Metabolic shift precedes the resolution of inflammation in a cohort of patients undergoing bariatric and metabolic surgery

Jose Romeo Villarreal-Calderon,Leticia Elizondo-Montemayor,Eder Luna-Ceron,Ricardo Cuellar-Tamez,Gerardo García-Rivas,Elena C Castillo

doi:10.1038/s41598-021-91393-y

Jose Romeo Villarreal-Calderon, Leticia Elizondo-Montemayor + Show 4 more

Open Access

https://doi.org/10.1038/s41598-021-91393-y

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Abstract

Bariatric and metabolic surgery has shown to promote weight loss and reduce systemic inflammation. However, the sequence and timing of events regarding metabolic improvement and inflammation resolution has been rarely explored. Furthermore, data on inflammatory markers of Th17 and Th1 cell responses after bariatric surgery is scarce. We conducted a prospective study in subjects with obesity that underwent bariatric and metabolic surgery, with follow-ups at 3 and 6 months. Anthropometric and metabolic markers such as insulin levels, HOMA-IR, and lipid parameters declined significantly 3 months after surgery; while hs-CRP, TNF-α, IL-1β, IL-6, and IL-8 serum concentrations decreased 6 months after the procedure. Concentrations of Th1 signature and driver cytokines, particularly IFN-γ, IL-12, and IL-18, and of Th17 driver IL-23 also decreased significantly after 6 months. Significant positive correlations between triglyceride levels and hs-CRP, IL-1β, and IFN-γ concentrations, and between Apo B and IFN-γ levels were observed 6 months after bariatric and metabolic surgery. In addition, BMI was associated with hs-CRP and TNF-α concentrations. Fat mass correlated with hs-CRP, TNF-α, and IL-12. Analysis of the temporality of metabolic and inflammatory events suggests that improvement in the metabolic status occurs before resolution of systemic inflammation and may be a requisite for the later event.

Highlights

Bariatric and metabolic surgery has shown to promote weight loss and reduce systemic inflammation
We noticed that in our cohort, metabolic parameters such as insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and triglycerides were predominantly reduced at 3 months, with relatively stable levels from 3 to 6 months after the surgery
Metabolic improvement seems to be an early change after bariatric surgery that may favor obesity-induced inflammation resolution

Summary

Introduction

Bariatric and metabolic surgery has shown to promote weight loss and reduce systemic inflammation. Anthropometric and metabolic markers such as insulin levels, HOMA-IR, and lipid parameters declined significantly 3 months after surgery; while hs-CRP, TNF-α, IL-1β, IL-6, and IL-8 serum concentrations decreased 6 months after the procedure. BMS has been shown to be a viable therapy to accomplish supported weight reduction and to promote metabolic improvement[10] In this regard, BMS-induced weight loss has been associated with both remission of comorbidities and reduction in systemic inflammation[11]. BMS has been shown to lead to significant improvements in insulin r esistance[16] and lipid m etabolism[17], as well as to resolve the low-grade systemic inflammation associated with obesity[12]. We integrated a detailed description of the molecular mechanisms of in-vitro and animal model studies to explain our findings, which are contained in an original figure

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