Advertisement

Long-term Impact of Mini-Gastric Bypass on Inflammatory Cytokines in Cohort of Morbidly Obese Patients: a Prospective Study

  • Mohamed Abdalla Salman
  • Ahmed Abdallah
  • Hani Maurice Sabri Mikhail
  • Ahmed Abdelsalam
  • Ayman Helmy Ibrahim
  • Ahmed Abd El Aal Sultan
  • Mohamed El-ghobary
  • Amro Abdelaziz Mohammed Ismail
  • Tarek Elsayed Abouelregal
  • Mahmoud Gouda Omar
  • Alhoussein Alsayed AbdelAal
  • Hossam El-Din Shaaban
  • Ghada M. K. GabAllah
  • Mohamed Tourky
  • Ahmed Abdallah SalmanEmail author
Original Contributions
  • 44 Downloads

Abstract

Purpose

One anastomosis gastric bypass (OAGB) is a promising bariatric procedure. We performed this study to evaluate the changes in a group of inflammatory cytokines 12 months after OAGB.

Methods

A single-arm prospective study was conducted on obese patients who underwent OAGB. The serum levels of the following adipocytokines were monitored pre- and 12 months postoperatively: adiponectin, leptin, interleukin 6 (IL-6), interleukin 8 (IL-8) levels, tumor necrosis factor-alpha (TNF-α), serum amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), and monocyte chemotactic protein 1 (MCP-1).

Results

A total of 62 patients were included with a mean age of 43.9 ± 6.8 years old. The serum adiponectin increased significantly from 7.64 ± 0.29 to 8.76 ± 0.42 μg/mL 12 months after the operation (p < 0.001). hs-CRP and IL-6 decreased significantly 12 months after the OAGB from 3323.35 ± 643.4 ng/mL and 3.72 ± 7.7 pg/mL to 1376.81 ± 609.4 ng/mL and 3.64 ± 6.9 pg/mL, respectively (p < 0.001). The MCP-1 showed significant increase in its level after OAGB as well (p = 0.014). In contrary, there were no significant changes in serum levels of IL-8 (p = 0.12) and TNF-α (p = 0.84) 12 months after the operation. The correlation analysis showed significant correlations between initial body mass index (BMI) with serum adiponectin, IL-8, and serum SAA.

Conclusion

OAGB can significantly impact the inflammatory cytokine profile in obese patients with possible subsequent protection from obesity-related comorbidities such as insulin resistance, cardiovascular diseases, and certain cancers.

Keywords

Bariatric surgery Inflammatory Adipokines One anastomosis gastric bypass 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Consent

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

References

  1. 1.
    World Health Organization. Overweight and Obesity Fact Sheet. 2019.Google Scholar
  2. 2.
    Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362–74.CrossRefGoogle Scholar
  3. 3.
    Poirier P, Cornier M-A, Mazzone T, et al. Bariatric surgery and cardiovascular risk factors. Circulation. 2011;123:1683–701.CrossRefGoogle Scholar
  4. 4.
    Flegal KM, Kit BK, Orpana H, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories. JAMA. 2013;309:71.CrossRefGoogle Scholar
  5. 5.
    Fain JN. Release of inflammatory mediators by human adipose tissue is enhanced in obesity and primarily by the nonfat cells: a review. Mediat Inflamm. 2010;2010:1–20.CrossRefGoogle Scholar
  6. 6.
    Cancello R, Henegar C, Viguerie N, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes. 2005;54:2277–86.CrossRefGoogle Scholar
  7. 7.
    Carey VJ, Walters EE, Colditz GA, et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women: the nurses’ health study. Am J Epidemiol. 1997;145:614–9.CrossRefGoogle Scholar
  8. 8.
    Sams VG, Blackledge C, Wijayatunga N, et al. Effect of bariatric surgery on systemic and adipose tissue inflammation. Surg Endosc. 2016;30:3499–504.CrossRefGoogle Scholar
  9. 9.
    Kwon H, Pessin JE. Adipokines mediate inflammation and insulin resistance. Front Endocrinol (Lausanne). 2013;4:71.CrossRefGoogle Scholar
  10. 10.
    Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641.Google Scholar
  11. 11.
    Mahawar K, Kumar P, Carr W, et al. Current status of mini-gastric bypass. J Minim Access Surg. 2016;12:305.CrossRefGoogle Scholar
  12. 12.
    Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg Elsevier Ltd. 2014;12:1495–9.Google Scholar
  13. 13.
    Lee W-J, Yu P-J, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.CrossRefGoogle Scholar
  14. 14.
    Lee W-J, Ser K-H, Lee Y-C, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22:1827–34.CrossRefGoogle Scholar
  15. 15.
    Mahawar KK, Jennings N, Brown J, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23:1890–8.CrossRefGoogle Scholar
  16. 16.
    Eder K, Baffy N, Falus A, et al. The major inflammatory mediator interleukin-6 and obesity. Inflamm Res. 2009;58:727–36.CrossRefGoogle Scholar
  17. 17.
    Bastard J-P. Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab. 2000;85:3338–42.PubMedGoogle Scholar
  18. 18.
    Gnacińska M, Małgorzewicz S, Guzek M, et al. Adipose tissue activity in relation to overweight or obesity. Endokrynol Pol. 61:160–8.Google Scholar
  19. 19.
    Conze D, Weiss L, Regen PS, et al. Autocrine production of interleukin 6 causes multidrug resistance in breast cancer cells. Cancer Res. 2001;61:8851–8.PubMedGoogle Scholar
  20. 20.
    Kelly AS, Ryder JR, Marlatt KL, et al. Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity. Int J Obes. 2016;40:275–80.CrossRefGoogle Scholar
  21. 21.
    Illán-Gómez F, Gonzálvez-Ortega M, Orea-Soler I, et al. Obesity and inflammation: change in adiponectin, C-reactive protein, tumour necrosis factor-alpha and interleukin-6 after bariatric surgery. Obes Surg. 2012;22:950–5.CrossRefGoogle Scholar
  22. 22.
    Miller GD, Nicklas BJ, Fernandez A. Serial changes in inflammatory biomarkers after Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2011;7:618–24.CrossRefGoogle Scholar
  23. 23.
    Lee YS, Choi I, Ning Y, et al. Interleukin-8 and its receptor CXCR2 in the tumour microenvironment promote colon cancer growth, progression and metastasis. Br J Cancer. 2012;106:1833–41.CrossRefGoogle Scholar
  24. 24.
    Dorneles GP, Haddad DO, Fagundes VO, et al. High intensity interval exercise decreases IL-8 and enhances the immunomodulatory cytokine interleukin-10 in lean and overweight–obese individuals. Cytokine. 2016;77:1–9.CrossRefGoogle Scholar
  25. 25.
    Botella-Carretero JI, Alvarez-Blasco F, Martinez-García MA, et al. The decrease in serum IL-18 levels after bariatric surgery in morbidly obese women is a time-dependent event. Obes Surg. 2007;17(9):1199–208.CrossRefGoogle Scholar
  26. 26.
    Gialamas SP, Sergentanis TN, Antonopoulos CN, et al. Circulating leptin levels and risk of colorectal cancer and adenoma: a case-control study and meta-analysis. Cancer Causes Control. 2013;24:2129–41.CrossRefGoogle Scholar
  27. 27.
    Ekmen N, Helvaci A, Gunaldi M, et al. Leptin as an important link between obesity and cardiovascular risk factors in men with acute myocardial infarction. Indian Heart J. 2016;68(2):132–7.CrossRefGoogle Scholar
  28. 28.
    Luo N, Liu J, Chung BH, et al. Macrophage adiponectin expression improves insulin sensitivity and protects against inflammation and atherosclerosis. Diabetes. 2010;59:791–9.CrossRefGoogle Scholar
  29. 29.
    Yadav R, Hama S, Liu Y, et al. Effect of Roux-en-Y bariatric surgery on lipoproteins, insulin resistance, and systemic and vascular inflammation in obesity and diabetes. Front Immunol. 2017;8:1512.CrossRefGoogle Scholar
  30. 30.
    Appachi S, Kashyap SR. “Adiposopathy” and cardiovascular disease: the benefits of bariatric surgery. Curr Opin Cardiol. 2013;28:540–6.PubMedGoogle Scholar
  31. 31.
    Elhelaly AE, AlBasher G, Alfarraj S, et al. Protective effects of hesperidin and diosmin against acrylamide-induced liver, kidney, and brain oxidative damage in rats. Environ Sci Pollut Res. 2019;Google Scholar
  32. 32.
    Shoelson SE, Herrero L, Naaz A. Obesity, inflammation, and insulin resistance. Gastroenterology. 2007;132:2169–80.CrossRefGoogle Scholar
  33. 33.
    Arner P. The adipocyte in insulin resistance: key molecules and the impact of the thiazolidinediones. Trends Endocrinol Metab. 2003;14:137–45.CrossRefGoogle Scholar
  34. 34.
    Johar D, Ahmed SM, El Hayek S, et al. Diabetes-induced proteome changes throughout development. Endocr Metab Immune Disord Drug Targets. 2019;19:732–43.CrossRefGoogle Scholar
  35. 35.
    Sato C, Shikata K, Hirota D, et al. P-Selectin glycoprotein ligand-1 deficiency is protective against obesity-related insulin resistance. Diabetes. 2011;60:189–99.CrossRefGoogle Scholar
  36. 36.
    Rao SR. Inflammatory markers and bariatric surgery: a meta-analysis. Inflamm Res. 2012;61:789–807.CrossRefGoogle Scholar
  37. 37.
    Naruse K, Ueno M, Satoh T, et al. A YAC contig of the human CC chemokine genes clustered on chromosome 17q11.2. Genomics. 1996;34:236–40.CrossRefGoogle Scholar
  38. 38.
    Proost P, Struyf S, Couvreur M, et al. Posttranslational modifications affect the activity of the human monocyte chemotactic proteins MCP-1 and MCP-2: identification of MCP-2(6-76) as a natural chemokine inhibitor. J Immunol. 1998;160:4034–41.PubMedGoogle Scholar
  39. 39.
    Huber J, Kiefer FW, Zeyda M, et al. CC chemokine and CC chemokine receptor profiles in visceral and subcutaneous adipose tissue are altered in human obesity. J Clin Endocrinol Metab. 2008;93:3215–21.CrossRefGoogle Scholar
  40. 40.
    Catalán V, Gómez-Ambrosi J, Ramirez B, et al. Proinflammatory cytokines in obesity: impact of type 2 diabetes mellitus and gastric bypass. Obes Surg. 2007;17:1464–74.CrossRefGoogle Scholar
  41. 41.
    Harman-Boehm I, Blüher M, Redel H, et al. Macrophage infiltration into omental versus subcutaneous fat across different populations: effect of regional adiposity and the comorbidities of obesity. J Clin Endocrinol Metab. 2007;92:2240–7.CrossRefGoogle Scholar
  42. 42.
    Kelly KR, Haus JM, Solomon TPJ, et al. A low-glycemic index diet and exercise intervention reduces TNF(alpha) in isolated mononuclear cells of older, obese adults. J Nutr. 2011;141:1089–94.CrossRefGoogle Scholar
  43. 43.
    Salcedo R, Ponce ML, Young HA, et al. Human endothelial cells express CCR2 and respond to MCP-1: direct role of MCP-1 in angiogenesis and tumor progression. Blood. 2000;96:34–40.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  • Mohamed Abdalla Salman
    • 1
  • Ahmed Abdallah
    • 1
  • Hani Maurice Sabri Mikhail
    • 1
  • Ahmed Abdelsalam
    • 1
  • Ayman Helmy Ibrahim
    • 2
  • Ahmed Abd El Aal Sultan
    • 2
  • Mohamed El-ghobary
    • 3
  • Amro Abdelaziz Mohammed Ismail
    • 3
  • Tarek Elsayed Abouelregal
    • 3
  • Mahmoud Gouda Omar
    • 3
  • Alhoussein Alsayed AbdelAal
    • 4
  • Hossam El-Din Shaaban
    • 5
  • Ghada M. K. GabAllah
    • 6
  • Mohamed Tourky
    • 7
  • Ahmed Abdallah Salman
    • 3
    Email author
  1. 1.General Surgery Department, Faculty of MedicineCairo UniversityGizaEgypt
  2. 2.General Surgery Department, Faculty of MedicineAl-Azhar UniversityCairoEgypt
  3. 3.Internal Medicine Department, Faculty of MedicineCairo UniversityGizaEgypt
  4. 4.Internal Medicine Department, Faculty of MedicineZagazig UniversityZagazigEgypt
  5. 5.National Hepatology and Tropical Medicine Research InstituteCairoEgypt
  6. 6.Medical Biochemistry Department, Faculty of MedicineMenoufia UniversityShibin El KomEgypt
  7. 7.Alawi TunsiMeccaSaudi Arabia

Personalised recommendations