The effects of bariatric surgery on inflammatory markers for cardiovascular diseases

Ali Kagan Coskun, MD¹, Ali Harlak, MD¹, Turgay Celik, MD², Taner Yigit, MD¹, Cengiz Ozturk, MD², Tuncer Cayci, MD³. ¹GATA Dept. of Surgery, ²GATA Dept. of Cardiology, ³GATA Dept. of Biochemistry

Background: The prevalence of obesity (BMI > 30 kg/m2) has an increase  in the last two decades. Obesity is defined as a risk factor for cardiovascular diseases by World Hearth Federation. Inflammation plays an important role in cardiovascular diseases. One of the common causes of cardiovascular disease is atherosclerosis which is a complex inflammatory process, is seen at obese patients. In recent studies, the neutrophil/leukocyte ratio, red cell distribution width and mean platelet volume were evaluated for being an inflamatory markers in cardiovascular diseases. We aimed to evaluate the levels of inflammatory markers for cardiovascular diseases undergoing bariatric surgery in obese patients at Gulhane Military Medical Academy.

Methods: The study consisted of 75 obese  patients undergone bariatric surgery. Age, sex, body mass index, operation type, cardiovascular risk factors , white blood cell count neutrophil-to-lymphocyte ratio, platelet count, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration ,  platelet distribution width and red cell distribution width were taken from hospital records and  surgeons notes ( including post-operative patients control ) . The data before the operation and aproximately 1 year  after the operation were compared and evaluated.

Results: Of the 75 patients , 56 of them undergone laparoscopic gastric by-pass and the other 19 of them were operated with sleeve gastrectomy technic. The average decrease at BMI levels was 34%. The cardiovascular disease risk was detected at 44 patients. The comparision between pre-operative and post-operative first year results of the markers of the patients who had cardiovascular risk factors resulted with significant difference (p<0.05) for white blood cell count,  neutrophil – to – lymphocyte ratio, platelet count, mean corpuscular volume , mean corpuscular hemoglobin and platelet distribution width.

Conclusion: Our study results showed that in the light of inflammation, the cardiovascular risk may be reduced with BMI decrease following bariatric surgery. However these significant changes in inflammation should be evaluated in terms of clinical implications with in large groups of patients.