Avaliação de marcadores inflamatórios sistêmicos, função hepática e resistência insulínica como preditores de resultados em diferentes técnicas de gastroplastia

Abstract

The inflammatory process in the pathophysiology of obesity is closely linked to insulin resistance and can lead to organic lesions. There are markers based on laboratory data that serve to stratify these variables. The objectives were to compare the variation of biochemical markers [triglyceride-glucose (TyG), fibrosis-4 index (FIB4), neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)] between different surgical techniques such as Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) and to evaluate these markers in weight loss and remission of comorbidities [arterial hypertension (AH), type 2 diabetes mellitus (DM), hepatic steatosis and dyslipidemia (DLP)] after bariatric surgery. Anthropometric and blood parameters were measured preoperatively, after 3 months and in 1 year of surgery. A total of 40 patients were analyzed, 20% male and 80% female, with a mean age of 36 ± 8 years. Preoperative comorbidities included hepatic steatosis in 68%, DLP in 48%, DM in 15% and AH in 38%. There was a statistically significant decrease in TyG and FIB4, but the same was not observed in NLR and PLR. There was a decrease in all hematological and biochemical parameters studied except glutamic oxalacetic transaminase. There was no statistical difference in inflammatory biomarkers evolution, insulin resistance and hepatic fibrosis between the groups of patients undergoing RYGB or VSG in most of the analyzed moments. Bariatric surgery led to adequate weight loss with remission of all evaluated comorbidities. Biochemical markers were useful in evaluating metabolic evolution in the postoperative period, except NLR and PLR. The results were similar between the twob techniques evaluated.