Abstract
BackgroundPrevious studies have examined changes in plasma markers of inflammation and oxidative stress up to 24 months following bariatric surgery, but there is limited evidence on the long-term effects of bariatric surgery.ObjectivesTo examine the effects of bariatric surgery on adipokines (adiponectin, leptin), inflammatory cytokines [C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10(IL-10)] and global plasma measures of oxidative stress [thiobarbituric acid reactive substances (TBARS) and total antioxidant status (TAOS) 1 and 6 months, and 4 years post-surgery in subjects with obesity and impaired glucose regulation.MethodsA prospective study comprising of 19 participants (13 females, mean age 50.4 ± 6.2 years, mean body mass index (BMI) 54 ± 14 kg/m2, 17 type 2 diabetes) undergoing bariatric surgery (10 sleeve gastrectomy, 6 biliopancreatic diversion, 2 Roux-en-Y gastric bypass and 1 laparoscopic adjustable gastric banding). Serial measurements of the above markers were made pre-operatively, 1 and 6 months and 4 years post-operatively.ResultsCompared to pre-operative levels, significant decreases were seen 4 years post-operatively in CRP (11.4 vs 2.8 ng/mL, p < 0.001), IL-6 (8.0 vs 2.1 pg/mL, p < 0.001) and leptin (60.7 vs 32.1 pg/mL, p = 0.001). At 4 years, both fasting and 120 min TAOS significantly increased by 35% and 19% respectively. However, fasting and 120 min TBARS did not show any significant changes.ConclusionTo our knowledge, no other studies have described changes in inflammation and oxidative stress at 4 years following bariatric surgery. This study contributes to the current literature supporting the longer-term beneficial effect of bariatric surgery on chronic inflammation and oxidative stress.
Highlights
Chronic systemic inflammation and increased oxidative stress play a role in the pathogenesis of obesity, type 2 diabetes (T2DM) and cardiovascular disease [1]
Catoi et al observed no change in global measures of oxidative stress; nitrite and OBES SURG (2020) 30:1712–1718 nitrate (NOx), total oxidant status (TOS), total antioxidant response (TAR), and oxidative stress index (OSI), 6 months after sleeve gastrectomy (SG) [5]
Cabrera et al demonstrated that plasma level of glutathione (GSH) and total radical antioxidant parameter (TRAP) was increased and plasma levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were decreased in 20 patients with obesity 12 months after Roux-en-Y Gastric Bypass (RYGB) [6]
Summary
Chronic systemic inflammation and increased oxidative stress play a role in the pathogenesis of obesity, type 2 diabetes (T2DM) and cardiovascular disease [1]. Bariatric surgery leads to a significant reduction in adipose tissue mass and subsequent improvement in systemic inflammation [4]. It is important to note that in most of the published studies examining inflammation or oxidative stress, the follow-up period was up to 2 years. There is limited literature available on the long-term effect of bariatric surgery on inflammation and no literature available on long-term effect of bariatric surgery on oxidative stress. Previous studies have examined changes in plasma markers of inflammation and oxidative stress up to 24 months following bariatric surgery, but there is limited evidence on the long-term effects of bariatric surgery
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