Evolution of the cytokine profile following duodenal-jejunal bypass liner in adolescents with obesity

Igor Terčon; Rober Šket; Tine Tesovnik; Tadej Battelino; Jernej Kovač; Primož Kotnik

Background: Treatment of adolescents with obesity with duodenal-jejunal bypass liner (DJBL) is effective in terms of lowering body mass index (BMI) and improving the metabolic complications of obesity.

Objective and hypotheses: To quantify the temporal and quantitative changes in the expression of cytokines associated with appetite and insulin resistance and C-reactive protein (CRP) after insertion of DJBL in correlation with a reduction in BMI.

Methods: Nineteen adolescents aged > 15 years with obesity and at least one metabolic complication were treated with the endoscopically inserted DJBL. Blood samples were collected before the procedure and at 1, 6 and 12 months thereafter when the device was removed. The cytokine profile has been determined by ELISA based on specific antibodies bound to nanoparticles and quantified by flow cytometry.

Results: Patients were divided into two groups according to the reduction of BMI (9 patients with BMI reduction <10% and 10 patients with BMI reduction >10%). The results related to baseline revealed a significant decrease in leptin levels in both groups, however more pronounced in the group with a reduction of > 10%. This was not paralleled by a significant decrease in inflammatory marker CRP, although a trend to a decrease in CRP could be observed in the group with the greater decrease in BMI.


BMI reduction <10% = avg. 0,96 ± 0,01					BMI reduction >10% = avg. 0,82 ± 0,01
	1 month	6 month	12 month	p		1 month	6 month	12 month	p
BMI	0,95 ± 0,01	0,94 ± 0,01	0,96 ± 0,01	***	BMI	0,93 ± 0,01	0,84 ± 0,01	0,82 ± 0,01	***
Leptin	0,69 ± 0,09	0,74 ± 0,05	0,85 ± 0,11	*	Leptin	0,65 ± 0,08	0,59 ± 0,07	0,60 ± 0,07	***
CRP	1,20 ±0,20	1,06 ± 0,08	1,06 ± 0,13		CRP	1,07 ± 0,09	0,99 ± 0,08	0,99 ± 0,07
Differences between measured parameters was determined by PERMANOVA test. () P <0.05, () P <0.01, (**) P <0.001

Conclusion: DJBL treatment resulted in a paralleled decrease in both BMI and leptin levels. This was however not accompanied by a significant decrease in CRP levels. Since there was a trend to a more significant decrease in CRP levels in those with BMI decrease of > 10 % identifies this decrease as a target goal for obesity management in children.

ESPE Abstracts

P1-239