Bariatric surgery rapidly improves mitochondrial respiration in morbidly obese patients
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and Other Interventional Techniques
Bariatric surgery rapidly improves mitochondrial respiration in morbidly obese patients Sheetal Nijhawan • William Richards • Martha F. O’Hea • Jonathon P. Audia • Diego F. Alvarez
Received: 20 April 2013 / Accepted: 17 July 2013 / Published online: 24 August 2013 Ó Springer Science+Business Media New York 2013
Abstract Background Obesity and its attendant comorbidities are an emerging epidemic. Chronic metabolic inflammation (metainflammation) is thought to precipitate obesity-associated morbidities; however, its mechanistic progression is poorly understood. Moreover, although interventions such as diet, exercise, and bariatric surgery can control body weight, their effects on metainflammation are also poorly understood. Recently, metainflammation and the pathobiology of obesity have been linked to mitochondrial Presented at the SAGES 2013 Annual Meeting, 17–20 April 2013, Baltimore, MD. S. Nijhawan (&) W. Richards M. F. O’Hea Department of Surgery, University of South Alabama College of Medicine, Mobile, AL 36688, USA e-mail: [email protected] J. P. Audia (&) Department of Microbiology and Immunology, University of South Alabama College of Medicine, Mobile, AL 36688, USA e-mail: [email protected] J. P. Audia Laboratory of Molecular Biology, University of South Alabama College of Medicine, Mobile, AL 36688, USA J. P. Audia D. F. Alvarez Center for Lung Biology, University of South Alabama College of Medicine, Mobile, AL 36688, USA D. F. Alvarez (&) Department of Internal Medicine, University of South Alabama College of Medicine, Mobile, AL 36688, USA e-mail: [email protected] D. F. Alvarez Department of Pharmacology, University of South Alabama College of Medicine, Mobile, AL 36688, USA
dysfunction. Herein we examined the effects of bariatric surgery on mitochondrial respiration as an index of resolving metainflammation in morbidly obese patients. Methods This institutional review board-approved study involved morbidly obese patients (body mass index [ 35 kg/m2) undergoing sleeve gastrectomy or Roux-en-Y gastric bypass. Mitochondrial respiration was assessed in peripheral blood monocytes and in skeletal muscle samples before surgery and at 12 weeks after surgery. Patient biometrics, homeostasis model assessment-estimated insulin resistance (HOMA-IR) score, C-reactive protein, and lipid profile were analyzed. Results Twenty patients were enrolled and showed an average percent excess body weight loss of 30.3 % weight loss at 12 weeks after surgery. Average HOMA-IR score decreased from 3.0 to 1.2 in insulin-resistant patients. C-reactive protein, an index of metainflammation, showed a modest decrease. Lipid profile remained stable. Intriguingly, mitochondrial basal and maximal respiration rates in peripheral blood monocytes increased after surgery. Basal rates of skeletal muscle mitochondrial respiration were unchanged, but the maximal respiration rate trended toward an increase after surgery. Conclusions Cellular and tissue mitochondrial respiration i
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