Immunometabolic Changes Following Gastric Bypass and Sleeve Gastrectomy: A Comparative Study.

IF 2.9 3区医学 Q1 SURGERY

Obesity Surgery Pub Date : 2025-02-01 Epub Date: 2025-01-11 DOI:10.1007/s11695-024-07598-3

Tania Rivera-Carranza, Alejandro Azaola-Espinosa, Rafael Bojalil-Parra, Eduardo Zúñiga-León, Angélica León-Téllez-Girón, Martín E Rojano-Rodríguez, Oralia Nájera-Medina

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引用次数: 0

Abstract

Background: Immunometabolism is the interaction between immune system and nutrient metabolism. Severe obesity is considered a state of meta-inflammation associated with obesity that influences the development of chronic-degenerative diseases.

Objective: We aimed to establish the immunometabolic differences in bariatric patients and to determine whether cellular immunity is associated with metabolic changes.

Methodology: We conducted an observational study in patients who underwent laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB). We explored the differences in the immunometabolic profile before and after surgery in the study group, by surgical technique, and we evaluated the changes in immunological variables as a function of metabolic variables with correlation analysis.

Results: The follow-up rate was 88.7%. After the intervention, there were changes in cellular immunity, with a decrease in effector T lymphocytes (CD8+CD28-) and an increase in B lymphocytes, memory helper T cells, and cytotoxic T lymphocytes. LSG resulted in a greater decrease in (CD4+CD62-) T lymphocytes compared with LRYGB. Patients who underwent surgery with LRYGB presented greater clinical and metabolic improvements, as well as improvement of obesity-associated medical problems. Women who underwent LRYGB showed a greater reduction in fat-free mass compared with women who underwent LSG.

Conclusion: Bariatric surgery, mainly LRYGB, leads to immunometabolic changes and improves associated medical problems.

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胃旁路术和袖式胃切除术后免疫代谢变化的比较研究。

背景：免疫代谢是免疫系统与营养物质代谢之间的相互作用。重度肥胖被认为是一种与肥胖相关的元炎症状态，影响慢性退行性疾病的发展。目的：我们旨在建立肥胖患者的免疫代谢差异，并确定细胞免疫是否与代谢变化有关。方法：我们对接受腹腔镜袖胃切除术（LSG）或腹腔镜Roux-en-Y胃旁路术（LRYGB）的患者进行了一项观察性研究。我们通过手术技术探讨了研究组手术前后免疫代谢谱的差异，并通过相关分析评估了免疫变量的变化作为代谢变量的函数。结果：随访率为88.7%。干预后，细胞免疫发生变化，效应T淋巴细胞（CD8+CD28-）减少，B淋巴细胞、记忆辅助T细胞和细胞毒性T淋巴细胞增加。与LRYGB相比，LSG导致（CD4+CD62-） T淋巴细胞的减少更大。接受LRYGB手术的患者表现出更大的临床和代谢改善，以及与肥胖相关的医学问题的改善。与接受LRYGB的女性相比，接受LRYGB的女性显示出更大的无脂质量减少。结论：以LRYGB为主的减肥手术可导致免疫代谢改变并改善相关医疗问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.