Bariatric surgery and calcifediol treatment, Gordian knot of severe-obesity-related comorbidities treatment

Front Endocrinol (Lausanne). 2023 Oct 6:14:1243906. doi: 10.3389/fendo.2023.1243906. eCollection 2023.

Abstract

Background: Obesity (OB) is a chronic metabolic disease with important associated comorbidities and mortality. Vitamin D supplementation is frequently administered after bariatric surgery (BS), so as to reduce OB-related complications, maybe including chronic inflammation.

Aim: This study aimed to explore relations between vitamin D metabolites and components of the inflammasome machinery in OB before and after BS and their relations with the improvement of metabolic comorbidities.

Patients and methods: Epidemiological/clinical/anthropometric/biochemical evaluation was performed in patients with OB at baseline and 6 months after BS. Evaluation of i) vitamin-D metabolites in plasma and ii) components of the inflammasome machinery and inflammatory-associated factors [NOD-like-receptors (NLRs), inflammasome-activation-components, cytokines and inflammation/apoptosis-related components, and cell-cycle and DNA-damage regulators] in peripheral blood mononuclear cells (PBMCs) was performed at baseline and 6 months after BS. Clinical and molecular correlations/associations were analyzed.

Results: Significant correlations between vitamin D metabolites and inflammasome-machinery components were observed at baseline, and these correlations were significantly reduced 6 months after BS in parallel to a decrease in inflammation markers, fat mass, and body weight. Treatment with calcifediol remarkably increased 25OHD levels, despite 24,25(OH)2D3 remained stable after BS. Several inflammasome-machinery components were associated with improvement in metabolic comorbidities, especially hypertension and dyslipidemia.

Conclusion: The beneficial effects of vitamin D on OB-related comorbidities after BS patients are associated with significant changes in the molecular expression of key inflammasome-machinery components. The expression profile of these inflammasome components can be dynamically modulated in PBMCs after BS and vitamin D supplementation, suggesting that this profile could likely serve as a sensor and early predictor of the reversal of OB-related complications after BS.

Keywords: bariatric surgery; comorbidities; inflammasome; obesity; vitamin D.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bariatric Surgery*
  • Calcifediol
  • Humans
  • Inflammasomes
  • Inflammation
  • Leukocytes, Mononuclear
  • Obesity / complications
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Vitamin D

Substances

  • Calcifediol
  • Inflammasomes
  • Vitamin D

Grants and funding

This work was funded by Junta de Andalucía (PI-0038-2019, BIO-0139), Instituto de Salud Carlos III, co-funded by European Union (ERDF/ESF, “Investing in your future”: ISCIII-AES-2019/002525; JR/00050), FEIOMM Translational Research Grant (2019), and CIBERobn. CIBER is an initiative of Instituto de Salud Carlos III, Ministerio de Sanidad, Servicios Sociales e Igualdad, Spain.