpwuzncMYx9KWTltEH_pGSTxlDR7xUH-bY-p5v29LNe_7d5y-lSDkuXfbfiN-MRDt-vguET9mjAcdEz-7fU_b53dtPl1fV9fb95vL8uupUI3PVIGLbgLWDAoTerAcjWm1rDX0PRpHqSVih0LSI0GpNWkFXq2GwXU1qaNUpe3XM3cX560Ipu8mnjsYRA81LcmAaXVsDTV3Ql_-gd_MSQ7nOgVVC1HYNUCg4Ul2cU4o0uF30E8a9A-EOitxRkSuK3EGROyS_uE9e2on6Pz9-OymAPAKpjEIR8dfq_6b-AoPKnFE</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Tirado, Raquel</creator><creator>Masdeu, Maria José</creator><creator>Vigil, Laura</creator><creator>Rigla, Mercedes</creator><creator>Luna, Alexis</creator><creator>Rebasa, Pere</creator><creator>Pareja, Rocío</creator><creator>Hurtado, Marta</creator><creator>Caixàs, Assumpta</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8472-9189</orcidid></search><sort><creationdate>20170901</creationdate><title>Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea</title><author>Tirado, Raquel ; Masdeu, Maria José ; Vigil, Laura ; Rigla, Mercedes ; Luna, Alexis ; Rebasa, Pere ; Pareja, Rocío ; Hurtado, Marta ; Caixàs, Assumpta</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-7aaab7199f31a1d85f80b69461dd183e3de0903a8baa1b66e631c43ff9c4e3fb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adiponectin - blood</topic><topic>Adult</topic><topic>Bariatric Surgery</topic><topic>C-Reactive Protein - metabolism</topic><topic>Female</topic><topic>Gastrointestinal surgery</topic><topic>Heme Oxygenase-1 - blood</topic><topic>Humans</topic><topic>Inflammation - blood</topic><topic>Inflammation - complications</topic><topic>Inflammation - metabolism</topic><topic>Inflammation - surgery</topic><topic>Insulin - blood</topic><topic>Insulin resistance</topic><topic>Insulin Resistance - physiology</topic><topic>Interleukin-6 - blood</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - metabolism</topic><topic>Obesity, Morbid - surgery</topic><topic>Original Contributions</topic><topic>Polysomnography</topic><topic>Sleep apnea</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - metabolism</topic><topic>Sleep Apnea, Obstructive - surgery</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Tumor Necrosis Factor-alpha - blood</topic><topic>Weight control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tirado, Raquel</creatorcontrib><creatorcontrib>Masdeu, Maria José</creatorcontrib><creatorcontrib>Vigil, Laura</creatorcontrib><creatorcontrib>Rigla, Mercedes</creatorcontrib><creatorcontrib>Luna, Alexis</creatorcontrib><creatorcontrib>Rebasa, Pere</creatorcontrib><creatorcontrib>Pareja, Rocío</creatorcontrib><creatorcontrib>Hurtado, Marta</creatorcontrib><creatorcontrib>Caixàs, Assumpta</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tirado, Raquel</au><au>Masdeu, Maria José</au><au>Vigil, Laura</au><au>Rigla, Mercedes</au><au>Luna, Alexis</au><au>Rebasa, Pere</au><au>Pareja, Rocío</au><au>Hurtado, Marta</au><au>Caixàs, Assumpta</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>27</volume><issue>9</issue><spage>2338</spage><epage>2346</epage><pages>2338-2346</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Introduction
Morbid obesity and obstructive sleep apnea (OSA) interact at an inflammatory level. Bariatric surgery reduces inflammatory responses associated with obesity. Heme oxygenase-1 (HO-1) is an enzyme with anti-inflammatory properties, which might be increased in morbid obesity or OSA. We studied morbidly obese patients with OSA to determine: (a) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and (b) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation.
Material and Methods
We analyzed the homeostasis model insulin resistance index (HOMA) and plasma concentrations of HO-1, tumor necrosis factor alpha, interleukin-6, interleukin-1-beta, C reactive protein (CRP), and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery and 12 months after surgery.
Results
Before surgery, HO-1 plasma concentrations were similar in three groups of patients with mild, moderate, and severe OSA, and correlated with HOMA (
r
= 0.27,
p
= 0.02). Twelve months after surgery, low-grade inflammation and insulin resistance had decreased in all the groups, but HO-1 plasma concentration had decreased only in the severe OSA group (
p
= 0.02). In this group, the reduction in HO-1 correlated with a reduction in CRP concentrations (
r
= 0.43,
p
= 0.04) and with improved HOMA score (
r
= 0.37,
p
= 0.03).
Conclusions
Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA, and this decrease is associated with decreases in insulin resistance and in inflammation.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28283920</pmid><doi>10.1007/s11695-017-2635-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8472-9189</orcidid></addata></record> |
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| ispartof | Obesity surgery, 2017-09, Vol.27 (9), p.2338-2346 |
| issn | 0960-8923 1708-0428 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adiponectin - blood Adult Bariatric Surgery C-Reactive Protein - metabolism Female Gastrointestinal surgery Heme Oxygenase-1 - blood Humans Inflammation - blood Inflammation - complications Inflammation - metabolism Inflammation - surgery Insulin - blood Insulin resistance Insulin Resistance - physiology Interleukin-6 - blood Male Medicine Medicine & Public Health Middle Aged Obesity Obesity, Morbid - complications Obesity, Morbid - metabolism Obesity, Morbid - surgery Original Contributions Polysomnography Sleep apnea Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - metabolism Sleep Apnea, Obstructive - surgery Surgery Surgical outcomes Tumor Necrosis Factor-alpha - blood Weight control |
| title | Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea |
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