Change in C-reactive protein after Roux-en-Y gastric bypass through 7 years of follow-up

Background: Long-term change in CRP is not well characterized in the context of RYGB. Objective: To report C-reactive protein (CRP) after Roux-en-Y gastric bypass surgery (RYGB). Setting: Between 2006 and 2009 1770 adults enrolled in a prospective cohort study underwent Rouxen-Y gastric bypass (RYGB) at 1 of 10 U.S. hospitals. Methods: Research assessments were conducted before surgery and annually postoperatively for up to 7 years. This study included those with high-sensitivity CRP assessed before surgery and 1 or more follow-up assessments (n = 1180). Results: Before surgery, participants' median age was 46 years, and the median body mass index (BMI) was 46 kg/m(2); 80% were female. Before surgery, mean (95% confidence interval [CI]) CRP was the highest of all time points (1.01 [.95-1.08] mg/L); it then decreased to a nadir of.18 (.15-.22) mg/L at 2 years postoperatively (P<.001). CRP was higher at 7 years (.26 [.22,.29] mg/L) than at 2 years postoperatively (P,.001) but remained lower at 7 years than preoperatively (P<.001). Additionally, only 3.2% (95% CI: 1.6%-4.8%) of participants had elevated CRP (>1 mg/ dL) 7 years postoperatively versus 32.9% (95% CI: 30.2%-35.3%) preoperatively (P < .001). Several preoperative factors were associated with following a less favorable CRP trajectory over time, including higher preoperative CRP level, higher BMI, current smoking, and diabetes. Conclusion: The vast majority of adults who underwent RYGB experienced a sustained improvement in CRP throughout 7 years of follow-up with nonelevated values. However, those with higher preoperative CRP and BMI levels and diabetes and who smoke may benefit from additional testing and monitoring to ensure nonelevated inflammation after surgery. (C) 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Automated summary

This study reveals a significant improvement in CRP levels after Roux-en-Y gastric bypass surgery, with the majority of participants maintaining normal levels throughout 7 years of follow-up. However, individuals with higher BMI, diabetes, and smoking habits may require additional monitoring to ensure normal inflammation levels post-surgery.