Effects of depressive symptoms on clinical outcomes, inflammatory markers and quality of life after a significant weight loss in a bariatric surgery sample

Abstract

Nicolau J, Simó R, Sanchís P, Ayala L, Fortuny R, Rivera R, Masmiquel L. Effects of depressive symptoms on clinical outcomes, infl ammatory markers and quality of life after a signifi cant weight loss in a bariatric surgery sample. AbstractIntroduction: Obesity is linked to a low-grade chronic systemic infl ammation that improves after weight loss. Depressive disorder has been suggested to be associated with systemic infl ammation up regulation. Objective: We aimed to explore whether, after a signifi cant weight loss, the presence of depressive symptoms was associated with differences in terms of infl ammatory markers and quality of life. Methods: Sixty patients (78.3%♀, age 46.4 ± 9.9) who underwent bariatric surgery, with a minimum follow up of 18 months, were evaluated. For the screening of depression, the Beck Depression Inventory (BDI) was administered. Results: Ten subjects (16.6%) had a positive screening for depressive disorder. The percentage of patients with weight regain was greater among subjects with symptoms of depression (70% vs. 32%; p = 0.024), although no differences were seen regarding BMI prior to surgery and current BMI. Acute phase reactants were higher among subjects with symptoms of depression: platelets (319 ± 15 x 10^12/L vs. 232 ± 47 x 10 ^ 12/L; p = 0.001), erythrocyte sedimentation rate (24.7 ± 11.3 mm vs. 17 ± 10 mm; p = 0.03), fi brinogen (486 ± 107 mg/dL vs. 406 ± 66 mg/dL; p = 0.003), ferritin (106 ± 180 ng/ml vs. 34 ± 44 ng/ml; p = 0.014) and ultrasensitive C-reactive protein (0.96 ± 1.84 mg/dL vs. 0.24 ± 0.26 mg/dL; p = 0.008). All domains of quality of life were signifi cantly lower in the depressive group. Conclusions: Despite a signifi cant weight loss, infl ammatory markers are greater and quality of life lower when associated with depressive symptoms.