Immunometabolic Changes Following Gastric Bypass and Sleeve Gastrectomy: A Comparative Study.

Background: Immunometabolism is the interaction between immune system and nutrient metabolism. Severe obesity is considered a state of meta-inflammation associated with obesity that influences the development of chronic-degenerative diseases.

Objective: We aimed to establish the immunometabolic differences in bariatric patients and to determine whether cellular immunity is associated with metabolic changes.

Methodology: We conducted an observational study in patients who underwent laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB). We explored the differences in the immunometabolic profile before and after surgery in the study group, by surgical technique, and we evaluated the changes in immunological variables as a function of metabolic variables with correlation analysis.

Results: The follow-up rate was 88.7%. After the intervention, there were changes in cellular immunity, with a decrease in effector T lymphocytes (CD8+CD28-) and an increase in B lymphocytes, memory helper T cells, and cytotoxic T lymphocytes. LSG resulted in a greater decrease in (CD4+CD62-) T lymphocytes compared with LRYGB. Patients who underwent surgery with LRYGB presented greater clinical and metabolic improvements, as well as improvement of obesity-associated medical problems. Women who underwent LRYGB showed a greater reduction in fat-free mass compared with women who underwent LSG.

Conclusion: Bariatric surgery, mainly LRYGB, leads to immunometabolic changes and improves associated medical problems.