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Surgery for Obesity and Weight-Related Diseases Changes the Inflammatory Profile in Women with Severe Obesity: a Randomized Controlled Clinical Trial

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Abstract

Introduction/Purpose

Obesity increases significantly every year worldwide. Since 1980, the prevalence of individuals with obesity has practically doubled. Obesity plays an important role in the pathophysiology of diseases that arise from a complex interaction of nutritional, genetic, and metabolic factors, characterizing a chronic inflammatory state. This study aimed to verify the systemic inflammatory response through the analysis of IGF-1, IL-23, and resistin levels and the lipid profile in severely obese women undergoing surgery for obesity and weight-related diseases.

Materials and Methods

This randomized controlled clinical trial includes female patients clinically diagnosed with severe obesity with an indication for bariatric surgery.

Results

In the initial evaluation, no significant difference was observed between the control (CG) and bariatric surgery (BSG) groups. The weight, BMI, systolic and diastolic blood pressures, total cholesterol, LDL, HDL, total non-HDL cholesterol, and glucose in BSG patients showed a significant change after surgery. Pre- and post-surgery levels of resistin, IGF-1, and IL-23 showed a significant difference in the BSG group, but only IL-23 was changed after 6 months in the CG.

Conclusion

The results of this study confirmed that weight loss induced by surgery for obesity and weight-related diseases improved the lipid profile and reduced the chronic inflammatory status in women with severe obesity.

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Acknowledgements

The authors would like to acknowledge the technical infrastructure support provided by Department of Surgery of Santa Casa Medical School (Sao Paulo, Brazil).

Funding

ARTS, EAP, and ASS receives grants of Coordenaçao de Apoio ao Pessoal de Nível Superior (CAPES/PROSUP); JPRA receive grants of Fundação de Amparo a Pesquisa (FAPEG), Goiás (GO), Brazil; LVFO receive grants Research Productivity, modality PQ1D; process no. 312731/2018–3 of Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (local acronym CNPq), Brazil.

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Authors and Affiliations

  1. Post Graduation Program in Health Sciences, Santa Casa of Sao Paulo Medical School, Sao Paulo, SP, 01221-010, Brazil

    Alan Robson Trigueiro de Sousa, Wilson Rodrigues Freitas Junior, Eduardo Araujo Perez, Elias Jirjoss Ilias, Anderson Soares Silva, Vera Lucia Santos Alves, Carlos Alberto Malheiros & Luis Vicente Franco Oliveira

  2. Human Movement and Rehabilitation Post-Graduation Program, Evangelical University of Goiás (UniEVANGELICA), Anápolis, GO, 75083-515, Brazil

    João Pedro Ribeiro Afonso, Miriã Cândida Oliveira, Adriano Luís Fonseca, Marcos Mota da Silva, Maria Eduarda Moreira Lino & Luis Vicente Franco Oliveira

  3. Brazilian Institute of Teaching and Research in Pulmonary and Exercise Immunology (IBEPIPE), São José dos Campos, SP, 12245-520, Brazil

    Manoel Carneiro Oliveira Junior, Rodolfo Paula Vieira & André Luis Lacerda Bachi

  4. Postgraduate Program in Bioengineering, Universidade Brasil, São Paulo, SP, 08230-030, Brazil

    Rodolfo Paula Vieira

  5. Clínica de Gastroenterologia e Medicina Avançada (GASTROMED), Anápolis, GO, 75080-620, Brazil

    Wilson José Sena Pedro

  6. Department of Otorhinolaryngology, ENT Lab, Federal University of São Paulo (UNIFESP), São Paulo, SP, 04021-001, Brazil

    André Luis Lacerda Bachi

  7. Post-Graduation Program in Health Science, Santo Amaro University (UNISA), São Paulo, SP, 04743-030, Brazil

    André Luis Lacerda Bachi

  8. Institute for Biomedical Research and Innovation, National Research Council of Italy (CNR), 90146, Palermo, Italy

    Giuseppe Insalaco

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  1. Alan Robson Trigueiro de Sousa
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  2. Wilson Rodrigues Freitas Junior
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Contributions

Conceived and designed of the study: LVFO, ARTS, WRFJ, CAM, and GI. Acquisition, statistical analysis, or interpretation of the data: EAP, ASS, VLSA, JPRA, MCO, LVFO, ALF, MEML, MCOJ, RPV, WJSP, and ALLB. Evaluation and implementation of bariatric surgery: ARTS, WRFJ, EJI, and CAM. Follow-up of surgical patients: MMS, ARTS, WRFJ, and CAM. Checking and interpretation of the data, drafting of the manuscript, and approved the submitted version of the manuscript: all authors.

Corresponding author

Correspondence to Luis Vicente Franco Oliveira.

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Ethical Approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments. This research was approved by the Human Research Ethics 564 Committees of Nove de Julho University (UNINOVE; protocol number 565 220506/2009) and Irmandade da Santa Casa de Misericordia de Sao 566 Paulo, Brazil (protocol number 742.865/2014). This trial was registered at ClinicalTrials.gov (02409160).

Informed Consent

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

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Key Points

- Unfortunately, weight loss resulting from clinical treatment for obesity is hardly achieved and sustained.

- Weight loss induced by surgery for obesity and weight-related diseases improved the lipid profile.

- The chronic inflammatory profile observed in severely obese women is considerably reduced after weight loss induced by surgery for obesity and weight-related diseases.

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de Sousa, A.R.T., Freitas Junior, W.R., Perez, E.A. et al. Surgery for Obesity and Weight-Related Diseases Changes the Inflammatory Profile in Women with Severe Obesity: a Randomized Controlled Clinical Trial. OBES SURG 31, 5224–5236 (2021). https://doi.org/10.1007/s11695-021-05702-5

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