Pre-operative and post-operative changes in CRP and other biomarkers sensitive to inflammatory status in patients with severe obesity undergoing laparoscopic sleeve gastrectomy

Introduction: C-reactive protein (CRP) is often elevated in patients living with severe obesity (BMI >= 35 kg/m(2)). However, there is limited information on how CRP, and other inflammation responsive biomarkers, change in response to weight loss following laparoscopic sleeve gastrectomy (LSG). We studied how CRP, ferritin and albumin change following LSG surgery in relation to obesity, metabolic syndrome (MetS) ATPIII risk components and diabetes mellitus (DM). Methods: Laboratory parameters (including CRP) were examined in 197 patients prior to LSG, and at 6, 12, 18 and 24 months. Changes in laboratory parameters, and laboratory investigations, were also examined in a 125 patient subgroup at both pre-LSG and at the 12 month follow-up visit. Results: All patients had BMI >= 35 kg/m(2). CRP levels positively correlated with BMI (r = 0.171, p = 0.016) and alkaline phosphatase (ALP; r = 0.309; P < 0.001), but negatively correlated with alanine aminotransferase (ALT; r = -0.260; P < 0.001) and albumin (r = -0.358; P < 0.001). LSG significantly reduced CRP and ferritin, which were maintained for at least 24 months. At 12 months post-LSG there was a significant decrease in weight (kgs) (p < 0.001), CRP (p < 0.001), ferritin (p = 0.004), and various MetS risk components (p < 0.001) but not albumin (p = 0.057). Changes in CRP also correlated with changes in weight (r = 0.233, p = 0.018) and ALP (r = 0.208, p = 0.034) but not albumin (r = -0.186, p = 0.058) or ferritin (r = 0.160, p = 0.113) after LSG. Conclusion: The negative correlation between CRP and albumin levels in obesity may indicate a low grade inflammatory process affecting both. LSG related weight loss decreased CRP and ferritin, likely explained by improvement in inflammatory status.