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Bariatric Surgery

Serum biomarkers of inflammation and adiposity in the LABS cohort: associations with metabolic disease and surgical outcomes

International Journal of Obesity volume 43, pages 285–296 (2019)Cite this article

Subjects

Abstract

Background

The utility of serum biomarkers related to inflammation and adiposity as predictors of metabolic disease prevalence and outcomes after bariatric surgery are not well-defined.

Methods

Associations between pre- and post-operative serum levels of four biomarkers (C-reactive protein (CRP), cystatin C (CC), leptin, and ghrelin) with baseline measures of adiposity and metabolic disease prevalence (asthma, diabetes, sleep apnea), and weight loss and metabolic disease remission after bariatric surgery were studied in the Longitudinal Assessment of Bariatric Surgery (LABS) cohort.

Results

Baseline CRP levels were positively associated with the odds of asthma but not diabetes or sleep apnea; baseline CC levels were positively associated with asthma, diabetes, and sleep apnea; baseline leptin levels were positively associated with asthma and negatively associated with diabetes and sleep apnea; baseline ghrelin levels were negatively associated with diabetes and sleep apnea. Increased weight loss was associated with increased baseline levels of leptin and CRP and decreased baseline levels of CC. Remission of diabetes and asthma was not associated with baseline levels of any biomarker. A higher likelihood of asthma remission was associated with a greater decrease in leptin levels, and a higher likelihood of diabetes remission was predicted by a lesser decrease in CC. Bariatric surgery was associated with decreased post-operative CC, CRP, and leptin levels, and increased post-operative ghrelin levels.

Conclusion

This is the largest study to date of serum biomarkers of inflammation and adiposity in a bariatric surgery cohort. Biomarker levels correlate with metabolic disease prevalence prior to bariatric surgery, and with weight loss but not metabolic disease remission after surgery. Bariatric surgery regulates serum biomarker levels in a manner consistent with anti-inflammatory and compensatory orexigenic effects. These data contribute to our understanding of the mechanisms underlying the biologic effects of bariatric surgery.

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Acknowledgements

R.W.O. is funded by the National Institutes of Health grants DK097449 and DK115190. LABS-2 was funded by a cooperative agreement by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grants U01 DK066557 (University of Pittsburgh, Data Coordinating Center); U01-DK66667 and UL1-RR024996 (Columbia-Presbyterian in collaboration with Cornell University Medical Center Clinical and Translational Research Center [CTRC]); U01-DK66568 and M01RR-00037 (University of Washington in collaboration with Cornell University Medical Center CTRC); U01-DK66471 (Neuropsychiatric Research Institute); U01-DK66526 (East Carolina University); U01-DK66585 and UL1-RR024153 (University of Pittsburgh Medical Center in collaboration with Cornell University Medical Center CTRC); and U01-DK66555 (Oregon Health and Science University). We thank David Cummings, MD for critical review of the manuscript.

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Authors and Affiliations

  1. Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA

    Robert W. O’Rourke

  2. Ann Arbor Veteran’s Administration Hospital, Ann Arbor, MI, USA

    Robert W. O’Rourke

  3. Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA

    Geoffrey S. Johnson & Abdus S. Wahed

  4. GlaxoSmithKline, Inc., Brentford, London, England

    Geoffrey S. Johnson

  5. Department of Medicine, Oregon Health and Science University, Portland, OR, USA

    Jonathan Q. Purnell

  6. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Anita P. Courcoulas

  7. Weill Cornell University Medical Center, New York, NY, USA

    Gregory F. Dakin & Alfons Pomp

  8. University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA

    Luis Garcia

  9. Department of Surgery, University of Washington, Seattle, WA, USA

    Marcelo Hinojosa & David R. Flum

  10. Neuropsychiatric Research Institute, Fargo, ND, USA

    James E. Mitchell

  11. Brody School of Medicine, East Carolina University, Greenville, NC, USA

    Walter J. Pories & Konstantinos Spaniolas

  12. Department of Surgery, Oregon Health and Science University, Portland, OR, USA

    Bruce M. Wolfe

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  1. Robert W. O’Rourke
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Correspondence to Robert W. O’Rourke.

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O’Rourke, R.W., Johnson, G.S., Purnell, J.Q. et al. Serum biomarkers of inflammation and adiposity in the LABS cohort: associations with metabolic disease and surgical outcomes. Int J Obes 43, 285–296 (2019). https://doi.org/10.1038/s41366-018-0088-z

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