The impact of metabolic bariatric surgery on biological markers of aging: a 2-year prospective observational study.
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BACKGROUND: Obesity-related proinflammatory mechanisms and genetic instability accelerate aging mechanisms. The effects of metabolic bariatric surgery (MBS) on premature aging remain unclear. OBJECTIVES: This study aimed to assess the impact of MBS on premature aging. SETTING: A prospective observational study was conducted in the university's reference department for bariatric surgery from July 2020 to May 2021. METHODS: The study included 100 participants qualified for laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass, aged 18-60 with a body mass index (BMI) >40 kg/m2 or >35 kg/m2 with obesity-related complications, excluding those with a history of bariatric surgery, pregnancy during follow-up, uncontrolled thyroid disorders, cognitive impairments, or relevant medication use. Forty participants were able to complete the study. Pre- and postoperative measurements of telo- 84 mere length (TL) determination using quantitative Polymerase Chain Reaction, DNA damage, C-reactive protein (CRP), interleukin 6 85 (IL-6), tumor necrosis factor alpha (TNFa), total oxidant status (TOS) were conducted. Cognitive function was assessed via the Color Trails Test (CTT), and body composition was analyzed using bioimpedance methodology in all participants. RESULTS: At the 2-year follow-up, a mean total weight loss (TWL) of 24.08% was achieved. TL increased significantly (4073.5 [1204.75] versus 9360 (2490) bp, P < .001), along with reductions in DNA damage (1424.16 [788.97] versus 707.27 [348,76] pg, P < .001), CRP (5.95 [1.09] versus 2.99 [2.3] mg/dl, P < .001), IL-6 (3.62 [2.71] versus 3 [1.51] pg/ml, P < .001), TNFa (24.4 [4.37] versus 10.69 [1.55] pg/ml, P < .001), TOS (228.5 [71.75] versus 191.5 [75.75] umol/L, P < .001). Cognitive function, assessed through CTT-1, showed improved performance in psychomotor abilities (CTT-1 46.95 [25.51] versus 55,85 [21.78] centile, P = .0098). Metabolic age index was significantly reduced ([83 (20.87] versus 62.5 [24.67] years, P < .001). CONCLUSIONS: MBS not only leads to weight reduction but also positively influences biological age markers. Investigating the reduction of premature aging as a consequence of bariatric surgery may be a valuable area of research.