Endocrine Abstracts

Introduction: Obesity related glomerulopathy (ORG) is an emerging epidemic alongside increasing incidences of obesity. ORG pathophysiology has not been explored despite poor prognosis in untreated patients. MCP-1, MIF, CCL-18 and CCL-15 are novel cytokines that may be pathologically involved in obesity-induced renal injury and explored in this study.

Methods: Blood pressure, urine and blood samples were collected from 34 morbidly obese patients before and 4 weeks after bariatric surgery. Biochemical parameters including serum creatinine, albumin, cholesterol, estimated glomerular filtration rate (eGFR) and C-reactive protein (CRP) alongside urine albumin and creatinine were recorded. Urinary and serum chemokines MCP-1, MIF, CCL-18 and CCL-15 were detected using ELISA.

Results: Thirty-four patients were analysed postoperatively with an average weight loss of 9.3 kg. Systolic blood pressure decreased from 142.9 to 128.1 mmHg (P<0.001), diastolic blood pressure decreased from 87.1 to 79.2 mmHg (P<0.001) and mean arterial blood pressure decreased from 105.7 to 95.5 mmHg postoperatively (P<0.001). Urinary albumin decreased from 45.3 to 21.9 mg/l (P<0.001), urinary creatinine decreased from 25.9 to 17.2 mmol/l postoperatively (P<0.01) whilst eGFR increased from 68.1 to 86.1 ml/min per 1.73 m². Serum creatinine decreased from 73.6 to 68.1 μmol/l postoperatively (P<0.05). Serum CRP values decreased from 25.2 to 8.08 mg/l postoperatively (P<0.001). Urinary MIF decreased from 203.1 to 90.4 ng/mmol Cr postoperatively (P<0.001). Urinary MCP-1 decreased from 26.1 to 16.7 ng/mmol Cr postoperatively (P<0.001). Urinary CCL-18 levels decreased from 96.8 to a postoperative value of 22.0 ng/mmol Cr (P<0.05), urinary CCL-15 changes were not statistically significant. Serum CCL-18 decreased from 576.2 to 122.6 ng/mmol Cr postoperatively (P<0.001). There were no significant changes in serum MIF, MCP-1 or CCL-15.

Conclusion: This study demonstrates the early benefits of surgically induced weight loss upon blood pressure and markers of renal function. Reduced urinary cytokines suggest bariatric surgery attenuates inflammatory status which may have an aetiological role in ORG.