Reduced Th1 response is associated with lower glycolytic activity in activated peripheral blood mononuclear cells after metabolic and bariatric surgery.

BACKGROUND: Obesity promotes cellular immunometabolism changes that trigger the activation of macrophages and lymphocytes, leading to systemic inflammation. Activated leukocytes undergo metabolic reprogramming, increasing glycolytic activity. OBJECTIVE: To examine whether the reduction in the inflammatory state associated with bariatric surgery is associated with decreased glycolytic activity in leukocytes. Setting Single-center, prospective observational study. METHODS: This study involved 18 patients with obesity undergoing bariatric surgery. All measurements were performed preoperatively and six months postoperatively. Peripheral blood mononuclear cells and plasma were obtained to determine the glycolytic rate and mitochondrial membrane potential as surrogates of the metabolic switching and high-sensitivity C-reactive protein, adipokines, and CD69 expression as inflammatory and activation markers. RESULTS: Glycolytic activity engaged by CD3/CD28 activation was reduced six months after bariatric surgery, associated with decreased levels of T helper (Th) 1 and Th17 signature cytokines. An overall reduction in inflammatory markers was observed, which correlated with a higher adiponectin/leptin ratio. CONCLUSIONS: Metabolic and bariatric surgery-induced weight loss leads to reprogramming in T cells' metabolic machinery, resulting in reduced stimulation of glycolysis after activation, which may explain the decrease in systemic inflammation mediated by cytokines such as interferon-γ and interleukin-17A.

School-based individualised lifestyle intervention decreases obesity and the metabolic syndrome in Mexican children.

BACKGROUND: Currently, there is limited evidence about effective strategies to manage childhood obesity and the metabolic syndrome in school settings. The present study aims to analyse changes in the prevalence of being overweight/obese and having the metabolic syndrome in relation to a 10-month lifestyle intervention based on individualised face-to-face sessions and parental education in school settings. METHODS: The study sample comprised a cross-sectional sample of 96 overweight/obese Mexican children aged 6-12 years from eight schools. Clinical, anthropometric measurements and 24-h recalls were obtained during each of 13 visits. Laboratory measurements were determined at the beginning and end. The energy-reduced diet was based on dietary recommended intakes. Individualised structured daily meals and a physical activity plan, tailored-made for each child, were provided every 3 weeks at the schools. Parental attendance was required. Student's t-test, McNemar and Shapiro-Wilk tests and simple linear regression were used for the statistical analysis. RESULTS: The prevalence of metabolic syndrome fell significantly from 44% to 16% (P < 0.01), high blood pressure fell from 19% to 0%, hypertrigliceridaemia fell from 64% to 35%, high-density lipoprotein-cholesterol ≤ 40 fell from 60% to 41%, hyperglycaemia fell from 1% to 0%, and waist circumference ≥90th percentile fell from 72% to 57%. There was a 2.84 [95% confidence interval (CI) = -4.10 to -1.58; P < 0.01] significant decrease in body mass index percentile and in body-fat percentage (95% CI = -3.31 to -1.55; P < 0.01). Of the overweight children, 32% achieved normal-weight, whereas 24% of the obese ones converted to overweight and 1% reached normal-weight. Physical activity increased 16 min/day(-1) (P = 0.02) and 2 days/week(-1) . CONCLUSIONS: A school-setting lifestyle intervention led to a decreased prevalence of being overweight/obese and to a striking reduction in the prevalence of the metabolic syndrome in a sample of Mexican children.