Can Bariatric Surgery Help to Prevent Autoimmunity?

Obesity has been linked to the development and progression of autoimmune diseases.

To investigate the presence of autoantibodies in the sera of bariatric-surgery patients.

During the pre- and postoperative period, sera from 79 patients undergoing bariatric surgery were tested for the presence of antinuclear antibodies (ANA), Rheumatoid Factor (RF), IgG and IgM anticardiolipin antibodies, and anti-endomysial antibodies. Anti-dsDNA and ENA profiles were also determined in positive ANA sera. A chart review was used to obtain clinical, epidemiological, and anthropometric data.

Preoperatively, 23/79 (29.1%) of the sera tested positive for ANA; postoperatively, this frequency decreased to 8/79 (10.1%) with p = 0.002 (OR = 3.6; 95%; CI = 1.4-8.3). The fine-speckled ANA pattern was the most common (73.9% preoperative and 87.3% postoperative). Preoperative ANA-positive and negative patients did not differ in epidemiological or anthropometric measurements (all p >0.05), but ANA-positive patients had lower serum vitamin D levels than the negatives (p = 0.002). RF positivity was found in 5/76 (6.5%) of preoperative sera and 3/76 (3.9%) of postoperative sera, with p = 0.71. Anti-ds-DNA, ENA profile, and anti-endomysial antibodies were all negative in all patients, both before and after surgery; anticardiolipin IgM was weakly positive in one postoperative sample.

Positive ANA is common in obese patients undergoing bariatric surgery, and it decreases after weight loss.