Plasma levels of soluble urokinase plasminogen activator receptor (suPAR) and high-sensitivity C-reactive protein after Roux-en-Y gastric bypass or sleeve gastrectomy: a 1-year prospective observational study.

Abstract

Low-grade inflammation in obesity contributes to the development of cardiovascular disease, diabetes mellitus and cancer, and is associated with increased mortality. The purpose of this 1-year prospective observational study was to examine the weight loss effect of bariatric surgery on plasma concentrations of two inflammatory markers, namely high-sensitivity C-reactive protein (hsCRP) and soluble urokinase-type plasminogen activator receptor (suPAR), in patients with obesity. Sixteen subjects without obesity and 32 patients with obesity class III, who had already settled upon Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) were included in the study. Subjects without obesity were examined once, at baseline; patients with obesity were examined preoperatively (baseline) and 3, 6 and 12months postoperatively. Plasma suPAR and hsCRP concentrations at baseline were higher in patients with obesity than in lean participants (2.68 ± 0.86 vs 1.86 ± 0.34ng/mL, p < 0.001 and 9.83 ± 9.55 vs 1.36 ± 1.95mg/dL, p < 0.001). Levels of suPAR following bariatric surgery increased significantly 3months after either RYGB or SG (3.58 ± 1.58 vs 3.26 ± 0.7ng/mL, respectively) and declined at 6 (3.19 ± 1.75 vs 2.8 ± 0.84ng/mL, respectively) and 12months (2.6 ± 1.5 vs 2.22 ± 0.49ng/mL, respectively; p < 0.05 for the effect of time on suPAR levels during the study), whereas those of hsCRP declined consistently after bariatric surgery (3months: 5.44 ± 3.99 vs 9.47 ± 11.98mg/dL, respectively; 6months; 5.39 ± 5.6 vs 10.25 ± 17.22mg/dL, respectively; and 12months: 2.23 ± 2.5 vs 3.07 ± 3.63mg/dL, respectively; p < 0.001 for the effect of time on hsCRP levels during the study). 1-year change in BMI was negatively associated with suPAR levels at 12months. Our findings support an association between obesity and low-grade inflammation. Weight loss following bariatric surgery is associated with a consistent decline in plasma hsCRP, while plasma suPAR levels increase at 3months and decline by 12months.