Weight Loss Reduces C-Reactive Protein Levels in Obese Postmenopausal Women Short-term changes in lipoprotein subclasses and C-reactive protein levels of hypertriglyceridemic adults on low-carbohydrate and low-fat diets. The effects of the dietary glycemic load on type 2 diabetes risk factors during weight loss. Inhibition of C-Reactive Protein in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy Diet-induced weight loss is associated with decreases in plasma serum amyloid a and C-reactive protein independent of dietary macronutrient composition in obese subjects. 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 Low Carbohydrate, High Fat Diet Increases C-Reactive Protein during Weight Loss Change in Levels of C-Reactive Protein (CRP) and Serum Cortisol in Morbidly Obese Patients After Laparoscopic Sleeve Gastrectomy Effect of diet with and without exercise training on markers of inflammation and fat distribution in overweight women. Effects of total and regional fat loss on plasma CRP and IL-6 in overweight and obese, older adults with knee osteoarthritis. C‐reactive protein, symptoms and activity of daily living in patients with advanced cancer receiving palliative care Weight loss larger than 10% is needed for general improvement of levels of circulating adiponectin and markers of inflammation in obese subjects: a 3-year weight loss study. Effect of periodontal treatment on serum C-reactive protein level in obese and normal-weight women affected with chronic periodontitis. Bariatric Surgery can Reduce Albuminuria in Patients with Severe Obesity and Normal Kidney Function by Reducing Systemic Inflammation The effect of diets high in protein or carbohydrate on inflammatory markers in overweight subjects Intensive lifestyle intervention or metformin on inflammation and coagulation in participants with impaired glucose tolerance. Effect of a High Protein Weight Loss Diet on Weight, High-Sensitivity C-Reactive Protein, and Cardiovascular Risk among Overweight and Obese Women: A Parallel Clinical Trial Effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in overweight/obese postmenopausal women: a randomized controlled trial. Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study [Impact of weight loss on adipocytokines, C-reactive protein and insulin sensitivity in hypertensive women with central obesity]. Differential effects of low-carbohydrate and low-fat diets on inflammation and endothelial function in diabetes. Two Patterns of Adipokine and Other Biomarker Dynamics in a Long-Term Weight Loss Intervention Effects of folic acid and vitamin B complex on serum C-reactive protein and albumin levels in stable hemodialysis patients* Effects of a Low-Fat versus a Low-Carbohydrate Diet on Adipocytokines in Obese Adults Rapid Reduction in C-Reactive Protein With Cerivastatin Among 785 Patients With Primary Hypercholesterolemia Exercise training is not associated with improved levels of C-reactive protein or adiponectin. No Reduction in C-Reactive Protein following a 12-Month Randomized Controlled Trial of Exercise in Men and Women Supplementary Ultrafiltration May Improve Inflammation and Cardiac Dysfunction in Patients with High Interdialytic Weight Gain Serum C-Reactive Protein and White Blood Cell Count in Morbidly Obese Surgical Patients
Background —C-reactive protein ( CRP ) has been proposed as an independent risk factor for cardiovascular disease and has been positively associated with body weight and body fatness . We examined the hypothesis that weight loss would reduce plasma CRP levels in obese postmenopausal women . Methods and Results —In a sample of 61 obese ( body mass index , 35.6±5.0 kg/m2 ) , postmenopausal women ( age , 56.4±5.2 years ) , we found that plasma CRP levels were positively associated with dual x-ray absorptiometry – measured total body fatness ( r = 0.36 , P < 0.005 ) and CT-measured intra-abdominal body fat area ( r = 0.30 , P < 0.02 ) . Significant correlations were also found between plasma CRP and triglyceride levels ( r = 0.33 , P < 0.009 ) and glucose disposal measured by the hyperinsulinemic-euglycemic clamp technique ( r = −0.29 , P < 0.03 ) . Twenty-five of the 61 women tested at baseline completed a weight loss protocol .  The average weight loss was 14.5±6.2 kg ( −15.6 % , P < 0.0001 ) , with losses of 10.4±5.4 kg fat mass ( −25.0 % , P < 0.0001 ) and 2.8±1.4 kg fat-free mass ( −6.0 % , P < 0.0001 ) . Visceral and subcutaneous fat areas were reduced by −36.4 % and −23.7 % , respectively ( P < 0.0001 ) . Plasma CRP levels were significantly reduced by weight loss : average −32.3 % , from 3.06 ( + 0.69 , −1.29 ) to 1.63 ( + 0.70 , −0.75 ) & mgr;g/mL ( P < 0.0001 , medians and interquartile differences ) . Changes in body weight and in total body fat mass were both positively associated with plasma CRP level reductions . Conclusions —Adiposity was a significant predictor of plasma CRP in postmenopausal women on a cross-sectional basis . Moreover , caloric restriction – induced weight loss decreased plasma CRP levels . Weight loss may represent an important intervention to reduce CRP levels , which may mediate part of its cardioprotective effects in obese postmenopausal women Diets design ed to promote weight loss and improve atherogenic lipid profiles traditionally include a reduction in total fat and , in particular , saturated fats . This study was design ed to test the efficacy of a low-fat diet vs a carbohydrate (CHO)-restricted ( low-CHO ) diet in hypertriglyceridemic patients on lipid profile , weight loss , high-sensitivity C-reactive protein ( hs-CRP ) , and satiety .  Twenty-eight hypertriglyceridemic subjects ( based on fasting triacylglycerol [ TG ] levels exceeding 1.69 mmol/L ) were r and omized to either the  low-CHO or low-fat diet  for 8 weeks . Fasting bloods were acquired at weeks 0 and 8 and analyzed for lipids and hs-CRP . Body weight and other anthropometric measures were also obtained . Three r and om 24-hour food recalls were used to assess compliance during the trial and 2 recalls before r and omization to permit individualized dietary education . A significant time-by-treatment interaction was observed ( P = .045 ) , wherein the small low-density lipoprotein cholesterol concentrations were reduced by 46 % in the low-CHO-assigned subjects and increased by 36 % for those assigned the low-fat plan . The observed decrease in TG ( 18 % ) among low-CHO subjects , in contrast to the 4 % increase for low-fat group , was not significant , nor were there significant differences in hs-CRP , overall dietary compliance , satiety , or the magnitude of body weight loss between groups ( low-CHO group , -3.8 % vs low-fat group , -1.6 % ) . Favorable reductions in small low-density lipoprotein concentrations after 8 weeks suggest that a moderately restricted carbohydrate diet ( 20 % CHO as energy ) can promote a less atherogenic lipid profile when compared to the low-fat diet OBJECTIVE To compare the effects of two calorie-restricted diets that differ in glycemic load ( GL ) on glucose tolerance and inflammation . RESEARCH METHODS AND PROCEDURES Thirty-four healthy overweight adults , ages 24 to 42 years , were r and omized to 30 % provided calorie-restricted diets with high ( HG ) or low ( LG ) glycemic load for 6 months . Outcomes were changes in glucose-insulin dynamics and C-reactive protein ( CRP ) levels . RESULTS Compared with baseline , levels of fasting insulin , homeostasis model assessment of insulin resistance , post-load insulin at 30 minutes , and incremental area-under-the-curve-insulin during the oral glucose tolerance test were significantly lower in both groups at 6 months ( p range , 0.01 to 0.05 ) , but after adjustment for baseline values and weight change , there were no differences between the two groups with regard to changes over time in any parameter . The mean percentage change in insulin sensitivity by a frequently sample d intravenous glucose tolerance test was + 26 % in the HG group and + 24 % in the LG group ( p = 0.83 ) ; first-phase acute insulin release was -20 % in the HG group and -21 % in the LG group ( p = 0.77 ) . More participants on the LG diet ( 14 of 16 subjects ) had a decline in serum CRP , compared with those on the HG diet ( 7 of 16 subjects ) ( p < 0.05 ) . DISCUSSION In healthy overweight adults provided with food for 6 months , the dietary GL did not seem to influence chronic adaptations in glucose-insulin dynamics above that associated with weight loss . This finding highlights the importance of absolute weight loss over the dietary macronutrient composition used to achieve weight loss . The finding of greater declines in CRP concentration after consumption of a low-GL diet warrants further investigation Background Obesity is considered a low- grade chronic inflammatory condition as reflected by increased C-reactive protein ( CRP ) levels . Inflammation is emerging as a predictor of cardiovascular disease and it may be a precursor of the metabolic syndrome . Bariatric surgery is commonly performed as a treatment for morbid obesity offering significant reductions in premature myocardial infa rct ion . Laparoscopic sleeve gastrectomy ( LSG ) is a relatively new bariatric procedure that is currently used as a definitive procedure for weight loss . The aim of this study is to assess the impact of sleeve gastrectomy on CRP levels . Methods This study is part of an ongoing , prospect i ve , cohort study to evaluate LSG impact on iron indices . CRP levels were compared preoperatively and 6 months after surgery . Similarly , demographics including body mass index and excess weight were also compared at these same study points . Data were analyzed using Student paired t test and Pearson product moment correlation analysis . Results Twenty-nine morbidly obese patients were included . There was significant decrease in body mass index ( BMI ) between the preoperative and 6-month period ( 50.9 ± 13.2 and 35.1 ± 6.85 , respectively ; P < 0.001 ) . Also CRP levels were statistically significantly lower at 6 months after surgery ( preoperative 12.3 ± 7.53 mg/L and postoperative 5.6 ± 4.2 mg/L. P < 0.0001 ) . The significant weight loss as reflected by change in BMI was correlated with the difference between preoperative and postoperative CRP levels . Conclusions Massive weight loss in morbidly obese patients induced by LSG causes a significant decrease in CRP levels , which could reduce the risk of cardiovascular diseases in these patients Elevated levels of serum amyloid A ( SAA ) and C-reactive protein ( CRP ) have been associated with increased cardiovascular risk . Although levels of CRP decrease with weight loss , it is not known whether SAA decreases with weight loss or whether dietary macronutrient composition affects levels of either SAA or CRP . SAA and CRP levels were measured retrospectively on baseline and 3-month plasma sample s from 41 obese ( mean body mass index 33.63 + /- 1.86 kg/m2 ) women completing a r and omized trial comparing a low-fat diet ( n = 19 ) and a very low-carbohydrate diet ( n = 22 ) . For the 41 participants , there were significant decreases from baseline to 3 months in both LogSAA ( P = 0.049 ) and LogCRP ( P = 0.035 ) . The very low-carbohydrate dieters had a significantly greater decrease in LogSAA ( P = 0.04 ) , but their weight loss also was significantly greater ( -7.6 + /- 3.2 vs. -4.3 + /- 3.5 kg , P < 0.01 ) . In this study , the decreases in inflammatory markers correlated significantly with weight loss ( r = 0.44 , P = 0.004 vs. LogSAA and r = 0.35 , P = 0.03 vs. LogCRP ) . Also , change in LogSAA correlated with change in insulin resistance ( r = 0.35 , P = 0.03 ) . Thus , in otherwise healthy , obese women , weight loss was associated with significant decreases in both SAA and CRP . These effects were proportional to the amount of weight lost but independent of dietary macronutrient composition 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 Objective : Chronic inflammation is associated with elevated risk of heart disease and may be linked to oxidative stress in obesity . Our objective was to evaluate the effect of weight loss diet composition ( low carbohydrate , high fat , LC or high carbohydrate , low fat , HC ) on inflammation and to determine whether this was related to oxidative stress . Methods : Twenty nine overweight women , BMI 32.1 ± 5.4 kg/m2 , were r and omly assigned to a self-selected LC or HC diet for 4 wks . Weekly group sessions and diet record collection s helped enhance compliance . Body weight , markers of inflammation ( serum interleukin-6 , IL-6 ; C-reactive protein , CRP ) oxidative stress ( urinary 8-epi-prostagl and in F2α , 8-epi ) and fasting blood glucose and free fatty acids were measured weekly . Results : The diets were similar in caloric intake ( 1357 kcal/d LC vs. 1361 HC , p=0.94 ) , but differed in macronutrients ( 58 , 12 , 30 and 24 , 59 , 18 for percent of energy as fat , carbohydrate , and protein for LC and HC , respectively ) . Although LC lost more weight ( 3.8 ± 1.2 kg LC vs. 2.6 ± 1.7 HC , p=0.04 ) , CRP increased 25 % ; this factor was reduced 43 % in HC ( p=0.02 ) . For both groups , glucose decreased with weight loss ( 85.4 vs. 82.1 mg/dl for baseline and wk 4 , p<0.01 ) , while IL-6 increased ( 1.39 to 1.62 pg/mL , p=0.04 ) . Urinary 8-epi varied differently over time between groups ( p<0.05 ) with no consistent pattern . Conclusion : Diet composition of the weight loss diet influenced a key marker of inflammation in that LC increased while HC reduced serum CRP but evidence did not support that this was related to oxidative stress Background C-Reactive protein ( CRP ) has been associated with the macro- and microvascular effects of hypertension and diabetes mellitus . Referring to serum cortisol , it has been proposed to contribute to the pathogenesis of metabolic syndrome , and it has been demonstrated that weight loss normalizes cortisol levels and improves insulin resistance . The aims of this study were to analyze CRP and cortisol levels pre- and postoperatively in morbidly obese patients undergoing a laparoscopic sleeve gastrectomy  and to correlate them with weight loss and parameters associated with cardiovascular risk . Methods A prospect i ve study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and May 2011 was performed . Results A total of 40 patients were included in the study .  CRP levels decreased significantly 12 months after surgery ( median reduction of 8.9 mg/l ; p = 0.001 ) . Serum cortisol levels decreased significantly 6 months after surgery ( median reduction of 34.9 μg/dl ; p = 0.001 ) . CRP values reached the normal range ( < 5 mg/l ) 1 year after surgery . Referring to cortisol , a significant association was observed with the cardiovascular risk predictor ( triglyceride/high-density lipoprotein cholesterol ratio ) from the 6th month after surgery onward ( Pearson correlation coefficient , 0.559 ; p = 0.008 ) . Conclusion CRP levels are increased preoperatively and in the postoperative course up to 1 year after surgery . Serum cortisol levels remain elevated until the 6th month after surgery . From this moment onward , serum cortisol is associated with the cardiovascular risk predictor reflecting the cardiovascular risk decreasement during the weight loss The independent effects of exercise and weight loss on markers of inflammation ( MOI ) in obese individuals have not been clearly characterized . The objectives of this study were to : ( i ) identify the independent effects of exercise and weight loss on MOI and ( ii ) determine whether changes in MOI were associated with changes in fat distribution . Subjects were 126 healthy , premenopausal women , BMI 27 - 30 kg/m(2 ) . They were r and omized to one of three groups : diet only , diet + aerobic- , or diet + resistance training until a BMI < 25 kg/m(2 ) was achieved . Fat distribution was measured with computed tomography , and body composition with dual-energy X-ray absorptiometry .  Serum concentrations of tumor necrosis factor (TNF)-α , soluble TNF receptor 1 ( sTNF-R1 ) , soluble TNF receptor 2 ( sTNF-R2 ) , C-reactive protein ( CRP ) , and interleukin (IL)-6 were assessed . Results of repeated- measures ANOVA indicated a significant effect of time on MOI , such that MOI decreased with weight loss . Results of mixed-model analysis indicated that adjusting for intra-abdominal adipose tissue ( IAAT ) and total fat mass explained the decreases in TNF-α and sTNF-R1 , whereas only total fat mass explained the decreases in sTNF-R2 , IL-6 , and CRP . In conclusion , weight loss was associated with decreases in MOI . The effect of weight loss appeared to be mediated by changes in total fat mass or IAAT . Addition of exercise did not alter the response , suggesting that weight loss has a more profound impact for reducing MOI in overweight women than exercise OBJECTIVE To describe associations between total and regional body fat mass loss and reduction of systemic levels of inflammation ( C-reactive protein ( CRP ) and interleukin-6 ( IL-6 ) ) in obese , older adults with osteoarthritis ( OA ) , undergoing intentional weight loss . DESIGN Data come from a single-blind , 18-month , r and omized controlled trial in adults ( age : 65.6 ± 6.2 ; Body mass index ( BMI ): 33.6 ± 3.7 ) with knee OA . Participants were r and omized to diet-induced weight loss plus exercise ( D + E ; n = 150 ) , diet-induced weight loss-only ( D ; n = 149 ) , or exercise-only ( E ; n = 151 ) . Total body and region-specific ( abdomen and thigh ) fat mass were measured at baseline and 18 months . High-sensitivity CRP and IL-6 were measured at baseline , six and 18 months . Intervention effects were assessed using mixed models and associations between inflammation and adiposity were compared using logistic and mixed linear regression models . RESULTS Intentional total body fat mass reduction was associated with significant reductions in log-adjusted CRP ( β = 0.06 ( 95 % CI = 0.04 , 0.08 ) mg/L ) and IL-6 ( β = 0.02 ( 95 % CI = 0.01 , 0.04 ) pg/mL ) . Loss of abdominal fat volume was also associated with reduced inflammation , independent of total body fat mass ; although models containing measures of total adiposity yielded the best fit . The odds of achieving clinical ly desirable levels of CRP ( < 3.0 mg/L ) and IL-6 ( < 2.5 pg/mL ) were 3.8 ( 95 % CI = 1.6 , 8.9 ) and 2.2 ( 95 % CI = 1.1 , 4.6 ) , respectively , with 5 % total weight and fat mass loss . CONCLUSIONS Achievement of clinical ly desirable levels of CRP and IL-6 more than double with intentional 5 % loss of total body weight and fat mass . Global , rather than regional , measures of adiposity are better predictors of change in inflammatory burden . CLINICAL TRIAL REGISTRATION NUMBER NCT00381290 Background The association between C‐reactive protein ( CRP ) level , symptoms , and activities of daily living ( ADL ) in advanced cancer patients is unclear . Methods Secondary data analysis of a multicenter prospect i ve cohort study consisted of 2426 advanced cancer patients referred to palliative care setting s was conducted to examine the cross‐sectional relationships between CRP level , symptoms , and ADL disabilities . Laboratory data , symptoms , ADL , and manual muscle testing ( MMT ) results were obtained at baseline . Participants were divided into four groups : low ( CRP < 1 mg/dl ) , moderate ( 1 = < CRP < 5 mg/dl ) , high ( 5 = < CRP < 10 mg/dl ) , and very high CRP ( 10 mg/dl = < CRP ) . The proportions of eight symptoms , five ADL disabilities , and three categories of MMT according to the CRP groups were tested by chi‐square tests . Multiple‐adjusted odd ratios ( ORs ) were calculated by using ordinal logistic regression after adjustment for age , gender , site of primary cancer , metastatic disease , performance status , chemotherapy , and setting of care . Results A total of 1702 patients were analysed . Positive rates of symptoms and ADL disabilities increased with increasing CRP level . In the very high‐CRP group , rates of positivity for anorexia , fatigue , and weight loss were 89.8 % , 81.0 % , and 79.2 % , respectively , and over 70 % of patients received assistance for bathing , dressing , going to the toilet , and transfer . The grade of MMT also deteriorated with increasing CRP level . Adjusted ORs for the accumulated symptoms significantly increased with increasing CRP level in the moderate‐CRP , high‐CRP , and very high‐CRP groups [ 1.6 ( 95 % confidence interval 1.2–2.0 ) , P < 0.001 ; 2.5 ( 1.9–3.2 ) , P < 0.001 ; 3.5 ( 2.7–4.6 ) , P < 0.001 , respectively ] . Adjusted ORs for the accumulated ADL disabilities significantly increased in the very high‐CRP groups [ 2.1 ( 1.5–2.9 ) , P < 0.001 ] . Conclusions Associations between CRP level , symptoms , and ADL were observed in advanced cancer patients receiving palliative care OBJECTIVE To investigate the effects of : I ) short- ( 8 weeks ) , II ) long-term ( 3 years ) weight loss , and III ) the degree of weight loss on circulating levels of adiponectin , high sensitive-C reactive protein ( hs-CRP ) , and fibrinogen in obese subjects . Moreover , to evaluate the effect of the lipase inhibitor , orlistat , on these parameters . DESIGN Weight loss induced in 93 obese subjects ( mean weight : 108.9+/-15.8 kg ) through  8-week very-low-energy diet ( VLED , 800 kcal/day ) followed by r and omization to orlistat or placebo together with lifestyle intervention for further 3 years . Adiponectin and hs-CRP were measured at baseline , after 8 weeks of VLED and 6 , 12 , and 36 months after the VLED by flowmetric xMAP technology ( Luminex Multi-Analyte Profiling System , Luminex Corp. , Austin , TX , USA ) . Fibrinogen was measured in a coagulation assay . RESULTS Weight loss after VLED treatment was 14.3+/-4.5 kg and after 3 years 7.7+/-8.7 kg . Orlistat-treated subjects regained 3.9 kg less than placebo-treated from the end of the VLED to 3 years ( P=0.01 ) . No differences were detected between the two groups regarding changes in adiponectin , hs-CRP , or fibrinogen . Accordingly , the groups were combined for further analyses . Serum adiponectin increased by 22 % ( P<0.05 ) after the VLED but returned to baseline after 3 years . Both short- and long-term weight losses needed to be in excess of 10 % ( approximately 12 kg ) in order to increase adiponectin levels significantly . Weight loss was associated with a significant decrease in hs-CRP . Fibrinogen decreased by 12 % ( P<0.05 ) after 3 years . CONCLUSIONS In obese subjects , weight loss was associated with an increase in serum adiponectin and a decrease in hs-CRP and plasma fibrinogen . Long-term weight loss ( 3 years ) must exceed 10 % to induce a combined significant improvement in these inflammatory markers OBJECTIVE To investigate the effect of conventional periodontal therapy on serum C-reactive protein ( CRP ) level and periodontal status in obese and normal-weight chronic periodontitis patients . METHODS This is a controlled clinical trial conducted at the King Abdulaziz University Faculty of Dentistry , Jeddah , Kingdom of Saudi Arabia between December 2009 and March 2011 . A total of 40 women affected with moderate to severe chronic periodontitis were selected ( 20 obese [ test group ] and 20 normal-weight [ control ] ) . Smokers , pregnant women , and subjects with any systemic disease were excluded . Serum CRP level and periodontal parameters , including clinical attachment level , probing depth , bleeding on probing and plaque scores were assessed at baseline , and 2 months after non-surgical periodontal treatment . RESULTS Periodontal therapy was effective in reducing gingival inflammation , as well as serum CRP level in the total sample and within each group . The pre-treatment mean level of serum CRP was 0.78 ( + /-0.51 ) and post- treatment was 0.55 ( + /-0.41 ) mg/l in the total sample ( p=0.001 ) . A tendency was observed toward a better systemic response to treatment in normal-weight compared to obese women , however , it was not statistically significant ( the mean changes in CRP levels after therapy were 0.28 [ + /-0.43 ] and 0.19 [ + /-0.32 ] mg/l ) . CONCLUSION Periodontal treatment is effective in reducing systemic inflammation as measured by serum CRP level , and obesity does not have a major negative impact on response to periodontal therapy Background Obesity causes renal problems including albuminuria . Bariatric surgery ( BS ) improves albuminuria . We investigated whether albuminuria is reduced by weight loss per se or by improved systemic inflammation induced by weight loss after BS . Methods Patients older than 18 years who received BS in Soonchunhyang University Hospital from 01 January 2011 to 31 December 2011 were included . Other inclusion criteria included body mass index ( BMI ) ≥ 30 kg/m2 , creatinine level ≤ 1.0 mg/dL , and no overt proteinuria ( trace amount or undetectable by dipstick ) . The patients were followed at 1 and 6 months after BS . Results Forty-three patients were analyzed . Three patients were men , 10 patients had diabetes , and 12 patients had hypertension . All patients had normal renal function ( creatinine ≤ 1.0 mg/dL ) , and estimated glomerular filtration rate was 115.7 ± 16.5 mL/min/1.73 m2 . There were significant reductions in body weight , BMI , high-sensitivity C-reactive protein ( hs-CRP ) , and urine albumin-to-creatinine ratio ( ACR ) . There were positive correlations between delta hs-CRP and delta body weight ( r = 0.349 , p = 0.043 ) or delta body mass index ( BMI , r = 0.362 , p = 0.035 ) ; between hs-CRP and body weight ( r = 0.374 , p = 0.001 ) , BMI ( r = 0.431 , p < 0.001 ) . Multivariate analysis using a linear mixed model demonstrated that hs-CRP ( β = 0.5364 , p = 0.026 ) was an independent risk factor affecting ACR . Conclusions Our study suggests that BS can reduce albuminuria in patients with severe obesity and normal kidney function by reducing systemic inflammation Aim : Increased levels of inflammatory markers have been associated with weight gain and cardiovascular disease . The aim of the present study was to investigate the effect of diets high in either carbohydrate or protein on the inflammatory markers C‐reactive protein ( CRP ) , haptoglobin and transferrin in plasma after weight loss Increases in sub clinical inflammation ( C-reactive protein [ CRP ] ) and impaired coagulation have been associated with increased obesity and insulin resistance . Only a few small studies have examined the effect of lifestyle changes , such as weight loss , increased physical activity , and insulin-sensitizing intervention on inflammation and coagulation . The Diabetes Prevention Program ( DPP ) clinical trial studied the effect of an intensive lifestyle intervention or metformin on progression to diabetes relative to placebo in 3,234 adults with impaired glucose tolerance . The effects of these interventions on CRP and fibrinogen at 12 months are examined in this report . Metformin reduced  CRP in women compared with the placebo group . In men , the median changes in CRP  from baseline to 1 year were -33 % in the lifestyle group , -7 % in the metformin group , and + 5 % in the placebo group . In women , the changes in CRP from baseline to follow-up were -29 % in the lifestyle group , -14 % in the metformin group , and 0 % in the placebo group . In the lifestyle group weight loss rather than increased physical activity seems to account for most of the changes in CRP . Only modest reductions ( although significant ) were seen in fibrinogen levels in the lifestyle group relative to the metformin and placebo group . Lifestyle intervention reduced levels of nontraditional cardiovascular risk factors relative to both placebo and to a lesser degree to metformin Studies regarding the effects of high protein ( HP ) diets on cardiovascular ( CVD ) risk factors have reported contradictory results . We aim ed to determine the effects of an HP diet on CVD risk factors and high-sensitivity C-reactive protein ( hs-CRP ) among overweight and obese women . In this r and omized controlled trial , we recruited 60 overweight and obese women , aged 20–65 , into an HP or energy-restricted control diet for three months ( protein , carbohydrate , and fat : 25 % , 45 % , and 30 % versus 15 % , 55 % , and 30 % , resp . ) . Total protein was divided between animal and plant sources in a 1 : 1 ratio , and animal sources were distributed equally between meats and dairy products . Fasting blood sample s , hs-CRP , lipid profile , systolic and diastolic blood pressure , and anthropometric measurements were assessed using st and ard guidelines . Percent change was significantly different between the two diet groups for weight ( st and ard protein ( SP ) : −3.90 ± 0.26 versus HP : −6.10 ± 0.34 % ; P < 0.0001 , resp . ) and waist circumference ( SP : −3.03 ± 0.21 versus HP : −5.06 ± 0.28 % ; P < 0.0001 , resp . ) . Percent change of fasting blood glucose ( FBG ) substantially decreased in the control group compared to the HP group ( −9.13 ± 0.67 versus −4.93 ± 1.4 % ; P = 0.01 , resp . ) . Total cholesterol , systolic blood pressure ( SBP ) , and diastolic blood pressure ( DBP ) decreased both in the HP and in the control diet groups ( P = 0.06 , P = 0.07 , and P = 0.09 , resp . ) ; however , the results were marginally significant . Serum levels of hs-CRP were reduced both in the control ( −0.08 ± 0.11 % , P = 0.06 ) and in the high protein groups ( −0.04 ± 0.09 % , P = 0.06 ) . The energy-restricted HP diet result ed in more beneficial effects on weight loss and reduction of waist circumference . CVD risk factors may improve with HP diets among overweight and obese women . When using isoenergetic weight loss diets , total cholesterol , hs-CRP , and SBP were marginally significantly reduced , independent of dietary protein content . This trial is registered with Clinical Trials.gov NCT01763528 Obese and sedentary persons have increased risk for cancer ; inflammation is a hypothesized mechanism . We examined the effects of a caloric restriction weight loss diet and exercise on  inflammatory biomarkers in 439 women . Overweight and obese postmenopausal women were r and omized to 1-year : caloric restriction diet ( goal of 10 % weight loss , N = 118 ) , aerobic exercise ( 225 min/wk of moderate-to-vigorous activity , N = 117 ) , combined diet + exercise ( N = 117 ) , or control ( N = 87 ) . Baseline and 1-year high-sensitivity C-reactive protein ( hs-CRP ) , serum amyloid A ( SAA ) , interleukin-6 ( IL-6 ) , leukocyte , and neutrophil levels were measured by investigators blind to group . Inflammatory biomarker changes were compared using generalized estimating equations . Models were adjusted for baseline body mass index ( BMI ) , race/ethnicity , and age . Four hundred and thirty-eight ( N = 1 in diet + exercise group was excluded ) were analyzed . Relative to controls , hs-CRP decreased by geometric mean ( 95 % confidence interval , P value ) : 0.92 mg/L ( 0.53 - 1.31 , P < 0.001 ) in the diet and 0.87 mg/L ( 0.51 - 1.23 , P < 0.0001 ) in the diet + exercise groups . IL-6 decreased by 0.34 pg/mL ( 0.13 - 0.55 , P = 0.001 ) in the diet and 0.32 pg/mL ( 0.15 - 0.49 , P < 0.001 ) in the diet + exercise groups . Neutrophil counts decreased by 0.31 × 10(9)/L ( 0.09 - 0.54 , P = 0.006 ) in the diet and 0.30 × 10(9)/L ( 0.09 - 0.50 , P = 0.005 ) in the diet + exercise groups . Diet and diet + exercise participants with 5 % or more weight loss reduced inflammatory biomarkers ( hs-CRP , SAA , and IL-6 ) compared with controls . The diet and diet + exercise groups reduced hs-CRP in all subgroups of baseline BMI , waist circumference , CRP level , and fasting glucose . Our findings indicate that a caloric restriction weight loss diet with or without exercise reduces biomarkers of inflammation  in postmenopausal women , with potential clinical significance for cancer risk reduction Background Flaxseed has received attention for its anti-inflammatory and antioxidant role . The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease . Methods In a prospect i ve , single blinded 42 days protocol , subjects were allocated into two groups with low carbohydrates intake : GriceLC ( 35 % of carbohydrate and 60 g of raw rice powder per day ) and GflaxLC ( 32 % of carbohydrate and 60 g of flaxseed powder per day ) . Blood pressure , anthropometric measures and serum levels of isoprostane , C-reactive protein , Tumor Necrosis Factor-alpha , glucose , lipidic profile , uric acid , adiponectin , leptin and insulin were measured at baseline and at the end of interventions . Serum and urinary enterodiol and enterolactione were also measured . Results A total of 27 men with cardiovascular risk factors were evaluated , with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC . Both groups experienced weight loss and systolic blood pressure reduction . A decrease in inflammatory markers ( CRP and TNF-α ) was observed after flaxseed intake ( mean decrease of 25 % and 46 % for GflaxLC respectively ) . All groups also showed improvement in levels of total cholesterol , LDL-c , uric acid and adiponectin . Only GflaxLC group showed a decrease in triglyceride levels . Conclusion This study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α . Trial registration Clinical Trials.gov NCT02132728 OBJECTIVE To assess the impact of weight reduction on serum adipocytokines , C-reactive protein ( CRP ) , and insulin sensitivity in hypertensive female patients with central obesity . METHODS This study was performed using the data base and stored serum sample s of female patients who had participated in an intervention study focused on weight loss . Thirty hypertensive women aged 18 to 65 , body mass index ( BMI ) > 27 kg/m2 , and central obesity were selected . They were r and omly assigned to receive either a low-calorie diet plus orlistat 120 mg three times daily or a low-calorie diet alone for 16 weeks . Patients who experienced weight loss greater than 5 % ( n = 24 ) were assessed for blood pressure , anthropometric parameters , visceral fat , insulin resistance ( HOMA-R - homeostasis model assessment of insulin resistance ) and sensitivity ( ISI - Insulin Sensitivity Index ) indices , plus serum lipids , adipocytokines ( adiponectin , leptin , IL-6 , and TNF-alpha ) and CRP levels . RESULTS After BMI had been reduced by approximately 5 % in both groups , visceral fat , fasting glucose , triglycerides , and TNF-alpha decreased . Only the orlistat group , which was more insulin resistant at baseline , showed a significant reduction in blood glucose after oral glucose load , in addition to increased insulin sensitivity . CONCLUSION This study 's findings indicate that a weight loss greater than 5 % is associated with improved inflammatory status and decreased insulin resistance , regardless of changes in adiponectin and TNF-a levels . The greatest improvements in insulin sensitivity experienced by the orlistat-treated patients could not be attributed to the use of this drug because of the higher number of insulin-resistant subjects in this group OBJECTIVE To characterize acute ( postpr and ial ) and chronic ( after a 6-month period of weight loss ) effects of a low-carbohydrate vs. a low-fat diet on sub clinical markers of cardiovascular disease ( CVD ) in adults with type 2 diabetes . DESIGN At baseline and 6 months , measures of C-reactive protein ( CRP ) , interleukin-6 ( IL-6 ) , soluble intercellular adhesion molecule ( sICAM ) and soluble E-selectin were obtained from archived sample s ( n = 51 ) of participants r and omized in a clinical trial comparing a low-carbohydrate and a low-fat diet .  In a subset of participants ( n = 27 ) , postpr and ial measures of these markers were obtained 3 h after a low-carbohydrate or low-fat liquid meal .  Endothelial function was also measured by reactive hyperemic peripheral arterial tonometry during the meal test . Paired t tests and unpaired t tests compared within- and between-group changes . RESULTS There were no significant differences observed in postpr and ial measures of inflammation or endothelial function . After 6 months , CRP ( mean ± S.E. ) decreased in the low-fat arm from 4.0 ± 0.77 to 3.0 ± 0.77 ( P = .01 ) . In the low-carbohydrate arm , sICAM decreased from 234 ± 22 to 199 ± 23 ( P = .001 ) , and soluble E-selectin decreased from 93 ± 10 to 82 ± 10 ( P = .05 . ) A significant correlation between change in high-density lipoprotein and change in soluble E-selectin ( r = -0.33 , P = .04 ) and with the change in ICAM ( r = -0.43 , P = .01 ) was observed . CONCLUSIONS Low-carbohydrate and low-fat diets both have beneficial effects on CVD markers . There may be different mechanisms through which weight loss with these diets potentially reduces CVD risk OBJECTIVE Long-term dietary intervention frequently induces a rapid weight decline followed by weight stabilization/regain . Here , we sought to identify adipokine biomarkers that may reflect continued beneficial effects of dieting despite partial weight regain . RESEARCH DESIGN AND METHODS We analyzed the dynamics of fasting serum levels of 12 traditional metabolic biomarkers and novel adipokines among 322 participants in the 2-year Dietary Intervention R and omized Controlled Trial ( DIRECT ) of low-fat , Mediterranean , or low-carbohydrate diets for weight loss . RESULTS We identified two distinct patterns : Pattern A includes biomarkers ( insulin , triglycerides , leptin , chemerin , monocyte chemoattractant protein 1 , and retinol-binding protein 4 ) whose dynamics tightly correspond to changes in body weight , with the trend during the weight loss phase ( months 0–6 ) going in the opposite direction to that in the weight maintenance/regain phase ( months 7–24 ) ( P < 0.05 between phases , all biomarkers ) . Pattern B includes biomarkers ( high molecular weight adiponectin , HDL cholesterol [ HDL-C ] , high-sensitivity C-reactive protein [ hsCRP ] , fetuin-A , progranulin , and vaspin ) that displayed a continued , cumulative improvement ( P < 0.05 compared with baseline , all biomarkers ) throughout the intervention . These patterns were consistent across sex , diabetic groups , and diet groups , although the magnitude of change varied . Hierarchical analysis suggested similar clusters , revealing that the dynamic of leptin ( pattern A ) was most closely linked to weight change and that the dynamic of hsCRP best typified pattern B. CONCLUSIONS hsCRP , HDL-C , adiponectin , fetuin-A , progranulin , and vaspin levels display a continued long-term improvement despite partial weight regain . This may likely reflect either a delayed effect of the initial weight loss or a continuous beneficial response to switching to healthier dietary patterns ABSTRACT Objective : Folic acid and vitamin B complex administration in uremic patients has been reported to lower plasma total homocysteine ( tHcy ) levels , but whether or not this has a beneficial effect on the inflammatory state is not clear . Methods : We conducted a r and omized open labeled study to determine the effects of folic acid ( 5 mg daily ) and vitamin B complex administration on plasma tHcy levels as well as inflammatory ( serum high-sensitivity C reactive protein , hs‑CRP ) and nutritional ( serum albumin ) markers in patients on maintenance hemodialysis . Treatment was given for 3 consecutive months to 61 patients on maintenance hemodialysis . Another 60 patients , all age- , sex- , hemodialysis duration -matched served as control group . Main outcome measures : Plasma tHcy , serum hs‑CRP , albumin , creatinine ( Cr ) , post-dialysis body weight ( BW ) , and normalized protein catabolism rate ( nPCR ) . Results : After 3 months , levels of plasma tHcy and serum hs‑CRP , Cr , and nPCR were significantly decreased while levels of serum albumin , vitamin B12 , folate , and BW were significantly increased . The dialytic dose ( KT/V ) and dietary intake remained unchanged . However , correlations between the magnitude of reduction of tHcy & hs‑CRP , tHcy & Cr , and Cr & nPCR were statistically significant . Conclusions : Folic acid and vitamin B complex co-administration effectively lowers tHcy and hs‑CRP levels and increases albumin levels in stable hemodialysis subjects , underscoring their potential benefit to attenuate the state of inflammation and possibly improve the nutritional status in patients on hemodialysis Background and Aims : There are few studies addressing the effect of weight loss on circulating levels of adipocytokines . The aim of our study was to determine whether different diets would have different weight loss effects and to examine the changes in adipocytokine levels . Methods : A population of 90 obesity non-diabetic out patients was analyzed in a prospect i ve way . The patients were r and omly allocated to two groups : ( a ) diet I ( low-fat diet ) , and ( b ) diet II ( low-carbohydrate diet ) . At baseline and after 3 months on the diet , adipocytokines were evaluated . Results : 43 patients were r and omized to group I and 47 patients to diet group II . No differences were detected between weight loss in either group ( 3.3 ± 0.51 vs. 4.4 ± 0.6 kg ; n.s . ) . In group I , a significant decrease in leptin levels was found . In group II , leptin and C-reactive protein ( CRP ) levels also decreased . The decrease in leptin levels was lower with diet I than II ( 16.4 vs. 22.8 % ; p < 0.05 ) . Conclusion : The serum leptin concentration decreased due to the 3-month intervention with low-fat and low-carbohydrate diets , without changes in other adipocytokines . The decrease in leptin and CRP levels were higher with a low-carbohydrate diet than a low-fat diet Background — Long-term therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors ( statins ) has been shown to reduce levels of C-reactive protein ( CRP ) . However , the generalizability , speed of onset , and dose-response characteristics of this effect are uncertain . Methods and Results — We measured CRP , LDL cholesterol ( LDL-C ) , and HDL cholesterol ( HDL-C ) levels among 785 patients with primary hypercholesterolemia at baseline and after 8 weeks of therapy with either 0.4 or 0.8 mg of cerivastatin . Overall , cerivastatin result ed in a 13.3 % reduction in median CRP levels ( P < 0.001 ) and a 24.5 % reduction in mean CRP levels ( P < 0.001 ) . Although LDL-C promptly decreased in a dose-dependent manner ( mean LDL-C reduction , 37.3 % for 0.4 mg and 42.2 % for 0.8 mg of cerivastatin ) , no clear dose-response effect of cerivastatin on CRP was observed , nor was there any substantive correlation between the magnitude of change in CRP and the magnitude of change in LDL-C ( r = −0.08 ) or the magnitude of change in HDL-C ( r = −0.04 ) . Thus , < 2 % of the variance in the percent change in CRP over 8 weeks could be attributed to the percent change in either of these lipid parameters . Further , there was no evidence of correlation between baseline CRP levels and baseline lipid levels or between end-of- study CRP levels and end-of- study lipid levels . Conclusions — Among 785 patients with primary hypercholesterolemia , CRP levels were significantly reduced within 8 weeks of initiating cerivastatin therapy in a lipid-independent manner The purpose of this study was to determine the effect of exercise training on the levels of C-reactive protein ( CRP ) and adiponectin , and to assess whether exercise-induced changes in insulin resistance could be explained in part by changes in these inflammation markers . Study participants included 51 middle-aged ( 45.3+/-8.3 years ; mean+/-SD ) , overweight ( 33.7+/-4.8 BMI ) , insulin-resistant , nondiabetic individuals . Subjects had their insulin sensitivity , body fat , CRP , and adiponectin levels measured , and their predicted maximal fitness calculated before and after 16 weeks of moderate , intense , or no exercise training . Modest improvements in fitness , body composition , and insulin sensitivity were observed , but these changes were not associated with decreased CRP or increased adiponectin levels , even when subjects were stratified by their change in fitness or obesity . Regression analysis demonstrated that the change in percentage of body fat was significantly related to changes in insulin sensitivity , whereas changes in VO2 MAX , CRP , and adiponectin were not . Participation in moderate to intense exercise was not associated with improved measures of chronic inflammation markers , as measured by CRP and adiponectin . Moreover , improvements in insulin sensitivity result ing from exercise or modest weight loss did not appear to be related to changes in these markers Low- grade systemic inflammation is suggested to play a role in the development of several chronic diseases including cancer . Higher levels of physical activity and lower adiposity have been associated with reduced levels of markers of systemic inflammation , such as C-reactive protein ( CRP ) ; however , reductions in CRP have not been consistently observed in r and omized controlled trials of exercise . Purpose : To examine the effect of a 12-month aerobic exercise intervention on CRP levels  in men and women . Methods : One hundred two men and 100 women , sedentary and of ages 40 to 75 years , with mean body mass index ( BMI ) of 29.9 and 28.7 kg/m2 , respectively , were r and omly assigned to a 12-month moderate-to-vigorous aerobic exercise intervention ( 6 d/wk , 60 min/d , 60 - 85 % maximum heart rate ) or control group .  Fasting blood sample s were collected at baseline and at 12 months . CRP levels were measured by high-sensitivity latex-enhanced nephelometry . Results : At baseline , CRP was 1.16 and 2.11 mg/L for men and women , respectively , and CRP was correlated with percent body fat ( r = 0.48 , P ≤0.001 ) , BMI ( r = 0.37 , P ≤ 0.001 ) , and aerobic fitness ( r = −0.49 , P ≤ 0.001 ) . No intervention effects were observed for CRP in men or women , or when stratified by baseline BMI ( < 30 versus ≥30 kg/m2 ) , baseline CRP ( <3 versus ≥3 mg/L ) , or change in body weight , body composition , or aerobic fitness . Conclusion : A 12-month moderate-to-vigorous aerobic exercise intervention did not affect CRP levels  in previously sedentary men or women with average-risk CRP values at baseline . ( Cancer Epidemiol Biomarkers Prev 2008;17(7):1714–8 Background / Aims : We tested the hypothesis that adding an ultrafiltration session per week may improve brain natriuretic peptide ( BNP ) and C-reactive protein ( CRP ) levels and left ventricular function in hypervolemic hemodialysis patients . Methods : Twenty-six patients ( 18 male , 8 female ; mean age 57.2 ± 12.7 years ) who had high BNP and CRP levels and interdialytic weight gain ( IDWG ) were recruited for the study . Patients were r and omly allocated to one of two groups , namely the supplementary ultrafiltration ( sUF ) group ( n = 13 ) , who had additional ultrafiltrations for 8 weeks , and the regular hemodialysis ( rHD ) group ( n = 13 ) , who continued regular dialysis treatments . Results : There were significant decreases in mean CRP and BNP levels and mean arterial blood pressure and significant improvements in left ventricular function in the sUF group , with no changes in the rHD group . Higher IDWG was observed in the rHD group compared to the sUF group after 8 weeks . Conclusion : sUF may be effective in reducing inflammatory burden and improving cardiac function Background Obesity has been widely recognized as a chronic inflammatory condition and associated with elevated inflammatory indicators including C-reactive protein ( CRP ) and white blood cell count ( WBC ) . Recent studies have shown elevated CRP or WBC is a significant risk factor for cardiac events and stroke but the clinical significance of CRP and WBC has not been clearly studied in morbidly obese patients . This study is aim ed at the clinical significance of WBC and CRP in morbidly obese patients and the change after bariatric surgery . Methods The study was a prospect ively controlled clinical study . From December 1 , 2001 to January 31 , 2006 , of 640 ( 442 females and 198 males ) consecutive morbid obese patients enrolled in a surgically supervised weight loss program with at least 1 year ’s follow-up were examined . Results Of the patients , 476 ( 74.4 % ) had elevated CRP and 100 ( 15.6 % ) had elevated WBC at preoperative study .  CRP and WBC were significantly related and both increased with increasing body mass index ( BMI ) . CRP is also increased with increasing waist , glucose level , hemoglobin , albumin , Ca , insulin , C-peptide , and metabolic syndrome while WBC is increased with metabolic syndrome but decreased with increasing age . Multivariate analysis confirmed fasting glucose level and hemoglobin are independent predictors of the elevation of CRP while age is the only independent predictor for elevated WBC . Both WBC and CRP levels decreased rapidly after obesity surgery . These improvements result ed in a 69.8 % reduction of CRP and 26.4 % reduction of WBC 1 year after surgery . Although individuals who underwent laparoscopic gastric bypass lost significantly more weight ( 36.8 ± 11.7 kg vs. 17.3 ± 10.8 kg ; p = 0.000 ) and achieved a lower BMI ( 27.8 ± 4.6 vs. 35.0 ± 5.5 ; p = 0.000 ) than individuals who underwent laparoscopic gastric b and ing , there was no difference in the resolution of elevated CRP 1 year after surgery ( 95.9 % vs. 84.5 % ; p = 0.169 ) and WBC ( 99.4 % vs. 98.3 % ; p = 0.323 ) . Conclusions Both baseline WBC and CRP are elevated in morbid obese patients but CRP has a better clinical significance . Significant weight reduction 1 year after surgery markedly reduced CRP and WBC with a resolution rate of 93.9 % and 98.2 % separately . Obesity surgery performed by laparoscopic surgery is recommended for obese patients with elevated CRP or WBC
RESULTS Weight loss was associated with a decline in CRP level .
Our results suggest that weight loss may be an effective nonpharmacologic strategy for lowering CRP level
BACKGROUND Several studies suggest that weight loss reduces C-reactive protein ( CRP ) level ; however , the consistency and magnitude of this effect has not been well characterized .
Our objective was to test the hypothesis that weight loss is directly related to a decline in CRP level .