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Randomized Controlled Trial
. 2024 Dec;34(12):4378-4384.
doi: 10.1007/s11695-024-07567-w. Epub 2024 Nov 7.

Association of High-Sensitivity C-Reactive Protein (hs-CRP) with Weight Loss After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass at 10 Years: A Secondary Analysis of the SLEEVEPASS Randomized Clinical Trial

Ilmari Saarinen  1   2 , Marjatta Strandberg  3 , Saija Hurme  1   3 , Sofia Grönroos  1   2 , Anne Juuti  4   5 , Mika Helmiö  1   3 , Paulina Salminen  6   7
Affiliations
Randomized Controlled Trial

Association of High-Sensitivity C-Reactive Protein (hs-CRP) with Weight Loss After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass at 10 Years: A Secondary Analysis of the SLEEVEPASS Randomized Clinical Trial

Ilmari Saarinen et al. Obes Surg. 2024 Dec.

Abstract

Background: Severe obesity is associated with a low-grade chronic inflammation, and high-sensitivity C-reactive protein (hs-CRP) is a marker that can be used to evaluate chronic inflammation status. Metabolic bariatric surgery (MBS) is shown to decrease hs-CRP level, but long-term results are scarce, and association with weight loss outcomes is undetermined. This study aims to evaluate chronic inflammation in patients with obesity using hs-CRP, and its association with long-term weight loss outcomes after laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods: The long-term follow-up data of SLEEVEPASS (ClinicalTrials.gov NCT00793143) randomized clinical trial (RCT) was used. Hs-CRP was measured at baseline, and at 6 months, 1, 3, 5, 7, and 10 years after surgery, and the association with weight and weight loss outcomes were analyzed.

Results: Hs-CRP at baseline was available for 59 out of 240 (24.6%) patients. In the whole study population, the nadir hs-CRP (mean estimate 1.14 mg/ml, 95% CI 0.87-1.49) was achieved at 3 years after surgery with a statistically significant difference to baseline (p = 0.003). No statistically significant difference was seen between LSG and LRYGB in hs-CRP change over time (operation*time interaction p = 0.540). Higher hs-CRP correlated with higher BMI at baseline (Spearman correlation 0.282, p = 0.030) and at 10 years (Spearman correlation 0.490, p = 0.001). At 10 years, a greater percentage total weight loss (%TWL) correlated with lower hs-CRP level (Spearman correlation - 0.558, p < 0.001). Baseline hs-CRP (Spearman correlation - 0.152, p = 0.299) and hs-CRP change in first 6 months postoperatively (Spearman correlation 0.167, p = 0.254) did not correlate statistically significantly with %TWL at 10 years.

Conclusions: MBS decreases hs-CRP also at long-term follow-up with weight loss as the driving force. Neither baseline hs-CRP nor hs-CRP change at 6 months were feasible as a predictive marker for long-term outcomes.

Keywords: Chronic inflammation; High-sensitivity CRP; Hs-CRP; Metabolic bariatric surgery; Roux-en-Y gastric bypass; Severe obesity; Sleeve gastrectomy.

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Conflict of interest statement

Declarations. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow of patients. Abbreviations: LSG, laparoscopic sleeve gastrectomy; LRYGB, laparoscopic Roux-en-Y gastric bypass; Hs-CRP, high-sensitivity C-reactive protein
Fig. 2
Fig. 2
Hs-CRP through a 10-year follow-up. A All study patients. B Divided by operation. The lower and upper hinges correspond to the first and third quartiles (the 25th and 75th percentiles), and whiskers indicate smallest observation greater than or equal to lower hinge—1.5 * IQR and largest observation less than or equal to upper hinge + 1.5 * IQR. Dots indicate outliers. Abbreviations: LSG, laparoscopic sleeve gastrectomy; LRYGB, laparoscopic Roux-en-Y gastric bypass; Hs-CRP, high-sensitivity C-reactive protein
See this image and copyright information in PMC

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