Improvements in humoral immune function and glucolipid metabolism after laparoscopic sleeve gastrectomy in patients with obesity

Abstract

BackgroundObesity is associated with impaired immunity and chronic, low-grade inflammation, but little is known about the immune system’s response to bariatric surgery–induced weight loss. ObjectivesTo determine whether circulating immunoglobulins and acute-phase reactant levels are altered after bariatric surgery. SettingUniversity Hospital, China. MethodsFifty-eight patients with obesity were recruited from the Second Xiangya Hospital of Central South University; 48 underwent laparoscopic sleeve gastrectomy and 10 underwent traditional medical therapy. ResultsDuring the 12-month follow-up, bariatric surgery showed pronounced effects on weight loss and glucose and lipid metabolism. Circulating concentrations of hypersensitive C-reactive protein, and complement components 3 and 4 decreased significantly. Compared with the presurgery level, the immunoglobulin A, immunoglobulin M, and immunoglobulin G levels increased significantly at 2 and 6 months postsurgery. Compared with the whole group, the same results were observed after surgery in the circulating concentrations of complement components 3 and 4 and hypersensitive C-reactive protein in patients with class I obesity. However, the immunoglobulin G concentration increased at 6 and 12 months postsurgery, immunoglobulin A increased at 12 months postsurgery, and no postsurgery changes in immunoglobulin M were found in patients with class I obesity. No significant changes were noted in patients who underwent traditional medical therapy. We also found a correlation between decreased complement factor levels and improved insulin sensitivity. ConclusionsIn addition to reducing weight and controlling diabetes and dyslipidemia, bariatric surgery is also effective for improving the immune function of patients with obesity.