Weight loss from laparoscopic gastric bypass surgery is associated with the lengthening of telomeres for patients who were in adverse cardiometabolic states before surgery, suggesting that weight loss surgery may help slow the aging process in this subset of patients, according to a research letter published in JAMA Surgery.
Telomere shortening is negatively correlated with severe inflammation and oxidative stress. The goal of the current study was to compare the telomere length of patients (N = 51; mean age, 48.6 years [range 19.0-68.0]; 76% female) before and after surgical weight loss from laparoscopic gastric bypass surgery. Telomere length and key biochemical cardiac risk factors were evaluated before surgery and at 3, 6, and 12 months postsurgery. Proportional telomere length was determined using a quantitative polymerase chain reaction to create a ratio of telomere relative to single copy gene (T/S ratio).
At 12 months postsurgery, the mean reduction in body mass index was 12.2 kg/m2, with a 70.4% reduction in excess weight (P =.01) and significant improvements in cardiometabolic risk factors. Overall, telomere lengths before surgery were not statistically different at 12 months postsurgery (0.987 vs 0.982; P =.76), but when patients were separated into subsets by lipid and inflammatory markers, significant differences were seen. Participants with low-density lipoprotein cholesterol (LDL-C) levels >140 mg/dL before surgery showed significant lengthening of telomeres compared with participants with low levels of LDL-C before surgery (+0.0227 [abnormal LDL-C] vs -0.0271 [normal LDL-C]; P =.04).
Participants with high-sensitivity C-reactive protein [CRP] levels >7 mg/L, the preoperative mean CRP level for the cohort, also had significant telomere lengthening compared with participants with low CRP levels (+0.04125 [high CRP] vs -0.02294 [low CRP]; P =.005). In addition, patients with high CRP had a significant positive association between weight loss and length of telomeres (P =.0498) as well as change in high-density lipoprotein cholesterol level and length of telomeres (P =.02).
Study investigators concluded that despite the limitations of examining a single site intervention and a small study population, these results suggest “that the greatest potential benefit for slowing the aging process as expressed by telomere lengthening is in patients with the most comorbidity before surgery. Further study is needed with greater numbers and diversity of procedures.”
Morton JM, Garg T, Leva N. Association of laparoscopic gastric bypass surgery with telomere length in patients with obesity [published online December 19, 2018]. JAMA Surg. doi:10.1001/jamasurg.2018.4830