Postgraduate Program in Clinical and Experimental Physiopathology (FISCLINEX), Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Obesity Unit (SAI-Ob), Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Obes Surg. 2022 Jun;32(6):1849-1855. doi: 10.1007/s11695-022-06025-9. Epub 2022 Mar 23.
Bariatric surgery promotes expressive weight loss, improving the metabolic and inflammatory profiles. The behavior of these indicators in bariatric patients with weight recidivism is unknown. We aimed to investigate both profiles in bariatric patients with high ratio of weight regain (RWR), comparing them with nonsurgical patients with obesity.
Forty patients with obesity subjected to Roux-en-Y gastric bypass (RYGB) with high RWR composed the bariatric group, and 40 controls matched for BMI, age, and gender were recruited as nonsurgical group. Between-group comparisons were performed for clinical history, physical examination, biochemical, metabolic, and inflammatory profiles.
Bariatric group was composed of a group with an excess weight loss of 85.9 ± 16.8%, a RWR of 56.5 ± 19.7%, and a time since surgery of 10.7 ± 4.3 years. We noticed a lower proportion of patients with type 2 diabetes mellitus and dyslipidemia (P ≤ 0.05) and lower neck and waist circumferences (P ≤ 0.05) in this group. No differences between groups were observed concerning hip circumference, blood pressure, heart rate, total cholesterol, LDL-c, acid uric, creatinine, ALT, ASP, interferon-γ (INF-γ), interferon gamma-induced protein-10 (IP-10), monocyte chemoattractant protein-1 (MCP-1), TNF-α, interleukin-1β (IL-1 β), interleukin-17 (IL-17), and interleukin-10 (IL-10). Of note, fasting glucose; HbA1c; triglycerides; and, surprisingly, IL-6 levels were lower (P ≤ 0.05) in the bariatric group than nonsurgical one while HDL-c level was higher (P < 0.001).
Expressive post-bariatric weight loss, even in patients with high RWR, suggests a possible metabolic benefit/protection in the long term. Probably decreased circulating levels of IL-6 are involved in it.
NCT04193397.
减重手术可显著减轻体重，改善代谢和炎症指标。然而，对于减重手术后体重反弹（RWR）的患者，这些指标的变化情况尚不清楚。本研究旨在观察减重手术后 RWR 较高的患者的代谢和炎症指标，并与非手术肥胖患者进行比较。
40 例 RYGB 术后 RWR 较高的肥胖患者纳入减重组，按照 BMI、年龄和性别匹配的 40 例非手术肥胖患者纳入非手术组。比较两组的临床病史、体格检查、生化、代谢和炎症指标。
减重组患者的体重减轻率为 85.9±16.8%，RWR 为 56.5±19.7%，手术时间为 10.7±4.3 年。与非手术组相比，该组患者的 2 型糖尿病和血脂异常的比例较低（P≤0.05），颈围和腰围较小（P≤0.05）。两组的臀围、血压、心率、总胆固醇、LDL-c、尿酸、肌酐、ALT、AST、IFN-γ、IP-10、MCP-1、TNF-α、IL-1β、IL-17 和 IL-10 水平无差异。值得注意的是，与非手术组相比，减重组的空腹血糖、HbA1c、甘油三酯和 IL-6 水平较低（P≤0.05），而 HDL-c 水平较高（P<0.001）。
即使 RWR 较高，减重手术后仍能显著减轻体重，提示长期来看可能存在代谢获益/保护作用。可能与循环中 IL-6 水平降低有关。
NCT04193397。
