Endocrine Abstracts

Background: Obesity is a widespread disease that causes chronic low-grade inflammation and related chronic diseases such as steatohepatitis, metabolic syndrome, diabetes mellitus (DM), and cancer. It is known that weight loss positively affects life expectancy by reducing obesity-related complications. Therefore, effective management of particularly morbidly obese patients is getting prominent in clinical practice. Bariatric surgery (BS) is the main effective treatment option and weight loss method for morbid obesity. This study aimed to investigate the impact of bariatric surgery on systemic inflammation and metabolic parameters.

Methods: Morbid obesity patients who underwent BS between December 2014 and June 2020 were screened retrospectively. Patients with inadequate data or diagnosed acute or chronic inflammatory disease were excluded. A total of 693 patients between 18 and 65 years were included in the study. The preoperative and postoperative 12th-month data were analyzed. A novel hematologic and immune biomarker systemic inflammation response index (SIRI) was calculated to evaluate inflammation. ΔSIRI computed as the preoperative SIRI (SIRI1) minus the postoperative 12th-month SIRI (SIRI2). The percent of total weight loss (%TWL) was also calculated to classify participants. The patients with %TWL<%40 were defined as Group 1, and patients with %TWL≥%40 were defined as Group 2. All parameters were compared between the groups.

Results: The mean age of 693 patients (152 female/541 male) was 39.9±10.3 years. The mean body mass index was 47.7±6 preoperatively and 30.2±5.4 postoperatively at the 12th month. The mean SIRI1 (1.14±0.54) was significantly higher than the mean SIRI2 (0.77±0.45) for all patients (P<0.001). Group 2 had significantly higher ΔSIRI and lower age than Group 1 (P=0.001, P<0.001, respectively). In addition, the frequency of both diabetes and hypertension increased in group 1 (P<0.001 for both). After controlling for age, gender, hypertension, and DM covariates, only ΔSIRI levels sustained the significant difference status (P=0.007). All metabolic parameters significantly improved after bariatric surgery (P<0.05).

Conclusion: The present study showed that regardless of age, DM, and hypertension, increased inflammation recovery is significantly associated with effective weight loss. In the light of this finding, we suggest BS may give an independent contribution to the improvement of chronic inflammation induced by obesity. Further prospective studies in larger populations may improve the management of morbidly obese patients by clarifying the inflammation mechanism and process.