Funding agencies: This study was funded by the Medical Research Foundation. MAH was supported by a MRC Senior Clinical Fellowship.
Mucosal biomarkers of colorectal cancer risk do not increase at 6 months following sleeve gastrectomy, unlike gastric bypass
Article first published online: 15 OCT 2013
© 2013 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS)
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Volume 22, Issue 1, pages 202–210, January 2014
How to Cite
Kant, P., Perry, S. L., Dexter, S. P., Race, A. D., Loadman, P. M. and Hull, M. A. (2014), Mucosal biomarkers of colorectal cancer risk do not increase at 6 months following sleeve gastrectomy, unlike gastric bypass. Obesity, 22: 202–210. doi: 10.1002/oby.20493
Disclosure: The Authors have no competing interests.
Author Contributions: PK, SPD, PML, and MAH conceived and carried out experiments. SLP and ADR performed experiments. All authors were involved in writing the paper and gave final approval of the submitted version.
- Issue published online: 11 JAN 2014
- Article first published online: 15 OCT 2013
- Accepted manuscript online: 27 APR 2013 02:06AM EST
- Manuscript Accepted: 5 APR 2013
- Manuscript Received: 15 JAN 2013
The hypothesis that sleeve gastrectomy (SG) is not associated with an increase in mucosal colorectal cancer (CRC) biomarkers, unlike Roux-en-Y gastric bypass (RYGB), was tested.
Design and Methods
Rectal mucosa, blood, and urine were obtained from morbidly obese patients (n = 23) before and after (median 28 months) SG, as well as from nonobese controls (n = 20). Rectal epithelial cell mitosis and apoptosis, crypt size/fission, and pro-inflammatory gene expression were measured, as well as systemic inflammatory biomarkers, including C-reactive protein (CRP).
The mean pre-operative body mass index in SG patients was 65.7 kg/m2 (24.7 kg/m2 in controls). Mean excess weight loss post-SG was 38.2%. There was a significant increase in mitosis frequency, crypt size, and crypt fission (all P < 0.01) in SG patients versus controls, as well as evidence of a chronic inflammatory state (raised CRP and mononuclear cell p65 NFκB binding), but there was no significant change in these biomarkers after SG, except CRP reduction. Macrophage migration inhibitory factor mRNA levels were increased by 39% post-SG (P = 0.038).
Mucosal biomarkers of CRC risk do not increase at 6 months following SG, unlike RYGB. Biomarkers of rectal crypt proliferation and systemic inflammation are increased in morbidly obese patients compared with controls.