Changes of Urinary Cytokines in Non-Diabetic Obese Patients After Laparoscopic Sleeve Gastrectomy

Ahmed Salman,1 Mohamed Salman,2 Mohamed D Sarhan,2 Karim Maurice,2 Mohamed Tag El-Din,3 Ahmed Youssef,1 Reham Ahmed,1 Tarek Abouelregal,1 Hossam El-Din Shaaban,4 Ghada MK GabAllah,5 Mahmoud Gouda Omar1 1Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 3General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 4Gastroenterology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; 5Medical Biochemistry Department, Faculty of Medicine, Menoufia University, Shibin Al Kawm, EgyptCorrespondence: Ahmed SalmanInternal Medicine Department, Faculty of Medicine, Cairo University, Cairo, 11311, EgyptTel +20 1000468664Email awea844@gmail.comIntroduction: Adipose tissues synthesize and secrete various proinflammatory and anti-inflammatory mediators, termed cytokines. This work aims to assess different serum and urinary cytokine levels before and 12 months after laparoscopic sleeve gastrectomy (LSG).Patients: This prospective study was performed on 61 obese non-diabetic patients who underwent LSG. All patients were followed up postoperatively at 12 months with the assessment of arterial blood pressure, microalbuminuria, urinary and serum levels of inflammatory cytokines (macrophage migration inhibitory factor “MIF,” monocyte chemotactic protein “MCP”-1, chemokine (C-C motif) ligand 15 (CCL-15), and CCL-18), in addition to serum creatinine, total cholesterol, and C-reactive protein (CRP).Results: Mean BMI showed decreased substantially from 44.78 ± 3.59 Kg/m2 to 34.56 ± 2.45. Systolic blood pressure decreased from 147.03 ± 16.89 mmHg to 128.82 ± 12.52 and diastolic blood pressure decreased from 90.51 ± 12.71 mmHg to 79.69 ± 10.39. At one-year of follow-up, there was statistically significant decrease of mean serum creatinine, total cholesterol, CRP, CCL-15, CCL-18, MIF/creatinine ratio, MCP-1/creatinine ratio, CCL-15/creatinine ratio, and CCL-18/creatinine ratio (P value < 0.001).Conclusion: Improvement of systemic and renal inflammatory states after LSG may positively affect obesity-related renal disease by steering the adipokine levels towards anti-inflammatory profiles.Keywords: laparoscopic sleeve gastrectomy, urinary cytokines