Inflammatory Cytokines' Changes After Weight loss via Bariatric Surgery and Lifestyle Intervention

• Published in: Obesity (Silver Spring, Md.) Vol. 30; pp. 10 - 11
• Main Authors: Abulmeaty, Mahmoud, Aldisi, Dara, Alkhathaami, Abdulaziz, Zaben, Mohamed Al, Razak, Suhail
• Format: Journal Article
• Language: English
• Published: Silver Spring Blackwell Publishing Ltd 01.11.2022
• Subjects: Cytokines; Gastrointestinal surgery; Intervention; Lifestyles; Obesity; Tumor necrosis factor-TNF; Weight control
• ISSN: 1930-7381; 1930-739X

Background: Obesity is associated with a state of chronic low-grade systemic inflammation. lifestyle intervention as a first-line in obesity management produces modest weight loss compared to bariatric sur-gery. However, both modalities' changes in inflammatory status after weight loss are not completely understood. This study aimed to study changes in the inflammatory cytokines after weight loss via lifestyle intervention versus bariatric surgery in a cohort of adults with obesity. Methods: A prospective study included a cohort of 28 patients with obesity who underwent laparoscopic sleeve gastrectomy (BS group) and 38 patients who were instructed to follow a lifestyle interven-tion program. The lifestyle cohort was further divided into either weight loser (WL) or weight resistant (WR) groups according to success or failure to achieve weight loss > 5%. Inclusion criteria included adult women or men with BMI>35 kg/m2 + comorbidities or >40 kg/m2 without. Lifestyle interventions included a 500 to 1000 calorie-deficit/balanced diet in addition to a gradual physical activity program with monthly visits to the clinic. Anthropometric measurements, and body composition changes (by bioelectrical impedance analysis, Tanita BC-418) were recorded at baseline and after 6 months for all participants. Basal and final blood samples were used for measurement of complete blood count to calculate neutrophil/lymphocytic ratio (NLR) and serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), and mono-cyte chemoattractant protein-1 (MCP-1). Changes in study parame-ters were calculated as (baseline value - final value). Results: In the WR group, despite insignificant weight loss, levels of inflammatory cytokines showed significant reductions (before-after decrease in IL-6 was 7.8±5.8 pg/ml, in TNF-a was 16.0±7.1 pg/ml, and in MCP-1 was 203.8±163.6 pg/ml). Compared to the WL group, the BS group showed more significant reductions in levels of IL-6 (3.7±5.6 vs. 9.6±5.2), TNF-a (9.9±15.1 vs. 30.3±4.1), and MCP-1 (232.3±159.9 vs. 367.4±69.2 pg/ml), as well as higher weight and fat mass loss. Conclusions: lifestyle modification may induce an ameliorative effect on inflammatory status even before significantly losing weight. Bariat-ric surgery is superior to successful lifestyle intervention in the reduc-tion of the obesity-related inflammatory status