Metabolic and bariatric surgery reduces aging biomarkers in patients with obesity, independently of achieving optimal total weight loss

TL;DR

Metabolic and bariatric surgery improves aging markers in obese patients, regardless of how much weight they lose.

Contribution

The study shows that aging biomarkers improve after surgery, independent of weight loss thresholds.

Findings

Both optimal and suboptimal weight loss groups showed significant improvements in telomere length and DNA damage.

Inflammatory markers like CRP, IL-6, and TNF-α decreased in both groups after surgery.

Only metabolic age showed greater improvement in the optimal weight loss group.

Abstract

Obesity, a chronic disease linked to premature aging, is increasingly managed through metabolic and bariatric surgery (MBS).

This study aimed to evaluate whether changes in biological age markers depended on the optimal weight loss rates resulting from MBS.

In this prospective, observational study, 100 patients with obesity scheduled for MBS from July 2020 to May 2021 underwent a 24-month postoperative follow-up. The telomere length (TL) was assessed using quantitative polymerase chain reaction. We also evaluated DNA damage, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) levels, total oxidant status (TOS), and the metabolic age. We checked whether the percentage of total body weight loss (%TWL) and the percentage excess weight loss (%EWL) correlated with the changes in aging markers postsurgery.

Forty patients completed follow-up, with 22 achieving optimal (%TWL ≥20%; %EWL ≥50%) and 18 suboptimal (%TWL <⁠20%; %EWL <⁠50%) surgical outcomes. Both groups showed a significant TL increase and a reduction of DNA damage, CRP, IL-6, and TNF-α levels, TOS, and the metabolic age. A greater change, however, was only observed for the metabolic age in the optimal outcome group. The Δ of change in the other aging markers did not differ between the groups.

Improvements in aging markers, such as TL, DNA damage, inflammatory parameters, and TOS occur independently of weight loss rates after MBS, suggesting that weight loss indices alone do not fully capture the therapeutic success of the procedure.

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