Long-Term Improvement of Chronic Low-Grade Inflammation After Bariatric Surgery
Anne Lautenbach, Fabian Stoll, Oliver Mann, Philipp Busch, Tobias B. Huber, Heike Kielstein, Ina Bähr, Jens Aberle
Abstract
Abstract Purpose Bariatric surgery (BS) was shown to improve inflammatory markers in previous short-term follow-up studies. The aim of the present study was to assess the long-term effects of BS on chronic low-grade inflammation markers related to severe obesity. Moreover, the meaning of the type of BS procedure as well as the remission of type 2 diabetes (T2D) for inflammatory status up to 4 years after BS was analyzed. Materials and Methods In a retrospective cohort study including 163 patients at baseline, inflammatory and metabolic parameters were assessed at 4 time points: before surgery (baseline), 6 months after surgery (visit 1), 2 years after surgery (visit 2), and 4 years after surgery (visit 3). Univariate regression analysis was used to identify variables that were thought to determine change in inflammatory parameters. Results CRP, hs-CRP, leucocytes, and ferritin significantly declined in the mid- and long-term according to the U-shaped curve of weight loss ( p <0.001). Change in body mass index (BMI) at long-time follow-up showed a significant linear effect on change in leucocytes ( B =0.082; p <0.001) and change in hs-CRP ( B =0.03; p <0.05). There was a strong, positive correlation between T2D and hs-CRP at visit 2 ( r s =0.195; p <0.05) and visit 3 ( r s =0.36; p =0.001). With regard to type of surgery and gender, there were no significant differences in inflammatory parameters. Conclusion BS is able to reduce obesity-related chronic low-grade inflammation up to 4 years after surgical intervention. The improvement in metaflammation is related to the change in BMI and remission of T2D in the long-term. Graphical abstract