Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, 63069, Offenbach am Main, Germany.
Department of Clinical Research, St Claraspital, Basel, Switzerland.
Obes Surg. 2018 Oct;28(10):3028-3040. doi: 10.1007/s11695-018-3320-y.
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.
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.
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 × 10/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.
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 × 10/μl ± 2 and 10.5 mg/l ± 8.1. At T6, mean value of leukocytes and CRP was 7.1 × 10/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.
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.
The National Clinical Trials number was NCT02697695 ( https://clinicaltrials.gov/ct2/show/NCT02697695 ).
肥胖和代谢手术已知可改善慢性炎症状态。但改善是否与解剖结构变化或体重减轻有关仍存在争议。
本临床试验旨在比较袖状胃切除术（SG）、Roux-en-Y 胃旁路术（RYGB）和单吻合口胃旁路术（OAGB）这三种减重手术对炎症标志物的影响。
纳入因严重肥胖行 SG、RYGB 或 OAGB 作为初始治疗的患者。收集术前（T0）和术后 1、3 和 6 个月（T6）的数据，包括性别、体重、基线时的合并症和不良生活习惯、体重指数（BMI）、腰围、总体重减轻百分比（TBWL）、白细胞计数（×10/μl）、C 反应蛋白（CRP）（mg/L）、糖化血红蛋白（HbA1c）（%）、天门冬氨酸转氨酶（U/L）、丙氨酸转氨酶（U/L）、γ-谷氨酰转移酶（U/L）、胆红素（mg/dL）、胆固醇（mg/dL）和甘油三酯（mg/dL）。
共纳入 468 例患者，T6 时的脱落率为 25.8%。术前白细胞和 CRP 的平均值分别为 7.4×10/μl±2 和 10.5mg/L±8.1。T6 时，白细胞和 CRP 的平均值分别为 7.1×10/μl±1.9（p=0.075）和 7.2mg/L±9.5（p<0.001）。T6 时 SG、RYGB 和 OAGB 组的 TBWL%分别为 24.2±7.6、25.8±5.9 和 25.5±4.6。比较 SG、RYGB 和 OAGB 三组白细胞计数和 CRP，组间无显著差异。
三种减重手术后 CRP 而非白细胞计数下降，但三组间无统计学意义。手术引起的体重减轻而不是解剖结构的变化可能对改善慢性炎症起重要作用。
国家临床试验编号 NCT02697695（https://clinicaltrials.gov/ct2/show/NCT02697695）。
