Introduction Morbid obesity is associated with a pro-inflammatory state, reflected by a relative increase in levels of pro-inflammatory cytokines and corresponding decrease in anti-inflammatory cytokines. The production of active mediators by the adipose tissue plays an important role in this pathological state. We aimed to study the effects of laparoscopic sleeve gastrectomy (LSG) on markers of oxidative stress, inflammatory mediators interleukin (IL) 6 and IL-10, and the adipocytokines Resistin, Leptin and Adiponectin.
Methods We prospectively studied 19 patients (13 females, mean age 45 years; range 27–64) who underwent LSG at our institution. Fasting bloodsamples were taken pre-operatively and at 6 months post surgery. Fasting blood glucose, serum insulin and lipids were also measured at the same time points. IL-6, IL10, Adiponectin, Leptin and Resistin were measured using a bead-based multiplex bioassay. HOMA-IR was used as a measure of insulin resistance. Markers of oxidative stress—lipid peroxidation (TBARS) and glutathione peroxidase (GPX)—were measured using commercially available biochemical kits. Results are expressed as mean. Statistical analysis employed one-way ANOVA with repeated measures.
Results LSG was associated with significant weight loss (pre-op 60.0±2.59 kg/m2, vs 53.0±2.35 at 6 weeks, 45.8±2.0 at 6 months, p<0.0001). Insulin resistance decreased significantly (HOMA-IR 8.7±1.4 vs 3.8±0.7 vs 2.4±0.5, p<0.0001). IL-6 and Leptin levels were significantly lower at 6 months post-op (6.6±1.0 pg/ml vs 4.8±1.1, p<0.031; 16.4±3.1 ng/ml vs 5.3±1.2, p<000.1). Resistin, Adiponectin and IL-10 levels did not change significantly: Resistin 1.0±0.1 ng/ml vs 0.97±0.1; Adiponectin 11.7±1.8 μg/ml vs 9.9±1.5; IL-10 pg/ml 0.72±0.1 vs 0.67±0.1. There were no significant changes in TBARS or GPX.
Conclusion Insulin resistance and BMI fall significantly after LSG and this is accompanied by a fall in pro-inflammatory cytokines, IL-6 and Leptin. There was no concomitant rise in anti-inflammatory IL-10 and adiponectin. Markers of oxidative stress did not change significantly. Restrictive surgery results in improvements in insulin resistance and a significant reduction in weight. The resulting reduction in adipose tissue, with changes in production of the adipocytokines, has a complex effect on the inflammatory milieu and requires further elucidation.
Competing interests None declared.
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