Omega-3 Fatty Acids in Bariatric Gastric Bypass Surgery: Effect on Liver Volume, Immune Response and Erythrocyte Function
Omega-3 Fatty Acids in Bariatric Gastric Bypass Surgery: Effect on Liver Volume, Immune Response and Erythrocyte Function
Gastric bypass surgery is the gold standard in bariatric surgery and is a successful method
 to reduce weight in morbidly obese subjects. Patients qualified for gastric bypass surgery
 are routinely pre-treated with a low calorie diet in order to reduce liver volume and to
 facilitate the approach of the gastro-oesophageal junction. Pre-treatment with omega-3 fatty
 acids has similar effects on liver volume, but a prospective comparison of both treatments
 has not been performed yet. Morbidly obese patients respond differently to surgical stress,
 due to a number of factors. First, obesity is associated with a low-grade inflammatory state
 induced by an increased amount of macrophages in adipose tissue. This state is associated
 with higher levels of pro-inflammatory cytokines in serum and with a less adequate immune
 response to infections. Second, obesity is associated with an altered cortisol metabolism
 possibly related to adrenal insufficiency. This could play an important role in the altered
 response to surgical stress and postoperative complications in obese subjects. Third, obesity
 is associated with altered erythrocyte function, including decreased erythrocyte
 deformability and increased aggregation, factors contributing to an impaired
 microcirculation.

 This study has a number of different aims. First, we will compare pre-treatment with the
 standard low calorie diet with omega-3 fatty acids on liver volume in patients qualified for
 gastric bypass surgery because of morbid obesity. Second, we will investigate the effect of
 omega-3 fatty acids on immune function, the low-inflammatory state of adipose tissue, the
 stress response of obese subjects before and erythrocyte function. Third, we will investigate
 the effect of gastric bypass surgery by comparing values before surgery with values on the
 first postoperative day and 6 months after surgery regarding to immunological parameters,
 stress response and erythrocyte function.
Inclusion Criteria:

 -  Females undergoing laparoscopic gastric bypass surgery because of morbid obesity

 -  Age between 18 and 65 years

 -  Able to fit in the MRI

 -  Written informed consent

 Exclusion Criteria:

 -  Pregnancy

 -  Diabetes mellitus type 1

 -  Current history of inflammatory, infectious or malignant disease

 -  Daily use of anti-inflammatory drugs

 -  Contra-indications for MRI imaging

 -  Contra-indications for the use of omega-3 fatty acids