Changes in the CALLY Index After Sleeve Gastrectomy and Their Association with Weight Loss and Metabolic Parameters...

Background: The C-reactive protein-albumin-lymphocyte (CALLY) index integrates systemic inflammation, nutritional status, and immune function. This study evaluated changes in the CALLY index after sleeve gastrectomy and their associations with weight loss and cardiometabolic changes in women. Methods: This retrospective, observational, single-center study included 72 women who underwent sleeve gastrectomy and had complete preoperative and 12-month postoperative data. The CALLY index was calculated preoperatively and at 12 months. ΔCALLY was defined as the 12-month value minus the preoperative value. Weight-loss outcomes were assessed using total weight loss (TWL) and excess weight loss (EWL). Associations were evaluated using Spearman's rank correlation analysis and multivariable linear regression. Results: The CALLY index increased from 1.70 [0.87-2.56] preoperatively to 6.94 [2.72-15.54] at 12 months (p < 0.001). Mean TWL and EWL were 31.43 ± 7.83% and 73.30 ± 20.12%, respectively. ΔCALLY correlated positively with TWL (r = 0.303, p = 0.010) and EWL (r = 0.312, p = 0.008) and negatively with ΔBMI (r = -0.250, p = 0.035), Δfasting insulin (r = -0.234, p = 0.046), ΔHOMA-IR (r = -0.243, p = 0.040), and Δtriglycerides (r = -0.254, p = 0.031). After adjustment for age, preoperative BMI, and diabetes mellitus, ΔCALLY remained positively associated with TWL (B = 0.342, 95% CI 0.172-0.513; p < 0.001). Conclusions: The CALLY index increased significantly during the first year after sleeve gastrectomy in women. Changes in the CALLY index were associated with weight loss and changes in selected metabolic parameters. ΔCALLY may reflect inflammatory and immunonutritional changes accompanying postoperative weight loss.