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Review

MicroRNAs and Bariatric/Metabolic Surgery: Biomarkers, Mediators of Metabolic Remission, or Both?

by
Antonina Gerganova-Sirakova
1,2,*,
Konstantin Grozdev
3,4,
Antoaneta Gateva
1,2,
Radka Kaneva
5,
Iveta Nedeva
6,
Yavor Assyov
1,2,
Vera Karamfilova
1,2,
Tsvetan Gatev
1,2,
Darina Kachakova-Yordanova
5,
Veronika Petkova
5,
Radosveta Bozhilova
5,
Silva Kyurkchiyan
5,
Kristina Sirakova
7,8 and
Zdravko Kamenov
1,2
1
Department of Internal Medicine, Medical Faculty, Medical University–Sofia, 1, Georgi Sofiyski Street, 1431 Sofia, Bulgaria
2
Clinic of Endocrinology, University Hospital “Alexandrovska”, 1431 Sofia, Bulgaria
3
Department of Surgery, General Hospital “St. Sofia”, 1618, Sofia, Bulgaria
4
University Specialized Hospital for Active Treatment in Endocrinology “Acad. Ivan Penchev”, 1431 Sofia, Bulgaria
5
Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical Faculty, Medical University–Sofia, 1431 Sofia, Bulgaria
6
Department of Epidemiology and Hygiene, Medical Faculty, Medical University–Sofia, 1431 Sofia, Bulgaria
7
Department of Radiology, University Hospital “Alexandrovska”, 1431 Sofia, Bulgaria
8
Department of Radiology, Medical Faculty, Medical University–Sofia, 1431 Sofia, Bulgaria
*
Author to whom correspondence should be addressed.
Obesities 2026, 6(4), 56; https://doi.org/10.3390/obesities6040056
Submission received: 16 June 2026 / Revised: 26 July 2026 / Accepted: 28 July 2026 / Published: 30 July 2026
Review Reports Versions Notes

Abstract

Purpose of Review: Obesity is a growing global health challenge, with severe obesity projected to affect up to 25% of individuals with obesity by 2030. Bariatric surgery remains the most effective treatment, yet the molecular mechanisms underlying its metabolic benefits are not fully understood. This review summarizes current evidence on the role of microRNAs in bariatric/metabolic surgery and evaluates their potential as biomarkers and therapeutic targets. Recent Findings: Bariatric surgery induces significant alterations in circulating and tissue-specific miRNA profiles, particularly those involved in glucose metabolism, inflammation, and adipose tissue remodeling. Among the most frequently reported candidates, miR-122, miR-221, miR-27a, miR-126, miR-144, miR-222, miR-223, miR-375, miR-92a, and miR-155 have been associated with weight loss, improved insulin sensitivity, and diabetes remission. Emerging data suggest that these miRNAs may act not only as biomarkers of metabolic recovery but also as regulators of insulin signaling, inflammatory pathways, and adipocyte function. Summary: Current evidence supports a role for miRNAs in the metabolic adaptations observed after bariatric surgery. Although further validation is required, miRNAs show promise as minimally invasive biomarkers for predicting and monitoring treatment response and may provide insight into the molecular mechanisms underlying obesity remission and improvement of obesity-related comorbidities.
Keywords: miRNA; microRNA; obesity; bariatric surgery; metabolic surgery; diabetes mellitus miRNA; microRNA; obesity; bariatric surgery; metabolic surgery; diabetes mellitus

Share and Cite

MDPI and ACS Style

Gerganova-Sirakova, A.; Grozdev, K.; Gateva, A.; Kaneva, R.; Nedeva, I.; Assyov, Y.; Karamfilova, V.; Gatev, T.; Kachakova-Yordanova, D.; Petkova, V.; et al. MicroRNAs and Bariatric/Metabolic Surgery: Biomarkers, Mediators of Metabolic Remission, or Both? Obesities 2026, 6, 56. https://doi.org/10.3390/obesities6040056

AMA Style

Gerganova-Sirakova A, Grozdev K, Gateva A, Kaneva R, Nedeva I, Assyov Y, Karamfilova V, Gatev T, Kachakova-Yordanova D, Petkova V, et al. MicroRNAs and Bariatric/Metabolic Surgery: Biomarkers, Mediators of Metabolic Remission, or Both? Obesities. 2026; 6(4):56. https://doi.org/10.3390/obesities6040056

Chicago/Turabian Style

Gerganova-Sirakova, Antonina, Konstantin Grozdev, Antoaneta Gateva, Radka Kaneva, Iveta Nedeva, Yavor Assyov, Vera Karamfilova, Tsvetan Gatev, Darina Kachakova-Yordanova, Veronika Petkova, and et al. 2026. "MicroRNAs and Bariatric/Metabolic Surgery: Biomarkers, Mediators of Metabolic Remission, or Both?" Obesities 6, no. 4: 56. https://doi.org/10.3390/obesities6040056

APA Style

Gerganova-Sirakova, A., Grozdev, K., Gateva, A., Kaneva, R., Nedeva, I., Assyov, Y., Karamfilova, V., Gatev, T., Kachakova-Yordanova, D., Petkova, V., Bozhilova, R., Kyurkchiyan, S., Sirakova, K., & Kamenov, Z. (2026). MicroRNAs and Bariatric/Metabolic Surgery: Biomarkers, Mediators of Metabolic Remission, or Both? Obesities, 6(4), 56. https://doi.org/10.3390/obesities6040056

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