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. 2013 Jan 21:2013:910586.
doi: 10.1155/2013/910586. eCollection 2013.

Surgical stress induces an amplified inflammatory response in patients with type 2 diabetes

Edward Lin  1 , Nana Gletsu-Miller  2
Affiliations

Surgical stress induces an amplified inflammatory response in patients with type 2 diabetes

Edward Lin et al. ISRN Obes. .

Abstract

Background. Morbid obesity is believed to be an extreme of the metabolic spectrum. Moreover, diabetes is hypothesized to be associated with a chronic inflammatory state that is not observed in nondiabetic healthy individuals. We investigated the differences in expression of inflammatory cytokines induced by surgical stress between diabetic and nondiabetic individuals. Method. 39 morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass (9 with type 2 diabetes mellitus) were compared with 8 nonobese euglycemic patients undergoing laparoscopic antireflux surgery. Cytokine levels for IL-6, IL-10, and IL-18 were measured 15 minutes before surgery and immediately after surgery. Results. IL-6 and IL-10 levels were elevated from baseline following surgery, but morbidly obese patients exhibited a much higher elevation than lean patients. Individuals with type 2 diabetes had the most pronounced IL-6 and IL-10 elevations. Baseline IL-18 levels were significantly higher in diabetic patients compared with nondiabetic or lean patients. However, IL-18 levels were not changed in response to surgery. Conclusions. Diabetes and morbid obesity are associated with augmented cytokine expression in response to surgical trauma that is several folds higher than in nonobese euglycemic patients. Diabetic patients exhibit a chronic elevation in IL-18 that is not changed by surgical stress.

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Figures

Figure 1
Figure 1
(a) Baseline and postsurgical IL-6 levels. (b) Baseline and postsurgical IL-10 levels. •: lean patients; ▲: nondiabetic obese; △: diabetic obese; *P < 0.01; + P < 0.001.
Figure 2
Figure 2
Baseline and postsurgical IL-18 levels. Black bars: diabetic obese patients. Grey bars: nondiabetic obese patients. White bars: lean patients. *P < 0.01.
See this image and copyright information in PMC

References

    1. Lin E, Calvano SE, Lowry SF. Cytokine response in abdominal surgery. In: Schein M, Wise L, editors. Cytokines and the Abdominal Surgeon. Austin, Tex, USA: R.G. Landes; 1998. pp. 17–34.
    1. Lin E, Lowry SF. Inflammatory cytokines in major surgery: a functional perspective. Intensive Care Medicine. 1999;25(3):255–257. - PubMed
    1. Ramos EJB, Xu Y, Romanova I, et al. Is obesity an inflammatory disease? Surgery. 2003;134(2):329–335. - PubMed
    1. Esposito K, Pontillo A, Di Palo C, et al. Effect of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. Journal of the American Medical Association. 2003;289(14):1799–1804. - PubMed
    1. Gonzalez R, Bowers SP, Venkatesh KR, Lin E, Smith CD. Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity. Surgical Endoscopy. 2003;17(12):1900–1904. - PubMed

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