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The Role of Serum Ferritin as Marker of Chronic Inflammation in Patients Undergoing Bariatric Surgery

Cristian Milla Matute, MD, Rene Aleman, MD, Maria C Fonseca Mora, MD, Francisco Ferri Abreu, MD, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Samuel Szomstein, MD, FACS, FASMBS, Raul J Rosenthal, MD, FACS, FASMBS. Cleveland Clinic Florida

INTRODUCTION: Ferritin is a cellular protein for iron storage, and it has been recently recognized as an acute phase reactant and marker of acute and chronic inflammation. Along with transferrin and the transferrin receptor, ferritin is a member of the protein family that orchestrates cellular defense against oxidative stress and processes. Obesity is a well-known chronic inflammatory state. The aim of this study is to analyze the variations of serum ferritin as an alternate potential marker of inflammation in severely obese subjects that undergo bariatric surgery.

METHODS: After IRB approval, we retrospectively reviewed the electronic charts of all patients who underwent bariatric surgery at Cleveland Clinic Florida from 2005 to 2016. We included all patients with serum ferritin measurements at the time of the surgery and a control measurement at 12 and 24 months after bariatric surgery. Demographics, type of procedure and comorbidities were reviewed. High values were determined >120 ng/dl as a mean for both genders. Patients with hematologic pathology, cancer, and autoimmune diseases were excluded from this analysis. SPSS software was used to apply a t-test for means.

RESULTS: From the of 1,260 patients analyzed with serum ferritin measurements before, surgery and at 12 and 24 months after surgery at follow up, a total of 24.7% (n=312) patients had abnormally high ferritin measurements before surgery. This population had a mean age of 57 years, a mean BMI of 42±7 before bariatric surgery, and Female gender was predominant with 62% (n=192). Regarding the type of procedure laparoscopic sleeve gastrectomy (LSG) was performed in 58% (n=183), Roux-N-Y Gastric Bypass (RNYGB) in 33% (n=103) and Laparoscopic Gastric Banding (LGB) in 8% (n=25). At the time of bariatric surgery, the serum measurements of ferritin had a mean value of 153.7±27 and after surgery a mean value of 137±23 (p=0.32).

CONCLUSIONS: Our study shows no statistically significant difference in serum ferritin level before and after surgery. Although many different indicators of chronic inflammation vary after bariatric surgery, Ferritin by itself does not seem to be helpful as surrogate for chronic inflammation measurements in this patient population. Further studies with a higher number of patients should be performed on an in order to better understanding the role of ferritin as an inflammatory marker.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95317

Program Number: P086

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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