Issue 162 Item 8 Weight Loss Tied to Decrease in Inflammatory Proteins, Improved

Weight loss in morbidly obese patients leads to significant decreases in C-reactive protein (CRP) and interleukin-6 (IL-6) concentrations

That, according to a report in the June issue of Arteriosclerosis, Thrombosis, and Vascular Biology. This is associated with an improvement of the insulin resistance syndrome.

"Obesity is closely linked to the insulin resistance syndrome (IRS), type-2 diabetes, and cardiovascular disease," Dr. Hans-Peter Kopp, of Rudolfstiftung Hospital, Vienna, Austria, and colleagues note, adding that "elevated levels of CRP and IL-6, indicating chronic subclinical inflammation, have been associated with features of the IRS and incident cardiovascular disease."

Thus, the team sought to investigate the potential clinical implications of changes in circulating levels of inflammatory proteins after weight loss.

In a cross-sectional, longitudinal study, the researchers examined the association between IRS and CRP, IL-6, and tumor necrosis factor-alpha (TNF-alpha) in 37 morbidly obese patients before and after gastric surgery.

Weight loss after gastric surgery led to a significant shift from diabetes (37% to 3%) to impaired glucose tolerance (40% versus 33%), and to normal glucose tolerance (23% versus 64%). Concentrations of CRP and IL-6 were reduced significantly, whereas levels of TNF-alpha remained unchanged.

Further analysis revealed an independent and significant correlation between a decrease in insulin resistance and a decrease in IL-6 concentrations (p < 0.01). In addition, a decrease in body mass index was independently and significantly correlated with a decrease in CRP (p < 0.05).

The authors speculate that "a significant reduction in CRP and IL-6 levels associated with weight loss could also reduce the cardiovascular risk in morbidly obese patients." However, they conclude that "long-term studies are needed to show whether this improvement in cardiovascular risk factors will eventually translate into a significant clinical benefit in regard to cardiovascular morbidity and mortality."
Arterioscler Thromb Vasc Biol 2003;23:1042-1047.

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FACT: In ASCOT-LLS Trial, with more than 19,000 people, they found that a statin drug was responsible for a 36% reduction in fatal coronary events and nonfatal heart attacks, 27% reduction in fatal and nonfatal strokes and a 21% reduction in cardiovascular events. The Lancet April 5, 2003