Lifestyle changes followed by bariatric surgery lower inflammatory markers and the cardiovascular risk factors C3 and C4. Impact of Bariatric Surgery on Heme Oxygenase-1, Inflammation, and Insulin Resistance in Morbid Obesity with Obstructive Sleep Apnea Effects of gastric bypass surgery followed by supervised physical training on inflammation and endothelial function: A randomized controlled trial. Interleukin-6, C-reactive protein, and tumor necrosis factor-alpha as predictors of mortality in frail, community-living elderly individuals. A Prospective Randomized Study Comparing Patients with Morbid Obesity Submitted to Sleeve Gastrectomy With or Without Omentectomy Changes in inflammatory markers after sleeve gastrectomy in patients with impaired glucose homeostasis and type 2 diabetes. Effect of 10-day broccoli consumption on inflammatory status of young healthy smokers Systemic inflammation after on-pump and off-pump coronary bypass surgery: a one-month follow-up. Effects of a 1-year supplementation with cholecalciferol on interleukin-6, tumor necrosis factor-alpha and insulin resistance in overweight and obese subjects. Effect of low-dose ketamine on inflammatory response in off-pump coronary artery bypass graft surgery. Mediator effects of parameters of inflammation and neurogenesis from a N-acetyl cysteine clinical-trial for bipolar depression. C-reactive protein, interleukin-6, soluble tumor necrosis factor α receptor 2 and incident clinical depression. Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-α) and essential hypertension Effects of anaesthesia based on high versus low doses of opioids on the cytokine and acute‐phase protein responses in patients undergoing cardiac surgery Effect of eicosapentaenoic acid and docosahexaenoic acid on oxidative stress and inflammatory markers in treated-hypertensive type 2 diabetic subjects. Inflammation markers predict zinc transporter gene expression in women with type 2 diabetes mellitus. Unsaturated fatty acids are inversely associated and n-6/n-3 ratios are positively related to inflammation and coagulation markers in plasma of apparently healthy adults. Markers of chronic inflammation and obesity: a prospective study on the reversibility of this association in middle-aged women undergoing weight loss by surgical intervention Inflammatory markers and risk of developing type 2 diabetes in women. Postprandial variations of plasma inflammatory markers in abdominally obese men. Plasma Interleukin-6 and Tumor Necrosis Factor-α Can Predict Coronary Endothelial Dysfunction in Hypertensive Patients Effect of statin and fibrate treatment on inflammation in type 2 diabetes. A randomized, cross-over study. Effects of corticosteroids on inflammatory response following cardiopulmonary bypass.
BACKGROUND Morbidly obese patients are at risk of developing insulin resistance and cardiovascular disease . Low- grade systemic inflammation is an important factor for this development . We evaluated the effect of bariatric surgery on markers of inflammation , coagulation and glucose metabolism . METHODS Ninety-seven morbidly obese patients and 17 lean subjects ( control group ) participated .  Anthropometric measurements  as well as  fasting blood sample s  were obtained at first admission , prior to surgery , and 1 year after surgery . RESULTS At admission , the morbidly obese group had significantly elevated levels of the complement components C3 and C4 compared to the lean control group ( P<0.0001 ) . Levels of C3 and C4 dropped significantly in the morbidly obese group over time ( P<0.0001 ) , and , 1 year after the operation , levels were comparable to those of the control group . The same changes were seen for markers of inflammation ( high-sensitivity C-reactive protein , tumor necrosis factor-α , interferon-γ , interleukin-1 receptor antagonist , IL-6 , and IL-13 ) , coagulation ( fibrinogen and plasminogen activator inhibitor-1 ) , and glucose metabolism ( leptin and insulin ) . There was a positive correlation between changes in C3 and body mass index , weight , coagulation parameters , inflammatory parameters , and leptin , respectively . CONCLUSIONS Bariatric surgery in morbidly obese patients  reduced weight effectively . Even more importantly , the increased levels of several risk factors associated with diabetes and cardiovascular co-morbidity normalized 1 year after surgery Introduction Morbid obesity and obstructive sleep apnea ( OSA ) interact at an inflammatory level . Bariatric surgery reduces inflammatory responses associated with obesity . Heme oxygenase-1 ( HO-1 ) is an enzyme with anti-inflammatory properties , which might be increased in morbid obesity or OSA . We studied morbidly obese patients with OSA to determine : ( a ) HO-1 plasma concentrations according to OSA severity and their relationship with insulin resistance and inflammation and ( b ) the impact of bariatric surgery on HO-1 and parameters of insulin resistance and inflammation . Material and Methods We analyzed the homeostasis model insulin resistance index ( HOMA ) and plasma concentrations of HO-1 , tumor necrosis factor alpha , interleukin-6 , interleukin-1-beta , C reactive protein ( CRP ) , and adiponectin according to polysomnography findings in 66 morbidly obese patients before bariatric surgery  and 12 months after surgery . Results Before surgery , HO-1 plasma concentrations were similar in three groups of patients with mild , moderate , and severe OSA , and correlated with HOMA ( r = 0.27 , p = 0.02 ) . Twelve months after surgery , low- grade inflammation and insulin resistance had decreased in all the groups , but HO-1 plasma concentration had decreased only in the severe OSA group ( p = 0.02 ) . In this group , the reduction in HO-1 correlated with a reduction in CRP concentrations ( r = 0.43 , p = 0.04 ) and with improved HOMA score ( r = 0.37 , p = 0.03 ) . Conclusions Bariatric surgery decreases HO-1 concentrations in morbid obesity with severe OSA , and this decrease is associated with decreases in insulin resistance and in inflammation BACKGROUND AND AIMS Obesity and physical inactivity are both associated with low- grade inflammation and endothelial dysfunction .  Bariatric surgery improves markers of inflammation and endothelial function , but it is unknown if physical training after bariatric surgery can improve these markers even further . Therefore , we aim ed to investigate the effects of Roux-en-Y gastric bypass ( RYGB ) followed by physical training on markers of low- grade inflammation and endothelial function . METHODS Sixty patients approved for RYGB underwent examinations pre-surgery , 6 , 12 , and 24 months post-surgery . Six months post-surgery , they were r and omized 1:1 to an intervention group or a control group . The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks . Fasting blood sample s were analyzed for concentrations of interleukin 6 ( IL-6 ) , C-reactive protein ( CRP ) , intercellular adhesion molecule 1 ( ICAM-1 ) , tissue-type plasminogen activator antigen ( t-PA : Ag ) and von Willebr and factor ( vWF ) . RESULTS RYGB markedly improved markers of inflammation ( IL-6 , CRP ) ( p < 0.001 ) and endothelial function ( ICAM-1 , t-PA : Ag , vWF ) ( p < 0.05 ) , and the improvements were sustained 24 months post-surgery ( p < 0.01 ) , except for the effects on vWF . We found no correlations between the changes in weight or BMI and the changes in markers of inflammation and endothelial function , except that the change in vWF was found to be inversely correlated with the changes in weight and BMI . We observed no effects of supervised physical training on markers on inflammation or endothelial function ( p>0.1 for all ) . CONCLUSIONS RYGB causes substantial and sustained favorable effects on markers of inflammation and endothelial function .  Supervised physical training after RYGB did not cause additional improvements UNLABELLED To investigate whether interleukin-6 ( IL-6 ) , C-reactive protein ( CRP ) and tumor necrosis factor-alpha ( TNF-α ) protein levels predict all-cause mortality in older persons living in the community . DESIGN Prospect i ve cohort study . SETTING Data were from the Aging and Longevity Study in the Sirente Geographic Area , a prospect i ve cohort study . PARTICIPANTS Individuals aged 80 and older living in an Italian mountain community ( N = 362 ) . MEASUREMENTS Participants were classified according to the median value of the three inflammation markers ( IL-6 , 2.08 pg/mL ; TNF-α , 1.43 pg/mL ; CRP , 3.08 mg/L ) . A composite summary score of inflammation was also created . The main outcome was risk of death after 4 years of follow-up . RESULTS One hundred fifty deaths occurred during 4 years of follow-up . In the unadjusted model , high levels of each of the three markers were associated with greater mortality . After adjusting for potential confounders , high levels of IL-6 ( hazard ratio ( HR ) = 2.18 , 95 % confidence interval ( CI ) = 1.29 - 3.69 ) and CRP ( HR = 2.58 , 95 % CI = 1.52 - 4.40 ) were associated with a significantly greater risk of death , whereas the association between TNF-α protein levels and mortality was no longer significant ( HR = 1.26 , 95 % CI = 0.74 - 2.15 ) . The composite summary score of inflammation was strongly associated with mortality , with the highest risk estimated for individuals with all three inflammatory markers above the median . CONCLUSION Low levels of inflammatory markers are associated with better survival in older adults , independent of age and other clinical and functional variables Background Increased visceral adipose tissue is a risk factor for the metabolic complications associated with obesity and promotes a low- grade chronic inflammatory process . Resection of the great omentum in patients su bmi tted to a bariatric procedure has been proposed for the amelioration of metabolic alterations and the maximization of weight loss . The aim of the present study was to investigate the impact of omentectomy performed in patients with morbid obesity undergoing sleeve gastrectomy ( SG ) on metabolic profile , adipokine secretion , inflammatory status , and weight loss . Methods Thirty-one obese patients were r and omized into two groups : SG alone or with omentectomy . Adiponectin , omentin , interleukin-6 ( IL-6 ) , tumor necrosis factor-α ( TNF-α ) , high-sensitivity C-reactive protein ( hs-CRP ) , blood lipids , fasting glucose , insulin , and insulin resistance were measured before surgery and at 7 days , and 1 , 3 and 12 months after surgery . Results During the 1-year follow-up , body mass index ( BMI ) decreased markedly and comparably in both groups ( p < 0.001 ) . Insulin , IL-6 , and hs-CRP levels decreased significantly compared to baseline ( p < 0.05 ) in both groups with no significant difference between groups . Adiponectin and high-density lipoprotein cholesterol levels were significantly and similarly increased compared to baseline ( p < 0.001 ) in both groups . Omentin levels increased significantly ( p < 0.05 ) in the control group and decreased in the omentectomy group 1 year postoperatively . There was no significant change in TNF-α levels in either group . Conclusions The theoretical advantages of omentectomy in regard to weight loss and obesity-related abnormalities are not confirmed in this prospect i ve study . Furthermore , omentectomy does not induce important changes in the inflammatory status in patients undergoing SG BACKGROUND Bariatric surgery is an effective treatment for morbid obesity . Obesity and type 2 diabetes are associated with chronic inflammation . There is lack of data examining the effects of sleeve gastrectomy ( SG ) on inflammatory biomarkers . Our aim was to study the effects of SG on specific cytokines associated with obesity including interleukin-6 ( IL-6 ) , interleukin-10 ( IL-10 ) , leptin , adiponectin , and C-reactive protein ( CRP ) preoperatively , 1 and 6 months after surgery . METHODS A nonr and omized prospect i ve study comprising of 22 participants with impaired glucose homeostasis and type 2 diabetes undergoing SG ( body mass index 50.1 kg/m(2 ) , glycated hemoglobin [ HbA1c ] 53 mmol/mol ) .  Serial measurements of IL-6 , IL-10 , leptin , adiponectin , and CRP  were performed during oral glucose tolerance testing preoperatively , 1 and 6 months postoperatively . RESULTS We observed significant improvements at 1 and 6 months in leptin ( P≤.001 ) and CRP ( P = .003 ) after SG . We also observed a significant reduction in IL-6 at 6 months ( P = .001 ) . No statistically significant differences were observed for adiponectin and IL-10 . CONCLUSION This study is the first to examine the detailed changes in the inflammatory cytokines after SG . Our study shows significant improvements in the inflammatory biomarkers after SG in patients with impaired glucose homeostasis and type 2 diabetes Abstract This study evaluated the effects of 10-day broccoli ( 250 g/day ) intake on dietary markers and markers of inflammations in young male smokers . A dietary intervention study with a repeated measures crossover design was conducted . Circulating levels of carotenoids , folate , C-reactive protein ( CRP ) , tumor necrosis factor alpha ( TNF-α ) , interleukin 6 ( IL-6 ) , interleukin 6 receptor ( IL-6sR ) and adiponectin were measured . Broccoli intake significantly increased plasma levels of folate ( + 17 % ) and lutein ( + 39 % ) , while no significant effect was observed for TNF-α , IL-6 , IL-6sR or adiponectin . Plasma CRP decreased by 48 % ( post-hoc analysis , p < 0.05 ) following broccoli diet ; this result ed to be independent from the plasma variations in lutein and folate . An inverse correlation between lycopene , TNF-α and IL-6sR was observed at baseline . In conclusion , broccoli consumption may reduce CRP levels in smokers , consistent with epidemiologic observations that fruit and vegetable intake is associated with lower circulating CRP concentrations BACKGROUND This study sought to assess inflammation activation in the follow-up ( up to one month ) of  coronary bypass surgery performed both on- ( CABG ) and off-pump ( OPCAB ) . METHODS Thirty patients , c and i date s for coronary surgery , were r and omized to undergo CABG ( n = 16 ) or OPCAB ( n = 14 ) . Blood sample s were collected before the intervention , after protamine administration , and 4 , 8 , and 30 days after surgery . RESULTS Plasma tumor necrosis factor-alpha ( TNF-alpha ) and interleukin-6 ( IL-6 ) levels significantly increased with respect to baseline from protamine administration up to eight postoperative days , whereas high-sensitivity C-reactive protein ( hs-CRP ) and fibrinogen increased after surgery up to eight postoperative days in both groups . On the other h and , neutrophil elastase levels were higher than baseline from protamine administration up to four postoperative days in CABG , and at the time point eight days after surgery in OPCAB . The only significant differences between CABG and OPCAB in inflammatory markers occurred intraoperatively , after protamine administration , when TNF-alpha and elastase levels were higher in CABG , whereas no differences were detected between CABG and OPCAB at any postoperative time point . Postoperative increases in fibrinogen and hs-CRP were positively correlated with increases in IL-6 , but not with postoperative changes in TNF-alpha both in CABG and OPCAB . CONCLUSIONS After coronary bypass surgery , there is a protracted postoperative activation of inflammation persisting several days after surgery ; this postoperative activation is not affected by the surgical strategy ( on-pump or off-pump ) Insufficient vitamin D status has been linked to autoimmune diseases , cancer and metabolic disorders , like obesity and insulin resistance . In vitro and animal studies suggest that vitamin D may play a crucial role in immune activation and inflammation . The relation between vitamin D and pro-inflammatory cytokines is not completely established . Furthermore , it is not known if the effect of vitamin D on entities of metabolic syndrome is mediated through its effect on cytokines or other biomarkers . The objectives of this study were to investigate if there is a relationship between vitamin D status and such pro-inflammatory cytokines as tumor necrosis factor-alpha ( TNF-α ) , interleukin 6 ( IL-6 ) and high sensitive C-reactive protein ( hs-CRP ) in patients with overweigh and obesity . We also proposed that the intervention with high dose of cholecalciferol may have effect on the cytokine levels and result in corresponding changes in the measures of insulin resistance ( HOMA-IR and QUICKI ) . Serum levels of IL-6 , TNF-α and hs-CRP were measured in 332 overweight and obese subjects who completed a 1-year r and omised intervention with either 40,000 IU vitamin D ( cholecalciferol ) per week or 20,000 IU vitamin D per week  ,  or placebo .  We found significant associations between IL-6 , TNF-α , vitamin D and insulin resistance indices at baseline . One year intervention with vitamin D  decreased serum IL-6 levels ; however hs-CRP levels were significantly increased . Neither measures of insulin resistance , nor TNF-α were influenced by a 1-year vitamin D supplementation BACKGROUND Off-pump coronary artery bypass graft surgery ( OPCAB ) is still associated with a marked systemic inflammatory response . The aim of this study was to investigate whether pre-emptive , low dose of ketamine , which has been reported to have anti-inflammatory activity in on-pump coronary artery bypass surgery , could reduce inflammatory response in low-risk patients undergoing OPCAB . METHODS In this prospect i ve r and omized-controlled trial , 50 patients with stable angina and preserved myocardial function undergoing OPCAB were r and omly assigned to receive either 0.5 mg kg(-1 ) of ketamine ( Ketamine group , n=25 ) or normal saline ( Control group , n=25 ) during induction of anaesthesia . Inflammatory markers including C-reactive protein ( CRP ) , interleukin (IL)-6 , tumour necrosis factor-alpha ( TNF-alpha ) , and cardiac enzymes were measured previous to induction ( T1 ) , 4 h after surgery ( T2 ) , and the first and second days after the surgery ( T3 and T4 ) . RESULTS There were no significant intergroup differences in the serum concentrations of the CRP , IL-6 , and TNF-alpha and cardiac enzymes . Pro-inflammatory markers and cardiac enzymes , except TNF-alpha , were all increased after the surgery compared with baseline values in both groups . CONCLUSIONS Low-dose ketamine administered during anaesthesia induction did not exert any evident anti-inflammatory effect in terms of reducing the serum concentrations of pro-inflammatory markers in low-risk patients undergoing OPCAB OBJECTIVE This study aim ed to explore effects of adjunctive treatment with N-acetyl cysteine ( NAC ) on markers of inflammation and neurogenesis in bipolar depression . METHODS This is a secondary analysis of a placebo-controlled r and omised trial . Serum sample s were collected at baseline , week 8 , and week 32 of the open-label and maintenance phases of the clinical trial to determine changes in interleukin (IL)-6 , IL-8 , IL-10 , tumour necrosis factor-α ( TNF-α ) , C-reactive protein ( CRP ) and brain-derived neurotrophic factor ( BDNF ) following adjunctive NAC treatment , and to explore mediation and moderator effects of the listed markers . RESULTS Levels of brain-derived neurotrophic factor ( BDNF ) , tumour necrosis factor-α ( TNF-α ) , C-reactive protein ( CRP ) , interleukins ( IL ) -6 , 8 , or 10 were not significantly changed during the course of the trial or specifically in the open-label and maintenance phases . There were no mediation or moderation effects of the biological factors on the clinical parameters . CONCLUSION The results suggest that these particular biological parameters may not be directly involved in the therapeutic mechanism of action of adjunctive NAC in bipolar depression BACKGROUND Despite an extensive literature on the role of inflammation and depression , few studies have evaluated the association between inflammatory biomarkers and depression in a prospect i ve manner , and results are inconclusive . METHODS We conducted a prospect i ve analysis of blood levels of CRP , IL-6 and TNFα-R2 in 4756 women participating in the Nurses׳ Health Study who donated blood in 1990 and were depression-free up to 1996 . Participants were followed between 1996 and 2008 for reports of clinical diagnosis depression or antidepressant use . Additionally , we conducted cross-sectional analyses for CRP , IL-6 and TNFα-R2 and antidepressant use at time of blood draw . RESULTS After adjustment for body mass index , menopause status , use of anti-inflammatory drugs and other covariates , no significant associations between CRP , IL-6 and TNFα-R2 and incident depression were observed after a follow-up of 6 - 18 years . However , menopause status appears to modify the association between IL-6 and depression risk . In cross-sectional analyses , TNFα-R2 was associated with antidepressant use ( OR=1.96 , 95 % CI=1.23 - 3.13 , P-trend=0.001 ) , but no significant associations were found for CRP and IL-6 . LIMITATIONS Depression diagnosis was first assessed in 1996 , 6 years after blood draw . However the biomarkers have high within-person correlations with measurements 4 years apart . CONCLUSIONS Blood levels of CRP , IL-6 and TNFα-R2 were not associated with incident depression over a follow-up of 6 - 18 years . In cross-sectional analyses , antidepressant use may be associated with higher levels of TNFα-R2 but no associations with depression or antidepressant use were observed in the prospect i ve analysis High blood pressure ( HBP ) has been associated with elevated C-reactive protein ( CRP ) , a marker of chronic mild inflammation . However , the association between HBP and other inflammatory markers , particularly interleukin 6 ( IL-6 ) and tumour necrosis alpha ( TNF-α ) , has not been evaluated in well-controlled studies . We examined the cross-sectional relationship between IL-6 , TNF-α , and CRP and HBP in a r and om sample of 196 healthy subjects . All markers were measured in duplicate with high-sensitivity ELISA tests . Three blood pressure ( BP ) measurments were averaged for the analysis , and subjects with systolic BP ⩾140 and /or diastolic BP ⩾90 mmHg were considered hypertensive . Log binomial regression was used to estimate multivariate-adjusted prevalence ratios ( PR ) of HBP . Of the subjects , 40 % ( 79 ) were hypertensive ( mean age : 44 years ; range 30–64 ) . After adjustment for age , sex , body mass index , family history of HBP , and the level of the other inflammatory markers , subjects in the second ( PR : 3.10 , P=0.003 ) , third ( PR : 2.32 ; P=0.031 ) , and fourth quartiles ( PR : 2.30 ; P=0.036 ) of IL-6 were more than twice as likely to be hypertensive than those in the first quartile . Corresponding PR estimates for TNF-α levels were 1.41 ( P=0.014 ) for the second ; 1.59 ( P=0.001 ) for the third ; and 1.61 ( P=0.025 ) for the fourth quartile . The CRP – HBP association was not statistically significant . Our results suggest that TNF-α and IL-6 could be independent risk factors for HBP in apparently healthy subjects . Nevertheless , the temporal relationship between elevated inflammation markers and HBP should be ascertained in prospect i ve cohort studies Background :  Cardiac surgery with cardiopulmonary bypass ( CPB )  evokes a systemic inflammatory response involving the proinflammatory cytokines tumor necrosis factor‐α ( TNFα ) , interleukin (iL)‐1 , IL‐6 , IL‐8 and anti‐inflammatory cytokines such as IL‐10 . Like IL‐10 , opioids downregulate the immune responses in vivo and in vitro , including the activity of the cytokine‐producing monocytes and granulocytes . The proinflammatory cytokines are potent inducers of the hepatic acute‐phase protein synthesis . The aim of the present study was to investigate if choice of anaesthesia , based on high‐dose opioids ( fentanyl ) versus low‐dose opioids  influenced the release of IL‐6 , IL‐8 , and IL‐10 . Secondly , it was investigated whether serum amyloid P‐component ( SAP ) is an acute‐phase protein in man such as C‐reactive protein ( CRP ) , with which it is physically and structurally related n-3 fatty acids reduce the risk of cardiovascular disease via a number of possible mechanisms . Despite this , there has been concern that these fatty acids may increase lipid peroxidation . The data in vivo are inconclusive , due in part to limitations in the method ologies . In this regard , the measurement of F2-isoprostanes provides a reliable assessment of in vivo lipid peroxidation and oxidant stress . This study aim ed to assess the effects of supplementation with purified eicosapentaenoic acid ( EPA ) or docosahexaenoic acid ( DHA ) , the two major n-3 fatty acids , on urinary F2-isoprostanes and markers of inflammation , in type 2 diabetic patients . In a double-blind , placebo controlled trial of parallel design , 59 nonsmoking , treated-hypertensive , type 2 diabetic subjects , were r and omized to 4 g daily of purified EPA , DHA , or olive oil for 6 weeks , while maintaining their usual diet . F2-isoprostanes , measured using gas chromatography-mass spectrometry in 24 h urines and C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha ( TNF-alpha ) , were measured before and after intervention . Thirty-nine men and 12 women aged 61.2 + /- 1.2 years , with body mass index ( BMI ) , 29.5 + /- 0.5 kg/m2 ; 24 h blood pressure , 138/73 mmHg ; HbA1c , 7.3 + /- 0.1 % and fasting glucose , 7.9 + /- 0.2 mmol/l completed the intervention .  Baseline urinary F2-isoprostanes were positively associated with HbA1c ( p=.011 ) and fasting glucose ( p=.032 ) . Relative to the olive oil group , postintervention urinary F2-isoprostanes were decreased 19 % by EPA ( p=.017 ) and 20 % by DHA ( p=.014 ) . There were no significant changes in CRP , IL-6 , and TNF-alpha following EPA or DHA supplementation . In regression analysis , Delta F2-isoprostanes were positively associated with Delta HbA1c ( p=.007 ) independent of treatment group ; and with Delta TNF-alpha ( p=.034 ) independent of age , gender , BMI , and treatment group . There were no associations with Delta CRP or Delta IL-6 . This study is the first report demonstrating that either EPA or DHA reduce in vivo oxidant stress without changing markers of inflammation , in treated hypertensive , type 2 diabetic subjects The pathology of type 2 diabetes mellitus ( DM ) often is associated with underlying states of conditioned zinc deficiency and chronic inflammation . Zinc and omega-3 polyunsaturated fatty acids each exhibit anti-inflammatory effects and may be of therapeutic benefit in the disease . The present r and omized , double-blind , placebo-controlled , 12-week trial was design ed to investigate the effects of zinc ( 40 mg/day ) and α-linolenic acid ( ALA ; 2 g/day flaxseed oil ) supplementation on markers of inflammation [ interleukin (IL)-1β , IL-6 , tumor necrosis factor (TNF)-α , C-reactive protein ( CRP ) ] and zinc transporter and metallothionein gene expression in 48 postmenopausal women with type 2 DM . No significant effects of  zinc or ALA supplementation were observed on inflammatory marker concentrations or fold change in zinc transporter and metallothionein gene expression . Significant increases in plasma zinc concentrations were observed over time in the groups supplemented with zinc alone or combined with ALA ( P=.007 and P=.009 , respectively ) . An impact of zinc treatment on zinc transporter gene expression was found ; ZnT5 was positively correlated with Zip3 mRNA ( P<.001 ) only in participants receiving zinc , while zinc supplementation abolished the relationship between ZnT5 and Zip10 . IL-6 predicted the expression levels and CRP predicted the fold change of the ZnT5 , ZnT7 , Zip1 , Zip7 and Zip10 mRNA cluster ( P<.001 and P=.031 , respectively ) . Fold change in the expression of metallothionein mRNA was predicted by TNF-α ( P=.022 ) . Associations among inflammatory cytokines and zinc transporter and metallothionein gene expression support an interrelationship between zinc homeostasis and inflammation in type 2 DM BACKGROUND Blood lipids and inflammatory markers levels have been associated with the development and progression of atherosclerosis . As the association of inflammatory markers with plasma fatty acids has not been extensively evaluated and understood , we sought to investigate the associations between dietary and plasma fatty acids with various inflammation and coagulation markers . METHODS High sensitivity C-reactive protein ( hsCRP ) , interleukin-6 ( IL-6 ) , tumor necrosis factor-alpha ( TNF-alpha ) , fibrinogen , and homocysteine were measured in serum of 374 free-living , healthy men and women , r and omly selected from the ATTICA 's study data base .  Total plasma fatty acids  were determined by gas chromatography . Dietary fatty acids  were assessed through a semi-quantitative FFQ . RESULTS Multi-adjusted regression analyses revealed that plasma n-3 fatty acids were inversely associated with CRP , IL-6 and TNF-alpha ; plasma n-6 fatty acids were inversely associated with CRP , IL-6 and fibrinogen ; monounsaturated fatty acids were inversely associated with CRP and IL-6 ( all p-values<0.05 ) . Interestingly , the n-6/n-3 ratios exhibited the strongest positive correlations with all the markers studied . No associations were observed between dietary fatty acids and the investigated markers . CONCLUSIONS Measurements of total plasma fatty acids could provide insights into the relationships between diet and atherosclerotic disease . Moreover , the n-6/n-3 ratio may constitute a predictor of low- grade inflammation and coagulation Background : Human adipose tissue expresses and releases proinflammatory cytokines and these measures of chronic inflammation have recently been associated with obesity . Hypothesis : To test whether the proinflammatory state is reversible in subjects undergoing weight loss by surgical measures .Subjects and Methods : Twenty morbidly obese women participated in this prospect i ve study . Subjects were examined for fat mass , high-sensitive C-reactive protein ( hs-CRP ) , interleukin 6 ( IL-6 ) and tumor necrosis factor-alpha ( TNF-α ) before and 1 y after Swedish adjustable gastric b and ing . Results : Anthropometric measures displayed a significant reduction of the body mass index ( BMI ) from 41.6±5.4 to 30.8±6.1 kg/m2 and the fat mass from 53.9±10.3 to 29.8±12.1 kg ( mean±s.d . ) . Hs-CRP levels decreased significantly from 1.33±1.21 mg/dl in pre-gastric b and ing subjects to 0.40±0.61 mg/dl in post-gastric b and ing subjects , respectively . IL-6 and TNF-α levels did not differ significantly between pre- and post-gastric b and ing subjects . Conclusions : We speculate that in these patients the marked reduction in C-reactive protein might be beneficial in reducing their cardiovascular risk and is not solely mediated by IL-6 and TNF-α We conducted a prospect i ve , nested , case-control study of inflammatory markers as predictors of  type 2 diabetes among 32,826 women who provided blood sample s in 1989 through 1990 in the Nurses ' Health Study . Among women free of diabetes , cardiovascular disease , or cancer at baseline , 737 had developed diabetes by 2000 . Control women ( n = 785 ) were selected matched on age , fasting status , race , and BMI for cases in the top BMI decile . Baseline levels of tumor necrosis factor (TNF)-alpha receptor 2 , interleukin (IL)-6 , and C-reactive protein ( CRP ) were significantly higher among case than control subjects ( all P < /= 0.001 ) . After adjusting for BMI and other lifestyle factors , all three biomarkers significantly predicted diabetes risk ; the odds ratios ( ORs ) comparing extreme quintiles were 1.64 ( 95 % CI 1.10 - 2.45 ) for TNF-alphaR2 , 1.91 ( 1.27 - 2.86 ) for IL-6 , and 4.36 ( 2.80 - 6.80 ) for CRP ( P for trend < 0.001 for all biomarkers ) . In a multivariate model simultaneously including the three biomarkers , only CRP levels were significantly associated with risk of diabetes ( OR comparing extreme quintiles of CRP = 3.99 , P for trend < 0.001 ) . These data support the role of inflammation in the pathogenesis of type 2 diabetes . Elevated CRP levels are a strong independent predictor of type 2 diabetes and may mediate associations of TNF-alphaR2 and IL-6 with type 2 diabetes OBJECTIVE Abdominal obesity is associated with a fasting proinflammatory condition . However , not much is known of the potential variations in circulating inflammatory markers after food intake . The purpose of the present study was to examine postpr and ial changes in plasma tumor necrosis factor (TNF)-alpha , interleukin (IL)-6 , and C-reactive protein ( CRP ) concentrations in men and their potential associations with fat distribution and metabolic profile variables . RESEARCH METHODS AND PROCEDURES Thirty-eight men were given a high-fat meal in the morning after an overnight fast , and TNF-alpha , IL-6 , and CRP levels were measured in plasma at 0 , 4 , and 8 hours after the meal . Physical and metabolic profiles were also assessed for each participant . RESULTS We observed a substantial increase in circulating IL-6 levels ( p < 0.0001 ) after the meal . Although postpr and ial variations in circulating TNF-alpha levels across time failed to reach statistical significance ( p = 0.02 ) , we noted a significant decrease in plasma TNF-alpha concentrations 4 hours ( -10 % , p < 0.001 vs. 0 hours ) after food intake . Plasma CRP levels were not affected by the fat load . We also noted that insulin-sensitive individuals displayed a less pronounced inflammatory response after food intake than insulin-resistant subjects . DISCUSSION Results of the present study show that consumption of a high-fat meal leads to an increase in plasma IL-6 concentrations and transient decrease in circulating TNF-alpha levels in overweight men . Our results suggest a possible role of insulin resistance in the modulation of the postpr and ial inflammatory response , which could , in turn , contribute to worsen the state of insulin resistance Coronary endothelial function is impaired in hypertension ; however , the severity of this impairment varies among patients . We aim ed to identify the predictors of coronary endothelial dysfunction among clinical variables related to hypertension and atherosclerosis . Twenty-seven untreated , uncomplicated essential hypertensive patients and 10 age-matched healthy controls were studied prospect ively . Myocardial blood flow ( MBF ) was measured by using 15O-water positron emission tomography ( PET ) at rest and during a cold pressor test ( CPT ) .  Coronary vascular resistance ( CVR ) during CPT was used as a marker of coronary endothelial function . Serum low density lipoprotein ( LDL ) cholesterol , high density lipoprotein ( HDL ) cholesterol , triglycerides , malondialdehyde-LDL , homeostasis model assessment , high-sensitivity C-reactive protein ( hs-CRP ) , and plasma interleukin-6 ( IL-6 ) and tumor necrosis factor (TNF)-α were also measured . CVR during CPT  was significantly higher in hypertensive patients than in healthy controls ( 114±26 vs. 94±12 mmHg/[mL/g/min ] ; p<0.05 ) . By univariate analysis , CVR during CPT  was correlated with LDL cholesterol ( r=0.38 , p<0.05 ) , IL-6 ( r=0.46 , p<0.02 ) , and TNF-α ( r=0.39 , p<0.05 ) in hypertensive patients . By multivariate analysis , IL-6 and TNF-α were significant independent predictors of CVR during CPT . Elevated plasma IL-6 and TNF-α levels were independent predictors of coronary endothelial dysfunction in hypertensive patients . These results suggest that plasma IL-6 and TNF-α might be useful for identifying the high risk subgroup of hypertensive patients with coronary endothelial dysfunction and provide an important clue to link systemic inflammation to the development of coronary atherosclerosis A r and omized , crossover study compared the effects of atorvastatin , gemfibrozil and their combination on inflammatory markers in type 2 diabetes .  C-reactive protein ( CRP ) , lipoprotein-associated phospholipase A2 ( Lp-PLA2 ) , secretory phospholipase A2 ( sPLA2 ) , interleukin 8 ( IL8 ) , monocyte chemotactic protein 1 ( MCP1 ) and tumor necrosis factor α ( TNFα ) were measured . Both lipid-lowering drugs had positive , complementary and additive effects on inflammatory markers , which were closely related to baseline inflammatory status AIM To investigate the effects of corticosteroids on the reduction of inflammatory response after cardiopulmonary bypass . METHODS Twenty patients undergoing elective coronary revascularization were r and omized into two groups , which both underwent coronary artery bypass surgery with the aid of normothermic cardiopulmonary bypass . One group received a single dose of methylprednisolone prior to normothermic cardiopulmonary bypass , whereas no steroid treatment was given to other group of patients . The two groups were comparable with respect to preoperative demographic data . Serum sample s from all patients were drawn preoperatively and 3 , 6 , and 24 hours after the surgical procedure . The serum concentrations of tumor necrosis factor alpha ( TNF-alpha ) , interleukin-1beta ( IL-1beta ) , interleukin-6 ( IL-6 ) , interleukin-8 ( IL-8 ) , as well as the white blood cell count were measured . Serum C-reactive protein concentrations ( CRP ) were determined preoperatively and 72 hours postoperatively . St and ard hemodynamic measurements for both groups were collected and analyzed . RESULTS We did not find any increase in the postoperative concentrations of TNF-alpha and IL-1beta in either group . The concentrations of IL-6 and IL-8 increased significantly in both groups , from immeasurable concentrations preoperatively to as high as 496 pg/mL for IL-6 and 128 pg/mL for IL-8 three hours after surgery . However , the observed increase was significantly smaller in the group of patients receiving methylprednisolone . CONCLUSION It seems that the administration of corticosteroids prior to the initiation of cardiopulmonary bypass may alleviate the intensity of the inflammatory response , as evidence d by reduced increase in inflammatory mediators
Bariatric surgery  significantly lowered inflammatory factors ; however , baseline BMI , follow-up duration and type of surgery could impact the extent of observed effects
Obesity is one of the main causes of inflammation .
Previous studies have reported inconclusive results regarding the effect of bariatric surgery on inflammatory markers .
This systematic review and meta- analysis is aim ed at describing the effect of bariatric surgery on C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) , tumor necrosis factor-α ( TNF-α ) .