Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Long-term Impact of Mini-Gastric Bypass on Inflammatory Cytokines in Cohort of Morbidly Obese Patients: a Prospective Study

  • 79 Accesses



One anastomosis gastric bypass (OAGB) is a promising bariatric procedure. We performed this study to evaluate the changes in a group of inflammatory cytokines 12 months after OAGB.


A single-arm prospective study was conducted on obese patients who underwent OAGB. The serum levels of the following adipocytokines were monitored pre- and 12 months postoperatively: adiponectin, leptin, interleukin 6 (IL-6), interleukin 8 (IL-8) levels, tumor necrosis factor-alpha (TNF-α), serum amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), and monocyte chemotactic protein 1 (MCP-1).


A total of 62 patients were included with a mean age of 43.9 ± 6.8 years old. The serum adiponectin increased significantly from 7.64 ± 0.29 to 8.76 ± 0.42 μg/mL 12 months after the operation (p < 0.001). hs-CRP and IL-6 decreased significantly 12 months after the OAGB from 3323.35 ± 643.4 ng/mL and 3.72 ± 7.7 pg/mL to 1376.81 ± 609.4 ng/mL and 3.64 ± 6.9 pg/mL, respectively (p < 0.001). The MCP-1 showed significant increase in its level after OAGB as well (p = 0.014). In contrary, there were no significant changes in serum levels of IL-8 (p = 0.12) and TNF-α (p = 0.84) 12 months after the operation. The correlation analysis showed significant correlations between initial body mass index (BMI) with serum adiponectin, IL-8, and serum SAA.


OAGB can significantly impact the inflammatory cytokine profile in obese patients with possible subsequent protection from obesity-related comorbidities such as insulin resistance, cardiovascular diseases, and certain cancers.

This is a preview of subscription content, log in to check access.


  1. 1.

    World Health Organization. Overweight and Obesity Fact Sheet. 2019.

  2. 2.

    Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350:2362–74.

  3. 3.

    Poirier P, Cornier M-A, Mazzone T, et al. Bariatric surgery and cardiovascular risk factors. Circulation. 2011;123:1683–701.

  4. 4.

    Flegal KM, Kit BK, Orpana H, et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories. JAMA. 2013;309:71.

  5. 5.

    Fain JN. Release of inflammatory mediators by human adipose tissue is enhanced in obesity and primarily by the nonfat cells: a review. Mediat Inflamm. 2010;2010:1–20.

  6. 6.

    Cancello R, Henegar C, Viguerie N, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes. 2005;54:2277–86.

  7. 7.

    Carey VJ, Walters EE, Colditz GA, et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women: the nurses’ health study. Am J Epidemiol. 1997;145:614–9.

  8. 8.

    Sams VG, Blackledge C, Wijayatunga N, et al. Effect of bariatric surgery on systemic and adipose tissue inflammation. Surg Endosc. 2016;30:3499–504.

  9. 9.

    Kwon H, Pessin JE. Adipokines mediate inflammation and insulin resistance. Front Endocrinol (Lausanne). 2013;4:71.

  10. 10.

    Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD003641.

  11. 11.

    Mahawar K, Kumar P, Carr W, et al. Current status of mini-gastric bypass. J Minim Access Surg. 2016;12:305.

  12. 12.

    Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg Elsevier Ltd. 2014;12:1495–9.

  13. 13.

    Lee W-J, Yu P-J, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242:20–8.

  14. 14.

    Lee W-J, Ser K-H, Lee Y-C, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22:1827–34.

  15. 15.

    Mahawar KK, Jennings N, Brown J, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23:1890–8.

  16. 16.

    Eder K, Baffy N, Falus A, et al. The major inflammatory mediator interleukin-6 and obesity. Inflamm Res. 2009;58:727–36.

  17. 17.

    Bastard J-P. Elevated levels of interleukin 6 are reduced in serum and subcutaneous adipose tissue of obese women after weight loss. J Clin Endocrinol Metab. 2000;85:3338–42.

  18. 18.

    Gnacińska M, Małgorzewicz S, Guzek M, et al. Adipose tissue activity in relation to overweight or obesity. Endokrynol Pol. 61:160–8.

  19. 19.

    Conze D, Weiss L, Regen PS, et al. Autocrine production of interleukin 6 causes multidrug resistance in breast cancer cells. Cancer Res. 2001;61:8851–8.

  20. 20.

    Kelly AS, Ryder JR, Marlatt KL, et al. Changes in inflammation, oxidative stress and adipokines following bariatric surgery among adolescents with severe obesity. Int J Obes. 2016;40:275–80.

  21. 21.

    Illán-Gómez F, Gonzálvez-Ortega M, Orea-Soler I, et al. Obesity and inflammation: change in adiponectin, C-reactive protein, tumour necrosis factor-alpha and interleukin-6 after bariatric surgery. Obes Surg. 2012;22:950–5.

  22. 22.

    Miller GD, Nicklas BJ, Fernandez A. Serial changes in inflammatory biomarkers after Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2011;7:618–24.

  23. 23.

    Lee YS, Choi I, Ning Y, et al. Interleukin-8 and its receptor CXCR2 in the tumour microenvironment promote colon cancer growth, progression and metastasis. Br J Cancer. 2012;106:1833–41.

  24. 24.

    Dorneles GP, Haddad DO, Fagundes VO, et al. High intensity interval exercise decreases IL-8 and enhances the immunomodulatory cytokine interleukin-10 in lean and overweight–obese individuals. Cytokine. 2016;77:1–9.

  25. 25.

    Botella-Carretero JI, Alvarez-Blasco F, Martinez-García MA, et al. The decrease in serum IL-18 levels after bariatric surgery in morbidly obese women is a time-dependent event. Obes Surg. 2007;17(9):1199–208.

  26. 26.

    Gialamas SP, Sergentanis TN, Antonopoulos CN, et al. Circulating leptin levels and risk of colorectal cancer and adenoma: a case-control study and meta-analysis. Cancer Causes Control. 2013;24:2129–41.

  27. 27.

    Ekmen N, Helvaci A, Gunaldi M, et al. Leptin as an important link between obesity and cardiovascular risk factors in men with acute myocardial infarction. Indian Heart J. 2016;68(2):132–7.

  28. 28.

    Luo N, Liu J, Chung BH, et al. Macrophage adiponectin expression improves insulin sensitivity and protects against inflammation and atherosclerosis. Diabetes. 2010;59:791–9.

  29. 29.

    Yadav R, Hama S, Liu Y, et al. Effect of Roux-en-Y bariatric surgery on lipoproteins, insulin resistance, and systemic and vascular inflammation in obesity and diabetes. Front Immunol. 2017;8:1512.

  30. 30.

    Appachi S, Kashyap SR. “Adiposopathy” and cardiovascular disease: the benefits of bariatric surgery. Curr Opin Cardiol. 2013;28:540–6.

  31. 31.

    Elhelaly AE, AlBasher G, Alfarraj S, et al. Protective effects of hesperidin and diosmin against acrylamide-induced liver, kidney, and brain oxidative damage in rats. Environ Sci Pollut Res. 2019;

  32. 32.

    Shoelson SE, Herrero L, Naaz A. Obesity, inflammation, and insulin resistance. Gastroenterology. 2007;132:2169–80.

  33. 33.

    Arner P. The adipocyte in insulin resistance: key molecules and the impact of the thiazolidinediones. Trends Endocrinol Metab. 2003;14:137–45.

  34. 34.

    Johar D, Ahmed SM, El Hayek S, et al. Diabetes-induced proteome changes throughout development. Endocr Metab Immune Disord Drug Targets. 2019;19:732–43.

  35. 35.

    Sato C, Shikata K, Hirota D, et al. P-Selectin glycoprotein ligand-1 deficiency is protective against obesity-related insulin resistance. Diabetes. 2011;60:189–99.

  36. 36.

    Rao SR. Inflammatory markers and bariatric surgery: a meta-analysis. Inflamm Res. 2012;61:789–807.

  37. 37.

    Naruse K, Ueno M, Satoh T, et al. A YAC contig of the human CC chemokine genes clustered on chromosome 17q11.2. Genomics. 1996;34:236–40.

  38. 38.

    Proost P, Struyf S, Couvreur M, et al. Posttranslational modifications affect the activity of the human monocyte chemotactic proteins MCP-1 and MCP-2: identification of MCP-2(6-76) as a natural chemokine inhibitor. J Immunol. 1998;160:4034–41.

  39. 39.

    Huber J, Kiefer FW, Zeyda M, et al. CC chemokine and CC chemokine receptor profiles in visceral and subcutaneous adipose tissue are altered in human obesity. J Clin Endocrinol Metab. 2008;93:3215–21.

  40. 40.

    Catalán V, Gómez-Ambrosi J, Ramirez B, et al. Proinflammatory cytokines in obesity: impact of type 2 diabetes mellitus and gastric bypass. Obes Surg. 2007;17:1464–74.

  41. 41.

    Harman-Boehm I, Blüher M, Redel H, et al. Macrophage infiltration into omental versus subcutaneous fat across different populations: effect of regional adiposity and the comorbidities of obesity. J Clin Endocrinol Metab. 2007;92:2240–7.

  42. 42.

    Kelly KR, Haus JM, Solomon TPJ, et al. A low-glycemic index diet and exercise intervention reduces TNF(alpha) in isolated mononuclear cells of older, obese adults. J Nutr. 2011;141:1089–94.

  43. 43.

    Salcedo R, Ponce ML, Young HA, et al. Human endothelial cells express CCR2 and respond to MCP-1: direct role of MCP-1 in angiogenesis and tumor progression. Blood. 2000;96:34–40.

Download references

Author information

Correspondence to Ahmed Abdallah Salman.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.


Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Salman, M.A., Abdallah, A., Mikhail, H.M.S. et al. Long-term Impact of Mini-Gastric Bypass on Inflammatory Cytokines in Cohort of Morbidly Obese Patients: a Prospective Study. OBES SURG (2020).

Download citation


  • Bariatric surgery
  • Inflammatory Adipokines
  • One anastomosis gastric bypass