Biomarkers of inflammatory status in patients with severe obesity before and after bariatric surgery

Abstract

Introduction : Obesity is recognized as a multifactorial chronic disease that has been associated with a chronic inflammatory status. Objective To analyze a series of inflammatory parameters in the pre- and postoperative period after bariatric surgery in order to assess the evolution of the inflammatory status before and after surgery. Method Observational study that included all patients undergoing bariatric surgery in a university hospital between 2013 and 2023. The variables sex, age, comorbidities, anthropometric parameters, surgical procedure performed, postoperative complications, inflammatory markers neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII), were obtained before surgery and after 6 months, 1, 3 and 5 years. Pre- and postoperative changes observed in these variables after bariatric surgery were analyzed. Results A final sample of 386 patients was included in the study, 140 (36.3%) men and 246 (63.7%) women, mean age 45.6 years (SD ± 9.6); 218 (56,5%) sleeve gastrectomy and 168 (43,5%) Roux-en-Y gastric bypass. Pre-surgery, BMI was statistically significantly related to the inflammatory markers NLR (p = 0.003), PLR (p = 0.041), baseline SIRI (p = 0.010) and baseline SIII (p = 0.003) and preoperative baseline weight was related to NLR (p = 0.003) and baseline SIII (p = 0.003). Postoperatively, the observed differences in weight and BMI were also significantly associated with changes in inflammatory marker levels 3 years later. Conclusions In patients with severe obesity, weight and BMI show an important relationship with inflammatory parameters. After bariatric surgery, the weight and BMI loss response are associated with a decrease in inflammatory markers.