Key result
Sleeve gastrectomy achieves superior weight loss over lifestyle intervention, but both similarly lower cardiovascular risk.
Why the study?
Obesity is a chronic inflammatory condition and major cardiovascular disease risk factor, but the comparative effects of sleeve gastrectomy versus lifestyle intervention on inflammatory cytokines, redox status, and CVD risk needed investigation.
Does sleeve gastrectomy improve inflammatory cytokines, redox status, and cardiovascular disease risk more than lifestyle intervention in adults with obesity?
Cohort (n=92)
No
Does sleeve gastrectomy improve inflammatory cytokines, redox status, and cardiovascular disease risk more than lifestyle intervention in adults with obesity?
Both bariatric surgery and lifestyle intervention can similarly improve inflammatory status, oxidative stress, and estimated cardiovascular disease risk in patients with obesity, benefits which are significantly correlated with fat mass loss.
Similar CV risk reductions despite greater fat loss with surgery; hypothesis-generating for shared mechanisms, needing RCT confirmation.
Background and Objectives: Obesity is a chronic inflammatory condition and is considered a major risk factor for cardiovascular disease (CVD). The effects of obesity management via sleeve gastrectomy (SG) and lifestyle intervention (LS) on inflammatory cytokines, redox status, and CVD risk were studied in this work. Materials and Methods: A total of 92 participants (18 to 60 years old) with obesity (BMI ≥ 35 kg/m2 were divided into two groups: the bariatric surgery (BS) group (n = 30), and the LS group (n = 62). According to the achievement of 7% weight loss after 6 months, the participants were allocated to either the BS group, the weight loss (WL) group, or the weight resistance (WR) group. Assessments were performed for body composition (by bioelectric impedance), inflammatory markers (by ELISA kits), oxidative stress (OS), antioxidants (by spectrophotometry), and CVD risk (by the Framingham risk score (FRS) and lifetime atherosclerotic cardiovascular disease risk (ASCVD)). Measurements were taken before and after six months of either SG or LS (500 kcal deficit balanced diet, physical activity, and behavioral modification). Results: At the final assessment, only 18 participants in the BS group, 14 participants in the WL group, and 24 participants in the WR group remained. The loss in fat mass (FM) and weight loss were greatest in the BS group (p < 0.0001). Levels of IL-6, TNF-a, MCP-1, CRP, and OS indicators were significantly reduced in the BS and WL groups. The WR group had significant change only in MCP-1 and CRP. Significant reductions in the CVD risk in the WL and BS groups were detected only when using FRS rather than ASCVD. The FM loss correlated inversely with FRS-BMI and ASCVD in the BS group, whereas in the WL group, FM loss correlated only with ASCVD. Conclusions: BS produced superior weight and fat mass loss. However, both BS and LS produced a similar reduction in the inflammatory cytokines, relief of OS indicators, and enhancement of antioxidant capacity, and consequently reduced the CVD risk.
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Abulmeaty et al. (2023) conducted a cohort in Obesity (n=92). Sleeve gastrectomy vs. Multimodal lifestyle intervention (500 kcal deficit diet, physical activity, and behavioral modification) was evaluated on Fat mass and weight loss (p=<0.0001). Sleeve gastrectomy produced superior weight and fat mass loss compared to lifestyle intervention (p < 0.0001), though both interventions similarly reduced inflammatory cytokines and estimated cardiovascular risk.
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