Age increases MCP‐1 level in association with bariatric surgery operating time and metabolic risk severity

OBJECTIVE: Assess the role of inflammation on operating time in younger vs. older bariatric surgery patients. METHODS: Fifty‐five younger (F: 46, Age: 34.9 ± 4.0 years, body mass index [BMI]: 48.2 ± 1.0 kg m(−2)) and 48 older (F: 34, Age: 57.0 ± 5.1 years, BMI: 46.8 ± 1.0 kg m(−2)) adults were studied prior to surgery. Blood pressure, glycaemic control (fasting glucose/insulin, HbA(1c)), lipids (high‐density lipoprotein and triglycerides) and inflammation (monocyte chemoattractant protein‐1 [MCP‐1]) were assessed. Metabolic risk severity z‐scores were calculated from clinical outcomes. Omental adipose biopsies were collected at surgery for MCP‐1 protein analysis. Operating time was used to characterize surgical difficulty. RESULTS: Older vs. younger adults had higher HbA(1c) (P = 0.03). There was no difference in BMI, lipids, metabolic risk severity or insulin between groups, but operating time was longer in older vs. younger individuals (P = 0.04). Circulating MCP‐1 was also elevated in older vs. younger adults (P = 0.04) independent of HbA(1c), although this was not explained by omental fat. Nevertheless, serum MCP‐1 was associated with increased metabolic risk severity (R = 0.27, P = 0.01). In addition, operating time was linked to HbA(1c) (R = 0.30, P = 0.01) and omental MCP‐1 protein (R = 0.31, P < 0.01). CONCLUSIONS: MCP‐1 is associated with longer operating time and increased metabolic risk severity in older bariatric patients independent of glycaemic control. Pre‐operative treatment of inflammation may be required to enhance surgery effectiveness.