Can Bariatric Surgery Help to Prevent Autoimmunity?

Abstract

Obesity has been linked to the development and progression of autoimmune diseases. To investigate the presence of autoantibodies in the sera of bariatric-surgery patients. During the pre- and postoperative period, sera from 79 patients undergoing bariatric surgery were tested for the presence of antinuclear antibodies (ANA), Rheumatoid Factor (RF), IgG and IgM anticardiolipin antibodies, and anti-endomysial antibodies. Anti-dsDNA and ENA profiles were also determined in positive ANA sera. A chart review was used to obtain clinical, epidemiological, and anthropometric data. Preoperatively, 23/79 (29.1%) of the sera tested positive for ANA; postoperatively, this frequency decreased to 8/79 (10.1%) with p=0.002 (OR=3.6; 95%; CI=1.4-8.3). The fine-speckled ANA pattern was the most common (73.9% preoperative and 87.3% postoperative). Preoperative ANA-positive and negative patients did not differ in epidemiological or anthropometric measurements (all p >0.05), but ANA-positive patients had lower serum vitamin D levels than the negatives (p=0.002). RF positivity was found in 5/76 (6.5%) of preoperative sera and 3/76 (3.9%) of postoperative sera, with p=0.71. Anti-ds-DNA, ENA profile, and anti-endomysial antibodies were all negative in all patients, both before and after surgery; anticardiolipin IgM was weakly positive in one postoperative sample. Positive ANA is common in obese patients undergoing bariatric surgery, and it decreases after weight loss.