Study of changes of obesity‐related inflammatory cytokines after laparoscopic sleeve gastrectomy

Abstract

Background: Chronic inflammation in adipose tissue may play a substantial role in the pathogenesis of obesity-related metabolic disorders. The present study aims to evaluate the changes in adipocytokines, bile acids, fibroblast growth factor 19 (FGF-19) and proinflammatory cytokines 6 months after laparoscopic sleeve gastrectomy (LSG). Methods: This prospective study included 75 obese patients with body mass index >35 kg/m 2 who underwent LSG. All patients were recruited preoperatively and followed up post-operatively at 6 months, with laboratory assessment of their cytokines including adiponectin, leptin, resistin, bile acid, interleukin (IL)-6, IL-8, tumour necrosis factor-α, monocyte chemotactic protein-1, high-sensitivity C-reactive protein, plasminogen activator inhibitor-1, serum amyloid-A and FGF-19. Results: There were statistically highly significant changes regarding anthropometric parameters (weight, body mass index and waist-to-hip ratio), blood glucose and lipid profile as well as liver enzymes at 6 months post-sleeve gastrectomy. The present study showed that the levels of serum adiponectin and FGF-19 significantly increased at 6 months of follow-up after surgery (P < 0.001), while the levels of serum leptin, resistin, highsensitivity C-reactive protein, plasminogen activator inhibitor-1 and serum amyloid-A significantly decreased at 6 months of follow-up after surgery (P < 0.001). There were no significant differences regarding serum bile acid, IL-6, IL-8, tumour necrosis factor-α and monocyte chemotactic protein-1. Conclusion: Weight loss after LSG is associated with significant improvement of the adipokine levels towards anti-diabetic and anti-inflammatory profiles. Future studies should use a larger sample size and longer follow-up periods.

Temporal Effects of Bariatric Surgery on Adipokines, Inflammation and Oxidative Stress in Subjects with Impaired Glucose Homeostasis at 4 Years of Follow-up

“…Similarly, Salman et al demonstrated that the levels of serum adiponectin significantly increased, while the levels of serum leptin, resistin, CRP, plasminogen activator inhibitor-1 and serum amyloid-A significantly decreased at 6 months after SG [34]. In contrast to previous studies [18,19,34], we observed no statistically significant change in serum adiponectin levels. This might be explained by a small sample size.…”

“…Zhu et al demonstrated a reduction in leptin, CRP and IL-6 in patients with morbid obesity and subclinical hypothyroidism 12 months following SG [33]. Similarly, Salman et al demonstrated that the levels of serum adiponectin significantly increased, while the levels of serum leptin, resistin, CRP, plasminogen activator inhibitor-1 and serum amyloid-A significantly decreased at 6 months after SG [34]. In contrast to previous studies [18,19,34], we observed no statistically significant change in serum adiponectin levels.…”

Reduction of IL‐6 gene expression in human adipose tissue after sleeve gastrectomy surgery

“…However, levels of IL‐6 at the systemic level increased 3 months after VSG‐induced weight loss, showing that there is a distinct mechanism of IL‐6 regulation occurring at the local compared with systemic level, likely involving other tissues. While studies have shown a reduction in pro‐inflammatory cytokines including IL‐6 one year after sleeve gastrectomy or no change in IL‐6 serum levels 6 months after VSG or Roux‐en‐Y gastric bypass (RYGB), to our knowledge, levels of systemic IL‐6 have not been shown to increase after VSG‐induced weight loss.…”

<p>Characterization and Treatment of Inflammation and Insulin Resistance in Obese Adipose Tissue</p>

“…104 Many clinical studies have also shown that inflammatory factors and TLR receptors are significantly reduced after surgery, but adipokines like leptin and adiponectin have not shown consistent results. [105][106][107] Some bariatric surgery patients regained weight after weight loss, but the inflammatory factors continued to decrease, indicating that bariatric surgery may have a long-term effect on inflammation control. 108…”