The Impact of Obesity and Metabolic Surgery on Chronic Inflammation.

BACKGROUND: Obesity and metabolic surgery is known to improve chronic inflammatory status. Whether improvement is related to anatomical changes or weight loss is still to debate.

OBJECTIVE: The aim of this clinical trial is to compare the different bariatric procedures sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and One-anastomosis gastric bypass (OAGB), pertaining to their effects on inflammation markers.

METHODS: Patients who underwent SG, RYGB, or OAGB as a primary treatment for severe obesity were included. The data collected preoperatively (T0) and 1, 3, and 6 (T6) months after surgery included gender, weight, comorbidities and toxic habits at baseline, body mass index (BMI), waist circumference, total body weight loss in % (TBWL), leukocyte count in × 103 /μl, C-reactive protein (CRP) in mg/l, HbA1c in %, aspartate transaminase in U/l, alanine transaminase in U/l, gamma-glutamyltransferase in U/l, bilirubin in mg/dl, cholesterol in mg/dl, and triglycerides in mg/dl.

RESULTS: Four hundred sixty-eight patients were included. Drop-out rate was 25.8% at T6. Preoperatively the mean value of leukocytes and CRP was 7.4 × 103 /μl ± 2 and 10.5 mg/l ± 8.1. At T6, mean value of leukocytes and CRP was 7.1 × 103 /μl ± 1.9 (p = 0.075) and 7.2 mg/l ± 9.5 (p < 0.001). TBWL % at T6 was 24.2 ± 7.6 in the SG, 25.8 ± 5.9 in the RYGB and 25.5 ± 4.6 in the OAGB group. Comparing SG, RYGB, and OAGB in relation to leukocyte count and CRP no significant difference was seen between the groups.

CONCLUSION: CRP but not leukocyte count decreased after all three bariatric procedures but without any significance between the three groups. Surgically induced weight loss and not anatomical changes might play an important role for improvement in chronic inflammation.

TRIAL REGISTRATION: The National Clinical Trials number was NCT02697695 ( https://clinicaltrials.gov/ct2/show/NCT02697695 ).