Anti-inflammatory effects of gastric bypass surgery and their association with improvement in metabolic profile

Abstract

Obesity is associated with chronic inflammation and metabolic disease. Bariatric surgery offers a treatment that can effectively reduce weight and improve the metabolic function. However, the effect of bariatric surgery on chronic inflammation in obesity is under-investigated. In this expert review, the authors outline the effect of Roux-en-Y gastric bypass, the most commonly performed bariatric surgery in current practice, on the markers of inflammation. They include a discussion of the relationship between inflammation and weight loss after surgery, the interaction between these markers and metabolic disease, and the effect on adipose tissue inflammation. They also briefly explore the role of glucagon-like-peptide 1 in remediating inflammation and the changes in gut microbiota after Roux-en-Y gastric bypass, and how they may be important in inflammation.

Keywords:

• bariatric surgery
• gastric bypass
• GLP-1
• gut microbiota
• inflammation

Financial & competing interests disclosure

CW le Roux received a Science Foundation Ireland research grant ref 12/YI/B2480. The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Obesity is a condition of chronic inflammation, and bariatric surgery can remediate this inflammation.

• Isolated analysis of changes in chemokines and cytokines can be misleading in clinical research, and system-specific or organ-specific research may prove more definitive.

• Some molecules such as monocyte chemoattractant protein-1 can be related to specific organ diseases and conditions, and therefore may prove useful in disease diagnosis or monitoring in future.

• Glucagon-like peptide-1 has an anti-inflammatory pro-resolution effect, and the use of glucagon-like peptide-1 receptor agonists or dipeptidyl peptidase 4 inhibitors may have a role in resolving the chronic inflammation in obesity and diabetes, with consequent results in cardiovascular disease and kidney disease.