**2.11 Biochemical and inflammatory markers**

Obesity, especially visceral obesity, is considered as a low-grade inflammatory disease. Serum concentrations of a number of inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) are elevated in overweight and obese individuals [40]. LSG improves the course of chronic diseases and the state of inflammation associated with obesity. Evidence showed improvements in systemic and urinary inflammatory markers with a significant decrease in interleukin-6 (IL-6), CRP, ferritin, and TNF-α [41]. These changes were also demonstrated in patients with T2DM, where there was significant improvement in inflammatory biomarkers including CRP (P = 0.003) and IL-6 at (P = 0.001) 6 months post LSG [42]. The reduction in inflammatory factors suggests that LSG may play a role in reducing the risk of T2DM and cardiovascular disease.
