Inflammatory and Metabolic changes following Bariatric Surgery

Bariatric surgery is beneficial not only in inducing significant weight loss but also improving insulin sensitivity thereby reducing morbidity and mortality. However, the exact mechanisms are not fully understood yet. We hypothesize that bariatric surgery results in metabolic improvements and decreased inflammation, leading to reduced obesity related co‐morbidities. To test this, we recruited patients undergoing Roux En Y gastric bypass and serum was collected during surgery, 2 weeks and 6 months post‐surgery. As expected, leptin, a marker of adiposity and other circulating pro‐inflammatory adipokines such as Tumor Necrosis Factor‐α and Monocyte Chemotractant Protein‐1 showed decreasing trends over time indicating reduced inflammation. Free fatty acids were also significantly reduced post‐surgery. Metabolomic analyses performed using Nuclear Magnetic Resonance spectrometry showed that branched chain amino acids (BCAA: Isoleucine, Leucine and Valine), and 2‐hydroxybutyrate were significantly reduced 6 months post‐surgery compared to time of surgery. These metabolic changes indicate alterations in fatty acid and amino acid metabolism and suggest possible reductions in oxidative stress and insulin resistance. In depth analyses of metabolic profiles and pathways pre vs post‐ surgery are currently underway. In conclusion, our studies demonstrate significant improvements in metabolic health and reduced inflammation that may contribute to enhanced insulin sensitivity following bariatric surgery. Physician's Medical Education & Research Foundation, Knoxville,TN & Texas Tech University