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Impact of Intragastric Balloon Treatment on Adipokines, Cytokines, and Metabolic Profile in Obese Individuals

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Marcella Rodrigues Guedes
Marcella Rodrigues Guedes
Marcella Rodrigues Guedes
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Ricardo J. Fittipaldi-Fernandez at Endogastro
Ricardo J. Fittipaldi-Fernandez
  • Endogastro
Cristina Fajardo Diestel at Rio de Janeiro State University
Cristina Fajardo Diestel
Márcia Regina Simas Torres Klein at Rio de Janeiro State University
Márcia Regina Simas Torres Klein
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Abstract

Background Obesity is accompanied by adipose tissue remodeling characterized by increased production of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, leptin and resistin and reduced secretion of adiponectin, which favors inflammation, metabolic disorders, and cardiovascular diseases. Although intragastric balloon (IGB) can be considered safe and effective for weight loss, its effect on serum levels of these biomarkers has been evaluated only in a few studies, while no previous study evaluated its effect on circulating levels of resistin, TNF-α, and IL-6. The aim of this study was to evaluate the changes in serum levels of metabolic and inflammatory biomarkers in obese patients submitted to IGB treatment. Methods A prospective observational study involving 42 patients with obesity using IGB for 6 months. The patients were evaluated, on the day of insertion and withdrawal or adjustment of IGB, for the following: anthropometric measures and serum levels of adiponectin, leptin, resistin, TNF-α, IL-6, high-sensitivity C-reactive protein (hs-CRP), glucose, insulin, uric acid, triglycerides, and total cholesterol and fractions. Results The body mass index decreased from 35.15 ± 0.41 to 29.50 ± 0.54 kg/m². There was a reduction (p < 0.05) in leptin, hs-CRP, glucose, insulin, HOMA-IR, and triglycerides, while the adiponectin/leptin ratio increased (p < 0.05). Moreover, weight loss presented (1) a positive association with the decrease in leptin, hs-CRP, glucose, insulin, HOMA-IR, uric acid, and total cholesterol and (2) a negative association with the reduction in adiponectin/leptin ratio. Conclusions The present study suggests that 6 months of IGB treatment in obese individuals reduce serum leptin and hs-CRP and improves insulin resistance and lipid profile which may decrease cardiovascular risk.
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ORIGINAL CONTRIBUTIONS
Impact of Intragastric Balloon Treatment on Adipokines, Cytokines,
and Metabolic Profile in Obese Individuals
Marcella Rodrigues Guedes
1,2
&Ricardo José Fittipaldi-Fernandez
1
&Cristina Fajardo Diestel
3
&
Márcia Regina Simas Torres Klein
3
Published online: 29 April 2019
#Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract
Background Obesity is accompanied by adipose tissue remodeling characterized by increased production of tumor necrosis
factor-alpha (TNF-α), interleukin (IL)-6, leptin and resistin and reduced secretion of adiponectin, which favors inflammation,
metabolic disorders, and cardiovascular diseases. Although intragastric balloon (IGB) can be considered safe and effective for
weight loss, its effect on serum levels of these biomarkers has been evaluated only in a few studies, while no previous study
evaluated its effect on circulating levels of resistin, TNF-α, and IL-6. The aim of this study was to evaluate the changes in serum
levels of metabolic and inflammatory biomarkers in obese patients submitted to IGB treatment.
Methods A prospective observational study involving 42 patients with obesity using IGB for 6 months. The patients were
evaluated, on the day of insertion and withdrawal or adjustment of IGB, for the following: anthropometric measures and serum
levels of adiponectin, leptin, resistin, TNF-α, IL-6, high-sensitivity C-reactive protein (hs-CRP), glucose, insulin, uric acid,
triglycerides, and total cholesterol and fractions.
Results The body mass index decreased from 35.15 ± 0.41 to 29.50 ± 0.54 kg/m
2
. There was a reduction (p< 0.05) in leptin, hs-
CRP, glucose, insulin, HOMA-IR, and triglycerides, while the adiponectin/leptin ratio increased (p< 0.05). Moreover, weight
loss presented (1) a positive association with the decrease in leptin, hs-CRP, glucose, insulin, HOMA-IR, uric acid, and total
cholesterol and (2) a negative association with the reduction in adiponectin/leptin ratio.
Conclusions The present study suggests that 6 monthsof IGB treatment in obese individuals reduce serum leptin and hs-CRP and
improves insulin resistance and lipid profile which may decrease cardiovascular risk.
Keywords Intragastric balloon .Obesity .Weight loss .Adipokines .Cytokines
Introduction
Obesity is a chronic disease that continues to be highly prev-
alent, representing a global public health problem [1]. As re-
ported by the World Health Organization (WHO), in 2016,
39% of the adult world population were overweight, while
11% of men and 15% of women were obese [2]. These data
are of concern since obesity is a risk factor for the develop-
ment of several chronic diseases, including type 2 diabetes,
hypertension, dyslipidemia, chronic kidney disease, obstruc-
tive sleep apnea, osteoarthritis, and cancer [3,4]. Many studies
have shown that obesity is associated with an increased risk of
all-cause mortality [5,6]. Therefore, a high body mass index
(BMI) can be considered a predictor of overall mortality with
a reduction in survival as the index increases [1,7].
Few of the consequences of obesity, such as sleep apnea
and osteoarthritis, can be attributed to the excessive
*Ricardo José Fittipaldi-Fernandez
ricfittipaldi@hotmail.com
Marcella Rodrigues Guedes
marcella.rg@hotmail.com
Cristina Fajardo Diestel
crisdiestel@hotmail.com
Márcia Regina Simas Torres Klein
marciarsimas@gmail.com
1
Division of Gastroenterology EndogastroRio Clinic, 43/1101,
Siqueira Campos Street, Rio de Janeiro, RJ 22031-901, Brazil
2
Post Graduation Program in Clinical and Experimental
Pathophysiology, Rio de Janeiro State University, Rio de
Janeiro, Brazil
3
Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro
State University, 12th floor/524, São Francisco Xavier Street, Rio de
Janeiro, RJ 20550-900, Brazil
Obesity Surgery (2019) 29:2600–2608
https://doi.org/10.1007/s11695-019-03891-8
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... Glucose, insulin, and HOMA-IR decreased independently of sex and BMI. Our results are consistent with the results of other studies confirming the beneficial effect of IGB implantation on carbohydrate haemostasis [23]. According to our observations, patients with a lower initial BMI achieved better results [24]. ...
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... A 2019 prospective observational cohort study by Guedes et al. looked at 6-month outcomes in adults with obesity (n = 42, mean age 37.6 ± SE 1.28 years, mean BMI 35.15 ± 0.41 kg/m 2 , 76% female) who used adjustable or non-adjustable fluid-filled intragastric balloons [71]. Results revealed a significant 15.88 ± 1.42% reduction in body weight and 12.07 ± 1.18% reduction in waist circumference (p < 0.0001 for both compared to baseline). ...
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Impact of Weight Loss With Intragastric Balloon on Bone Density and Microstructure in Obese Adults
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  • Mar 2018
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Guideline Recommendations for Obesity Management
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  • Jan 2018
It is an obligation for all health care providers to participate in obesity management. This article discusses obesity guidelines from The Obesity Society; the Endocrine Society; and the American Association of Clinical Endocrinologists. It reviews and compares findings and recommendations across these guidelines, identifies areas of controversy and concordance, and suggests how primary care practices may make use of the most appropriate recommendations for their circumstances.
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Introduction: The State of Obesity in 2017
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  • Jan 2018
Obesity continues to be a major national and global health challenge and a risk factor for an expanding set of chronic diseases. In 2015, high body mass index contributed to 4.0 million deaths globally, which represented 7.1% of the deaths from any cause. Obesity is now regarded as a disease, and multiple health care societies have begun to tackle obesity as a discrete target for assessment and treatment that is supported by several position statements and guidelines. Nonetheless, a perception and treatment gap continues to exist between health care providers and patients regarding the provision of obesity care.
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Impact of Weight Loss on Inflammation and Red Blood Cell Biomarkers after Laparoscopic Gastric Banding Surgery
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  • Nov 2017
Adipose tissue produces several adipokines that are enrolled in different metabolic and inflammatory pathways that may disturb iron metabolism and erythropoiesis. Considering that laparoscopic adjustable gastric banding (LAGB) has not been associated with a long-term risk of malabsorption, we performed a 13-month follow-up study in severe obese patients submitted to LAGB in order to clarify its impact on inflammation, iron metabolism and on red blood cell (RBC) biomarkers. Twenty obese patients were enrolled in the study, being clinical and analytically assessed before (T0) and 13 months after LAGB intervention (T1). Inflammation, iron bioavailability and RBC biomarkers were evaluated at T0 and T1. At T1, weight and anthropometric indices decreased significantly; patients showed a significant increase in mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration (MCHC), and a reduction in red cell distribution width, ferritin, hepcidin, tumor necrosis factor-α, interleukin-6 (IL-6) and C-reactive protein. Before LAGB, IL-6 correlated negatively with iron, hemoglobin concentration and MCHC; hepcidin correlated inversely with transferrin. Our data show that 13 months after LAGB, the weight loss is associated with an improvement in inflammation, namely a reduction in IL-6 that may reduce hepcidin production, improving iron availability for erythropoiesis, as shown by more adequate erythrocyte hemoglobinization.
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