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The Impact of Obesity and Metabolic Surgery on Chronic Inflammation

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A Correction to this article was published on 27 June 2018

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Abstract

Background

Obesity and metabolic surgery is known to improve chronic inflammatory status. Whether improvement is related to anatomical changes or weight loss is still to debate.

Objective

The aim of this clinical trial is to compare the different bariatric procedures sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and One-anastomosis gastric bypass (OAGB), pertaining to their effects on inflammation markers.

Methods

Patients who underwent SG, RYGB, or OAGB as a primary treatment for severe obesity were included. The data collected preoperatively (T0) and 1, 3, and 6 (T6) months after surgery included gender, weight, comorbidities and toxic habits at baseline, body mass index (BMI), waist circumference, total body weight loss in % (TBWL), leukocyte count in × 103/μl, C-reactive protein (CRP) in mg/l, HbA1c in %, aspartate transaminase in U/l, alanine transaminase in U/l, gamma-glutamyltransferase in U/l, bilirubin in mg/dl, cholesterol in mg/dl, and triglycerides in mg/dl.

Results

Four hundred sixty-eight patients were included. Drop-out rate was 25.8% at T6. Preoperatively the mean value of leukocytes and CRP was 7.4 × 103/μl ± 2 and 10.5 mg/l ± 8.1. At T6, mean value of leukocytes and CRP was 7.1 × 103/μl ± 1.9 (p = 0.075) and 7.2 mg/l ± 9.5 (p < 0.001). TBWL % at T6 was 24.2 ± 7.6 in the SG, 25.8 ± 5.9 in the RYGB and 25.5 ± 4.6 in the OAGB group. Comparing SG, RYGB, and OAGB in relation to leukocyte count and CRP no significant difference was seen between the groups.

Conclusion

CRP but not leukocyte count decreased after all three bariatric procedures but without any significance between the three groups. Surgically induced weight loss and not anatomical changes might play an important role for improvement in chronic inflammation.

Trial Registration

The National Clinical Trials number was NCT02697695 (https://clinicaltrials.gov/ct2/show/NCT02697695).

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Change history

  • 27 June 2018

    In Table 4 the column labeled “p values” and its data should be deleted.

Abbreviations

SG:

Sleeve gastrectomy

RYGB:

Roux-en-Y gastric bypass

OAGB:

One-anastomosis gastric bypass

BMI:

Body mass index

WC:

Waist circumference

EWL:

Excess weight loss

TBWL:

Total body weight loss

CRP:

C-reactive protein

ICAM-1:

Intercellular adhesion molecules

RNA:

Ribonucleic acid

NF-κB:

Nuclear transcription factor kappa B

TNF-α:

Tumor necrosis factor-α

IL-1:

Interleukin-1

IL-6:

interleukin-6

BDNF:

Brain-derived neurotrophic factor

T2DM:

Type 2 diabetes mellitus

CD14:

Cluster of differentiation 14

VLCD:

Very low-calorie diet

SD:

Standard deviation

NASH:

Non-alcoholic statosis hepatitis

AST:

Aspartate transaminase

ALT:

Alanine transaminase

GGT:

Gamma-glutamyltransferase

OSAS:

Obstructive sleep apnea

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Author information

Authors and Affiliations

  1. Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, 63069, Offenbach am Main, Germany

    Sonja Chiappetta, Hannah M. Schaack & Rudolf A. Weiner

  2. Department of Clinical Research, St Claraspital, Basel, Switzerland

    Bettina Wölnerhannsen

  3. Adipositaszentrum, University Hospital of Würzburg, Würzburg, Germany

    Christine Stier

  4. Ospedale del Mare, Naples, Italy

    Simone Squillante

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  1. Sonja Chiappetta
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  4. Christine Stier
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Correspondence to Sonja Chiappetta.

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The authors declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from all the individual participants included in the study.

Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Chiappetta, S., Schaack, H.M., Wölnerhannsen, B. et al. The Impact of Obesity and Metabolic Surgery on Chronic Inflammation. OBES SURG 28, 3028–3040 (2018). https://doi.org/10.1007/s11695-018-3320-y

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  • DOI: https://doi.org/10.1007/s11695-018-3320-y

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