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Soluble CD40L in patients with morbid obesity: significant reduction after bariatric surgery
G-H Schernthaner1, H-P Kopp, K Krzyzanowska
1Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria. gerit.schernthaner@meduniwien.ac.at
Insights
Massive weight loss through bariatric surgery significantly reduced soluble CD40 Ligand (sCD40L) in morbidly obese patients. This reduction correlated with improved insulin resistance and inflammation, suggesting clinical relevance for cardiovascular health.
Area of Science:
- Cardiovascular Disease
- Metabolic Syndrome
- Inflammation Biology
Background:
- Morbid obesity is linked to higher cardiovascular risks.
- Soluble CD40 Ligand (sCD40L) may contribute to atherothrombosis, inflammation, and thrombosis.
- Obesity is associated with chronic inflammation and insulin resistance (IR).
Purpose of the Study:
- To investigate sCD40L levels in morbidly obese patients before and after bariatric surgery.
- To assess the impact of massive weight loss on sCD40L, insulin resistance, and inflammation.
Main Methods:
- 34 morbidly obese patients were studied pre- and post-bariatric surgery (mean 27.2 months).
- High-sensitivity assays measured fasting sCD40L, MCP-1, and hsCRP.
- Univariate and multivariate regression analyzed changes in parameters.
Main Results:
- Mean weight loss was 33.1 kg.
- Circulating sCD40L significantly decreased post-surgery (3.7 to 2.2 ng/mL, P < 0.001).
- sCD40L decline correlated with reduced insulin (fasting, 2-h, HOMA-IR), triglycerides, MCP-1, and hsCRP.
Conclusions:
- Bariatric surgery led to a significant decrease in sCD40L in morbidly obese patients.
- Weight loss improved insulin resistance and chronic inflammation markers.
- Lowered sCD40L post-surgery may have clinical implications for cardiovascular event risk.
Background:
Morbid obesity is associated with increased cardiovascular morbidity and mortality. Recent studies suggest that soluble CD40 Ligand (sCD40L) may play a pathogenetic role in atherothrombotic complications in cardiovascular disease as well as in inflammation and thrombosis. As morbid obesity is closely associated with chronic inflammation and insulin resistance (IR), it was of interest to study sCD40L in patients with morbid obesity before and after massive weight loss induced by bariatric surgery.
Patients And Methods:
A total of 34 patients (mean age 40 +/- 12 years) with morbid obesity were studied before and 27.2 months after bariatric surgery. High sensitivity assays were used to measure concentrations of fasting sCD40L, monocyte-chemoattractant-protein-1 (MCP-1) and high-sensitive C-reactive protein (hsCRP). To investigate the associations of concentration changes of the parameters studied, differences between pre- and post-operative data were assessed and tested by univariate and multivariate linear regression analysis.
Results:
After a mean weight loss of 33.1 +/- 18.4 kg, circulating sCD40L decreased significantly from (3.7 +/- 1.5) ng mL(-1) to (2.2 +/- 0.7) ng mL(-1), (P < 0.001). The decline in sCD40L after weight loss correlated significantly with the decrease in fasting insulin, 2-h insulin, HOMA insulin resistance (HOMA-IR), triglycerides, and the inflammatory biomarkers MCP-1 and hsCRP.
Conclusions:
We have shown a marked decrease in circulating sCD40L in association with an improvement of both insulin resistance and chronic inflammation in morbidly obese patients after bariatric surgery. As high sCD40L was shown to predict cardiovascular death and myocardial infarction in several prospective studies, the observed marked lowering of sCD40L might be of clinical relevance in morbidly obese patients.
