To the Editor: Dr Visser and colleagues1 found that obesity is associated with elevated
levels of CRP and hypothesized that this is related to increased IL-6 production
by excess adipose tissue.
We reported clinical data in 24 morbidly obese patients being evaluated
for gastric bypass surgery that are consistent with their findings.2 More than half of these patients had erythrocyte
sedimentation rates (ESRs) exceeding the upper limit of normal, with levels
more than twice normal for the 3 most obese individuals (greater than 275%
of desirable body weight). White blood cell counts were normal, hemoglobin
values were all greater than 120 g/L, and none of the patients had evidence
of an inflammatory disorder. The ESR is a nonspecific indicator of a systemic
inflammatory response. The much higher prevalence of elevated levels of ESR
in our sample compared with only 6.7% of the population with clinically raised
levels of CRP in the study of Visser et al presumably reflects the much higher
prevalence of obesity in our sample. It is interesting to speculate that a
common consequence of systemic inflammation is the development of anorexia.3
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