Effects of Roux-en-Y gastric bypass on the metabolic profile and systemic inflammatory status of women with metabolic syndrome: randomized controlled clinical trial

Background Obesity remains a public health problem worldwide. The high prevalence of this condition in the population raises further concerns, considering that comorbidities are often associated with obesity. Among the comorbidities closely associated with obesity, metabolic syndrome (MS) is particularly important, which potentially increases the risk of manifestation of other disorders, such as the prothrombotic and systemic pro-infammatory states.Methods A randomized, controlled clinical trial was performed involving female patients (n = 32) aged between 18 and 65 years, with a clinical diagnosis of MS, with severe obesity undergoing Roux-en-Y gastric bypass (RYGB). The study design followed the Consolidated Standards of Reporting Trials statement (CONSORT). Lipid profle, blood glucose and adipokines (adiponectin, leptin, and resistin) and (cytokines IL-1?, IL-6, IL-17, IL-23, and TNF-?) in blood plasma samples were evaluated before and six months after RYGB.Results Patients undergoing RYGB (BSG) showed a signifcant improvement from preoperative grade III obesity to postoperative grade I obesity. The results showed that while HDL levels increased, the other parameters showed a signifcant reduction in their postoperative values when compared not only to the values observed before surgery in the BSG group, but also to the values obtained in the control group (CG). As for systemic infammatory markers adiponectin, leptin, resistin, IL-1?, IL-6, IL-17, IL-23 and TNF- ? it was observed that the levels of resistin and IL-17 in the second evaluation increased signifcantly when compared to the levels observed in the frst evaluation in the CG. In the BSG group, while the levels of adiponectin increased, the levels of the other markers showed signifcant reductions in the postoperative period, in relation to the respective preoperative levels. The analysis of Spearman's correlation coefcient showed a signifcant positive correlation between IL-17 and IL-23 in the preoperative period, signifcant positive correlations between TNF-? and IL-6, TNF-? and IL-17, IL-6 and IL-17, and IL-17 and IL-23 were observed postoperatively.Conclusions: According to our results, the reduction of anthropometric measurements induced by RYGB, signifcantly improves not only the plasma biochemical parameters (lipid profle and glycemia), but also the systemic infammatory status of severely obese patients with MS