Salman A, Salman MA. Long-term adipocytokine changes after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: A comparative minireview. World J Transl Med 2026; 12(3): 124909 [DOI: 10.5528/wjtm.124909]
Corresponding Author of This Article
Ahmed Salman, FRACP, FRCP, Department of Internal Medicine, Kasr Alainy School of Medicine, 1 Al-Saray Street, Al-Manial, Cairo 11562, Egypt. awea844@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Salman A, Salman MA. Long-term adipocytokine changes after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: A comparative minireview. World J Transl Med 2026; 12(3): 124909 [DOI: 10.5528/wjtm.124909]
World J Transl Med. Sep 28, 2026; 12(3): 124909 Published online Sep 28, 2026. doi: 10.5528/wjtm.124909
Long-term adipocytokine changes after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: A comparative minireview
Ahmed Salman, Mohamed AbdAlla Salman
Ahmed Salman, Department of Internal Medicine, Kasr Alainy School of Medicine, Cairo 11562, Egypt
Mohamed AbdAlla Salman, Department of General Surgery, Kasralainy School of Medicine, Cairo 11562, Egypt
Author contributions: Salman A contributed to the study conception, literature review, manuscript drafting, and critical revision; Salman MA contributed to data interpretation and critical revision; and both authors approved the final version of the manuscript.
AI contribution statement: OpenAI Codex (GPT-6.5) was used for language editing, formatting, and organization of the revision. It was not used to generate research data. The authors reviewed and revised all AI-assisted text and take responsibility for the manuscript’s accuracy, originality, and integrity.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Ahmed Salman, FRACP, FRCP, Department of Internal Medicine, Kasr Alainy School of Medicine, 1 Al-Saray Street, Al-Manial, Cairo 11562, Egypt. awea844@gmail.com
Received: June 29, 2026 Revised: August 4, 2026 Accepted: August 17, 2026 Published online: September 28, 2026 Processing time: 69 Days and 13.5 Hours
Abstract
Bariatric surgery alters adipose tissue endocrine function; however, whether Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) produce different long-term adipokine profiles remains uncertain. This narrative mini-review summarizes head-to-head human evidence supported by mechanistic studies on leptin, adiponectin, resistin, and chemerin. Mid-term and long-term follow-up were defined as 6-12 months and ≥ 12 months, respectively. Both procedures consistently lower leptin levels and the best randomized evidence indicates comparable 12-month reductions when weight loss is similar. Furthermore, chemerin levels decreased after both surgeries, although comparative evidence is limited. Adiponectin increased after RYGB and LSG; several small cohort studies reported a greater increase after RYGB, whereas other studies found similar changes. However, evidence for the procedure-specific effects of resistin is sparse and inconsistent. Changes in adipokines correlate with insulin resistance and other metabolic risk markers; however, current studies have not established whether these biomarkers mediate durable diabetes remission, cardiovascular events, or liver outcomes. Baseline adiposity, diabetes status, postoperative weight loss, supplementation, assay methods, and study design preclude between-procedure comparisons. Adipokine measurements are, as yet, inadequate to guide procedure selection, and larger, longer, randomized studies with standardized assays are needed.
Core Tip: Direct comparisons indicate that Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy produce broadly similar long-term reductions in leptin and chemerin. Adiponectin increases after both procedures; a greater post-RYGB increase has been reported in some small cohorts but is not consistent across studies. Evidence for resistin is limited. Because postoperative weight loss, baseline diabetes, supplementation, and assay differences confound comparisons, current adipokine data cannot determine the preferred operation or predict individual outcomes. Larger randomized studies with standardized measurements and > 1-year follow-up are needed.
