Anthropometric Changes and Systemic Inflammation After Sleeve Gastrectomy: Do Composite Markers Reflect the Change?

BACKGROUND

This study evaluated how sleeve gastrectomy affects inflammatory and nutritional markers in obese, comorbidity-free individuals, and their relationship with anthropometric measurements.

METHODS

This study retrospectively evaluated 160 obese patients who underwent primary laparoscopic sleeve gastrectomy from 2021 to 2024. Demographic, anthropometric, and lab data were analyzed pre- and 6 months post-op. Changes in body mass index (BMI), waist circumference, and weight loss percentages were calculated. Hepatic steatosis was assessed by ultrasound. Complete blood count, albumin, and hemoglobin levels were also analyzed. From these, the Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, Systemic Immune-Inflammation Index (SII), Prognostic Nutritional Index (PNI), Pan-Immune-Inflammation Value (PIV), lymphocyte-to-monocyte ratio (LMR), and Modified Systemic Inflammation Score (mSIS) were calculated.

RESULTS

The patients averaged 33.7 ± 10.4 years old; 61.9% (n = 99) were female. Post-op, significant decreases occurred in body weight, BMI, waist circumference, hepatic steatosis, neutrophil, lymphocyte, monocyte, and platelet counts, SII, and PIV (p < 0.001 for all, except lymphocytes, p = 0.002). LMR significantly increased (p < 0.001), while PNI showed a mild but significant decrease (p = 0.021). Although weak positive correlations were observed between the reduction in waist circumference and HALP (r = 0.171, p = 0.038), and between the percentage reduction in waist circumference and change in SII (r = 0.159, p = 0.046), no significant relationship was found between the change in the anthropometric measurements and inflammatory markers overall.

CONCLUSIONS

Sleeve gastrectomy significantly reduces both weight and systemic inflammation. However, there's no significant association between weight loss or body composition and inflammatory markers. This suggests that factors beyond just weight reduction may influence systemic inflammation.