Piotr J Gorecki, MD, Kendra M Black, MA, MD, Ankeet Udani, MD, Krystyna Kabata, PA, Anthony Tortolani, MD. New York Methodist Hospital
Introduction: It has been shown that morbid obesity is associated with a chronic inflammatory state and is associated with increased C-reactive protein (CRP) levels. In this study, we examine the dynamics of serum CRP levels with long term follow up in patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB).
Methods and Procedures: All patients met the NIH criteria for Bariatric surgery and were operated upon by a single surgeon (PG) in a single institution between June 2006 and January 2008. Demographic data, weight, BMI, comorbidities and perioperative data were entered into the database prospectively. The same clinical pathways and the same technique were utilized for all patients. There were no postoperative mortalities. Serum CRP levels were obtained during routine pre-operative blood work and every year post-operatively up to 6 years. Yearly post-operative CRP levels were compared to the pre-operative CRP levels using a paired two sample means t-test.
Results: Fifty-three patients (average age 41.0 ± 12.2 years, average BMI 48.2±7.67) were followed for 6 years post-operatively. Routine pre-operative testing showed that 46 patients (87%) had elevated CRP levels preoperatively. Significant reduction of serum CRP levels occurred postoperatively – see table.
|Follow-up Time||Number of patients||Mean CRP±stddev (mg/L)||Mean CRP change||P-value paired t-test||%with normal CRP||Average BMI (kg/m2)|
|1 yr. post-op||36||6.8±6.10||-9.41||0.0234||72%||30.8|
|2 yr. post-op||33||2.26±2.10||-8.88||0.0325||88%||30.3|
|3 yr. post-op||28||1.30±1.17||-8.71||0.0408||86%||30.6|
|4 yr. post-op||28||2.21±4.67||-10.37||0.0094||93%||31.4|
|5 yr. post-op||16||1.59±2.41||-7.36||0.2401||94%||32|
|6 yr. post-op||9||2.13±1.01||-3.42||0.6794||100%||33|
Conclusion: Our study demonstrates that CRP levels were significantly reduced at 1, 2, 3 and 4 years post-operatively following LRYGB. This study shows that 100% of post-op patients had clinically normal CRP levels at 6 years follow-up indicating that bariatric surgery causes a favorable reduction in CRP, a known inflammatory marker.