Differences in peri-operative serum inflammatory markers between normoponderal and obese patients undergoing large joint replacement for osteoarthritis—a descriptive study
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The occurrence, evolution and treatment outcome of osteoarthritis are influenced by a series of factors, including obesity. Assessing how chronic inflammation present in obesity changes the values of peri-operative biological tests could facilitate a clearer interpretation of laboratory examinations for the proper management of possible complications.
This descriptive study compared biological and clinical factors during the peri-operative period in patients undergoing total hip/knee replacement, in order to identify the special characteristics of the inflammatory status in obese compared to normal weight patients. In the two groups (71 normoponderal, 74 obese), serum levels of fibrinogen, high-sensitivity C-reactive protein (hsCRP), tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were determined 24 hours pre- and post-operatively.
Our results found significant post-operative increases in serum levels of IL-6 and hsCRP in both groups (p = 0.0001), with inter-group differences in pre-operative hsCRP (p = 0.02) and post-operative IL-6 levels (p = 0.013). Interestingly, TNF-alpha levels were much higher in the obese pre-operatively than post-operatively (p = 0.002) and higher than the normoponderals (p = 0.003), decreasing to levels similar to those of the normal weight patients on day two.
Because of its important clinical implications, an appropriate comprehension of the peri-operative changes in a patient’s inflammatory status has the potential to influence therapeutic attitude. We failed to observe any significant post-operative differences in the mean values of the markers assessed, except those of IL-6, implying that serum levels of fibrinogen, hsCRP and TNF-alpha within 24 hours after large joint replacements are not influenced by the patient’s ponderal status.
KeywordsInflammatory markers Obesity Joint replacement IL-6 hsCRP TNF-alpha
We are grateful to the staff of the Clinic of Orthopaedics and Traumatology of the Clinical County Hospital Mureș and to the staff of the Centre for Advanced Medical and Pharmaceutical Research of the University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș for their help and involvement in this research project and for kindly providing facilities.
This study was supported by a private research grant from SC CATTUS SRL and involved the University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș, contract no. 5068/26.04.2016.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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