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GRK 1482 Jahrbuch 2011-2014

Abstract Due to the lacking success of traditional methods to reduce body weight in the long term, especially in morbidly obese patients, the de- mand for surgical therapies is increasing. As a relatively new proce- dure in bariatric surgery laparoscopic gastric sleeve resection is per- formed increasingly frequent. However, the long-term effects of this operation are not well investigated so far. Hence, for our study patients who are undergoing laparoscopic sleeve gastrectomy are recruited. To investigate the development of inflammation in adipose tissue as well as the relevance for the vitamin status in these subjects, visce- ral and subcutaneous adipose tissue are taken during operation and blood samples will be taken before and after surgery. Introduction Obesity remains a worldwide health issue. Between 1980 and 2008 the prevalence has more than dou- bled [1]. In Germany no decline can be observed for the last two decades [2]. Obese subjects are not only stigmatized, discrimi- nated and limited in their physical capabilities [3], obesity is also correlated to a significantly increa- sed mortality. Comorbidities such as cardiovascu- lar disease, dyslipidaemia, hypertension and type 2 diabetes mellitus are responsible for this situation [4] [5]. Highlighting type 2 diabetes amongst these comorbidities, a low grade inflammatory condition in adipose tissue is considered as an important contributor [6]. In this regard, special attention has been directed to RANTES (regulated upon activati- on normal T cell expressed and secreted) – an adi- pokine which shows 1) a higher gene expression in adipose tissue, 2) higher serum levels in obese than in lean subjects as well as 3) higher levels in sub- jects with type 2 diabetes or impaired glucose tole- rance [7]. Furthermore, administration of RANTES caused reduced plasma GLP-1-levels and conse- quently an impaired insulin secretion after an oral glucose load in mice [8]. It is repeatedly shown that weight loss in obese subjects leads to a rapid improvement of meta- bolic and cardiovascular comorbidities [9]. But, in most cases weight maintenance after weight loss cannot be achieved with a conventional therapy. Recent results suggest, that the most efficient and sustainable approach for morbid obese subjects to reduce weight is bariatric surgery [10]. As a re- latively new procedure laparoscopic gastric sleeve (LGS) surgery is increasingly performed. During this operation the fundus and the greater curvature of the stomach is resected, so that only a sleeve is left. However, little is known about the long term consequences e.g. for vitamin absorption in those patients. ASSOCIATED FELLOWS Page 64 | GRK Progress Report 2011-2014 Britta Fischer (M.Sc.) Nutritional Medicine PhD Phenotypic characterization of very obese patients before and after weight loss due to bariatric surgery