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Changes in high-sensitivity C-reactive protein levels after laparoscopic gastric stapling procedures versus
Alana Gebhart1, Monica Young, James Villamere
1Department of Surgery, University of California Irvine Medical Center, Orange, California, USA.
Insights
Gastric stapling procedures led to a more significant reduction in cardiovascular risk and inflammatory markers compared to gastric banding in morbidly obese patients. This suggests stapling offers superior improvements in cardiovascular health post-bariatric surgery.
Area of Science:
- Cardiovascular Medicine
- Bariatric Surgery
- Inflammation Biomarkers
Background:
- Obesity, hypertension, diabetes, and hyperlipidemia are key risk factors for coronary artery disease.
- High-sensitivity C-reactive protein (hs-CRP) is a validated inflammatory biomarker predicting cardiovascular risk.
Purpose of the Study:
- To compare the cardiovascular risk profile changes after laparoscopic gastric stapling (bypass/sleeve) versus gastric banding.
- To evaluate the impact of bariatric surgery on hs-CRP levels and associated cardiovascular risk.
Main Methods:
- Prospective study measuring hs-CRP preoperatively and 1-2 years postoperatively in 101 morbidly obese patients.
- Patients were divided into gastric stapling (n=52) and gastric banding (n=49) groups.
- Cardiovascular risk was categorized based on hs-CRP levels: low (<1 mg/L), moderate (1-3 mg/L), high (>3 mg/L).
Main Results:
- Gastric stapling resulted in significantly lower BMI at 24 months compared to gastric banding (30.4 vs 36.1 kg/m²).
- A greater proportion of gastric stapling patients (64.0%) experienced a reduction in cardiovascular risk category versus gastric banding patients (57.8%).
- The mean reduction in hs-CRP was significantly greater in the gastric stapling group (-1.10 mg/L) compared to the gastric banding group (-0.67 mg/L).
Conclusions:
- Bariatric surgery, particularly gastric stapling, improves cardiovascular risk profiles in morbidly obese patients.
- Gastric stapling procedures demonstrate a more pronounced reduction in hs-CRP levels and cardiovascular risk compared to gastric banding.
- These findings highlight the efficacy of gastric stapling in mitigating cardiovascular risk factors associated with obesity.
Abstract:
Obesity, hypertension, diabetes, and hyperlipidemia are risk factors for the development of coronary artery disease. High-sensitivity C-reactive protein (hs-CRP) is an inflammatory biomarker that has been shown to be an independent predictor for cardiovascular risk. The aim of the current study was to examine the changes in cardiovascular risk profile in morbidly obese patients who underwent laparoscopic gastric stapling procedures (bypass and sleeve) compared with laparoscopic gastric banding. Levels of hs-CRP were measured preoperatively and at 12 to 24 months postoperatively. Based on hs-CRP levels, cardiovascular risk was categorized as low (less than 1 mg/L), moderate (1 to 3 mg/L), or high (greater than 3 mg/L). A total of 52 patients underwent gastric stapling procedures and 49 underwent gastric banding and both had preoperative and postoperative hs-CRP levels measured. There were no significant differences in age, gender, or preoperative body mass index (BMI) between groups. At baseline, 48.0 per cent of patients undergoing gastric stapling and 38.8 per cent of patients undergoing gastric banding had moderate or high cardiovascular risk. BMI at 24 months was significantly lower in the gastric stapling compared with the gastric banding group (30.4 ± 5.4 vs 36.1 ± 5.5 kg/m(2), respectively, P < 0.01). Of the patients with elevated cardiovascular risk, 64.0 per cent of gastric stapling versus 57.8 per cent of gastric banding patients had a reduction in risk category at 12 to 24 months follow-up, whereas 1.9 per cent of patients undergoing gastric stapling versus 4.1 per cent of patients undergoing gastric banding had an increase in risk category. The mean reduction in hs-CRP level for patients with elevated cardiovascular risk was greater for gastric stapling compared with gastric banding procedures (-1.10 ± 0.94 mg/L vs -0.67 ± 0.82 mg/L, respectively, P < 0.05). Cardiovascular risk improved in the majority of patients after bariatric surgery, but a more pronounced improvement occurred in patients who underwent gastric stapling procedures.
