Short-term Changes in Tnf-alpha, Il-6 and Adiponectin Following Bariatric Surgery in Romanian Obese Adults – an Observational Case-control Study

Abstract

Background: Bariatric surgery plays an impotant role in immnological modulation by reducing levels of systemic inflammatory markers, such as interkleukin-6 and tumor necrosis factor alpha. The goal of this study is to establish the possible correlations between obesity-linked chronic systemic inflammation, materialized objectived through the cytokine plasma profile and weight loss process after metabolic surgery. Materials and methods: An observational cohort study included two categories: patients with obesity – bariatric group and patients without obesity – control group between February 1, 2021 and March 1, 2023. Baseline characteristic, anthropometric measurements, biochemical assessments and inflammatory biomarkers were taken both before surgery and one year after the procedure. The bariatric group undergo two types of bariatric procedures: majority were performed to laparoscopic sleeve gastrectomy whereas a select few of patients underwent one anastomosis laparoscopic gastric bypass. Results: A prospective study comprising 55 Caucasian patients - 33 patients with morbid obesity mean age of 41.76±10.78 and mean BMI of 43.34± 7.51 kg/m2. We note that preoperative levels of IL-6 have a positive correlation with WC (r=0.354, p=0.043), weight (r=0.549, p=0.001) and BMI (r=0.520, p=0.002). After applying the Kruskal Wallis Test and Dunn’s Test significant differences for IL-6 (p=0.010, p<0.05) and adiponectin (p=0.024, p<0.05) were obtained. No correlation was found between adiponectin, IL-6, TNF- α and anthropometric indices after surgery. Conclusions: Our study demonstrated that bariatric surgery significantly changes the level of inflammatory cytokines one year after operation. We failed to demonstrate the predictive role of preoperative plasma cytokine profile for the weight loss process after metabolic procedures.