Diker Dror, Vishne Tali, Maayan Rachel, Weizman Abraham, Vardi Pnina, Dreznik Zeev, Seror Dan, Ram Edward
Internal Medicine D, Rabin Medical Center, Campus Golda, Petach Tikva, Israel.
Obes Surg. 2006 Aug;16(8):1057-61. doi: 10.1381/096089206778026244.
Several endocrine abnormalities are reported in obesity. In an earlier study, we found that the changes in BMI following laparoscopic adjustable gastric banding (LAGB) were associated with changes in hormone profiles such as insulin and proinsulin. In the current study, we explored the changes in plasma adiponectin levels in morbidly obese subjects who lost abundant weight following LAGB.
23 adult morbidly obese patients (15 females), aged 21-56 years, were studied. Blood samples were collected before, and 6 and 14 months after LAGB. The plasma adiponectin levels were determined by commercial kit (B-Bridge International, Inc). Statistical analysis was based on one-way repeated measures ANOVA, followed by Student-Newman-Keuls post-hoc test. Regression model was used to look for predictors of adiponectin change after LAGB.
Mean BMI before surgery was 46.04+/-4.44 kg/m2, and decreased significantly by 18% 6 months after surgery to 37.67+/-4.47 kg/m2. BMI further decreased by 32% 14 months after surgery to a mean of 31.30+/-4.65 kg/m2 (P=.000). The mean adiponectin level before surgery was 3997+/-1766 microg/ml, and increased significantly by 16% to 4763+/-1776 microg/ml 6 months after surgery, and to 6336+/-3292 microg/ml (37%) 14 months after surgery. Although BMI persistently decreased, while adiponectin persistently increased, BMI did not correlate with adiponectin.
In morbidly obese patients who underwent LAGB, adiponectin levels persistently increased, probably due to the reduction of visceral fat mass. Adiponectin plasma increase was correlated with proinsulin levels prior to the surgery. The interaction between adiponectin, proinsulin and BMI change in morbid obesity merits further investigation.
肥胖症患者存在多种内分泌异常情况。在早期一项研究中，我们发现腹腔镜可调节胃束带术（LAGB）后体重指数（BMI）的变化与胰岛素和胰岛素原等激素水平的变化有关。在本研究中，我们探讨了接受LAGB后体重显著减轻的病态肥胖受试者血浆脂联素水平的变化。
研究对象为23例年龄在21至56岁之间的成年病态肥胖患者（15例女性）。在LAGB术前、术后6个月和14个月采集血样。采用商业试剂盒（B - Bridge International, Inc）测定血浆脂联素水平。统计分析基于单向重复测量方差分析，随后进行Student - Newman - Keuls事后检验。使用回归模型寻找LAGB术后脂联素变化的预测因素。
术前平均BMI为46.04±4.44kg/m²，术后6个月显著下降18%，至37.67±4.47kg/m²。术后14个月BMI进一步下降32%，平均降至31.30±4.65kg/m²（P = 0.000）。术前平均脂联素水平为3997±1766μg/ml，术后6个月显著升高16%，至4763±1776μg/ml，术后14个月升至6336±3292μg/ml（升高37%）。尽管BMI持续下降，脂联素持续升高，但BMI与脂联素不相关。
接受LAGB的病态肥胖患者脂联素水平持续升高，可能是由于内脏脂肪量减少。术前血浆脂联素升高与胰岛素原水平相关。病态肥胖中脂联素、胰岛素原和BMI变化之间的相互作用值得进一步研究。
