Franny Jongbloed

149 6 MORBID OBESITY, BARIATRIC SURGERY AND T-CELL AGING Table 1. Baseline characteristics of the three different patient cohorts Characteristics/ Subjects BMI ≥ 35 no MetS BMI ≥ 35 with MetS Healthy Individuals N 41 67 10 Gender (male/female)* 5/36* 21/44* 2/8 BMI (Kg/m2)* 43 (35-66)* 43 (35-65) 25±1.5* Age (yrs) 39 (18-62) 43 (22-60) 45 (27-59) AGE ≤50/ >50 YEARS N 28/13 41/26 6/4 Age (yrs)* 31(18-49)*/54(51-62) 36(22-48)*/55(50-60) 36(27-48)/57(55-59) CMV-/CMV+ N 27/14 30/29 5/5 Age (yrs) 39(18-62)/38(25-56) 42(22-60)/45(25-60) 42(27-54)/56(28-59) MetS = metabolic syndrome; BMI = Body Mass Index; CMV = cytomegalovirus. Significance between two groups are highlighted with an asterisk at the groups within the significant comparisons. * = P< 0.05 Obesity and metabolic syndrome enhance T-cell differentiation status Obesity resulted in a significant higher number of CD4 + central memory (CM; CD45R0 + / CCR7 + ) cells compared toHC(Table 2).This significance remained inbothMetS andnoMetS groups. The presence of MetS resulted in an advanced T-cell differentiation, with significant increased numbers of CD4 + CD28null T-cells. In the CD8 + compartment, obesity led to a higher number of more differentiated effector memory RA (EMRA; CD45R0 - /CCR7 - ) cells. Upon dissection into the presence or absence of MetS, this higher number of EMRA CD8 + T-cells only remained significant in the MetS group. The presence of MetS also induced a significantly higher number of total memory, central memory, differentiated EMRA and CD28null cells in the CD8+ compartment. (Table 2). Advanced age led to a significant lower number of CD8 + naive T-cells (CD45RO - /CCR7+). In patients ≤50 years, the presence of MetS gave rise to a higher number of CD4 + CD28null T-cells. In the CD8 + compartment, the younger age resulted in significantly more mature CD8 + EMRA T-cells, while patients >50 years having MetS showed higher total number of CD8 + cells, central memory cells and total number of memory T-cells, including EMRA and CD28null T-cells. Taken together, in both age groups MetS resulted in a shift towards a more mature T-cell differentiation status, which was most pronounced in the older age group. CMV-seropositivity resulted in more differentiated (EMRA and CD28null) T-cells in both CD4 + and CD8 + T-cells. Gender differences were reflected by the higher number of CD4 + CD31 naive and EMRA T-cells in female patients compared to males (Table 3). A multivariate analysis including MetS,