Inflammatory and Metabolic Markers in Pre- and Post- Treatment of Obesity
Pp. 49-66 (18)
Silvia de Barros-Mazon, Daniela Miguel Marin, Camila Puzzi de Carvalho and Sarah Monte Alegre
Obesity is a challenging health problem in the industrialized world and in recent
population studies the prevalence of overweight, obesity and abdominal obesity is constantly
increasing, reaching to an epidemic proportions. The excess of body weight is associated with a
low-grade systemic inflammation and a cluster of metabolic alterations such as insulin resistance,
hypertension and dyslipidemia, which is presumed to play a role in the development of
cardiovascular disease and type 2 diabetes mellitus. It is now well-established that adipocytes
secrete proteins (adipokines) that actively control energy homeostasis, glucose and lipid metabolism,
neuroendocrine and cardiovascular function and inflammatory response. Excessive levels of
some adipokines such as TNF-α and IL-6 can disturb the metabolism suggesting the adipose tissue
as a link between obesity, low grade inflammation and insulin resistance. In obesity, sustained
weight loss has several beneficial effects on lipid metabolism, glucose tolerance and arterial blood
pressure. There have been an increasing number of obese patients requiring treatment (bariatric
surgery and/or diet) for weight loss. The weight loss induced by bariatric surgery causes a reduction
in the inflammatory state, increasing levels of adiponectin and GLP-1, which are all related to
beneficial metabolic changes described above. GLP-1 is especially related to insulinotropic
properties through induced expansion of insulin secreting B-cell mass and enhanced insulin
secretion. GLP-1 acts also in insulin action enhancing B-cell glucose sensitivity contributing to
glycemic control after surgical procedure. So our focus in this chapter is to emphasize metabolic
and inflammatory profile in obesity and its metabolic changes after weight loss.
Obesity, adipokines, inflammatory cytokines, insulin resistence, GLP-1, weight loss.
Department of Clinical Pathology, 2Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Sao Paulo, Brazil.