Study of urinary monocyte chemoattractant protein-1(MCP-1) level in severely obese patients before and after bariatric surgeries and its relation to renal function

Abstract

Background Bariatric surgery has been the most effective and permanent treatment for severe obesity and has resulted in significant improvement or reduction of comorbidities due to obesity. Obesity represents a serious and urgent global health problem. It has a tendency to aggravate multiple comorbidities, physiological abnormalities and immune impairments. In the long term, bariatric surgery protects against renal function decline in obese patients. The objectives of this study is to assess the level of renal inflammatory marker urinary monocyte chemoattractant protein -1(MCP-1), measure the urinary MCP-1 to urinary creatinine concentration ratio in severely obese patients before and after bariatric surgeries. To study if there any possible relation between the urinary MCP-1 levels and renal function before and after surgery. Materials and Methods This prospective study of 40 severely obese patients undergoing bariatric surgery were recruited in the study in the interval between October 2018 and July 2019. Evaluate the level of MCP-1, urinary creatinine, urinary albumin, glomerular filtration rate (GFR), body weight, BMI, C-reactive protein (CRP), serum albumin, blood pressure and lipid profile before and after three months of bariatric surgeries. Results The mean urinary level of MCP-1 preoperative was 105.19 ± 15.25 pg/ml (range between 75.41 and 131.67) and this level was decreased postoperatively to 74.20 ± 22.77 (range between 30.5 and 114.4) with high statistically significant difference (P < 0.001). While urinary MCP-1/creatinine ratio; the bariatric surgery significantly reduced the mean of urinary MCP-1/creatinine ratios from 2.08 ± 1.43 to 0.86 ± 0.51 (P < 0.001). Also, there were significant improvement of blood pressure, C-reactive protein, lipid profile and body mass index three months after bariatric surgery. Conclusion Urinary MCP-1 levels following bariatric surgery can be used as potential marker to the ongoing renal inflammatory process.