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腹腔镜可调节胃束带术和腹腔镜袖状胃切除术对体重减轻、血浆胃饥饿素、胰岛素、血糖和血脂的影响。

The influence of laparoscopic adjustable gastric banding and laparoscopic sleeve gastrectomy on weight loss, plasma ghrelin, insulin, glucose and lipids.

作者信息

Hady Hady Razak, Golaszewski Pawel, Zbucki Robert Lukasz, Dadan Jacek

机构信息

Ist Department of General and Endocrinological Surgery, Medical University of Bialystok, Poland.

出版信息

Folia Histochem Cytobiol. 2012 Jul 5;50(2):292-303. doi: 10.5603/fhc.2012.0039.

DOI:10.5603/fhc.2012.0039
PMID:22763970
Abstract

The aim of this study was to assess the impact of laparoscopic gastric banding and laparoscopic sleeve gastrectomy on the concentration of ghrelin, insulin, glucose, triglycerides, total and HDL-cholesterol, as well as AST and ALT levels in plasma in patients with obesity. The research includes 200 patients operated using LAGB (34 men average age 37.0 ± 12.6 years and 66 women average age 39.18 ± 12.17 years) and LSG (48 men average age 47.93 ± 9.24 years and 52 women, 19 ± 9.33 years). The percentage of effective weight loss, effective BMI loss, concentration of ghrelin, insulin, glucose, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, ALT, AST and HOMA IR values was taken preoperatively and at 7th day, 1 month, 3 and 6 months after surgery. Both after LSG and after LAGB, statistically significant reduction in BMI, serum insulin, glucose and HOMA IR was noticed in comparison to the preoperative values. Post LAGB, patients showed an increase of ghrelin, while LSG proved ghrelin decreased. Correlations between glucose and BMI loss, and between insulin and BMI loss in both cases are more favorable in the LSG group. Lipid parameters, AST and ALT have undergone declines or increases in the particular time points. Both techniques cause weight loss and this way lead to changes in the concentration of ghrelin, as well as to the improvement of insulin, glucose, cholesterol and triglycerides metabolism. They reduce metabolic syndrome and multiple comorbidities of obesity.

摘要

本研究旨在评估腹腔镜胃束带术和腹腔镜袖状胃切除术对肥胖患者血浆中胃饥饿素、胰岛素、葡萄糖、甘油三酯、总胆固醇和高密度脂蛋白胆固醇浓度,以及谷草转氨酶(AST)和谷丙转氨酶(ALT)水平的影响。该研究纳入了200例行腹腔镜胃束带术(LAGB)的患者(34名男性,平均年龄37.0±12.6岁;66名女性,平均年龄39.18±12.17岁)和行腹腔镜袖状胃切除术(LSG)的患者(48名男性,平均年龄47.93±9.24岁;52名女性,平均年龄49.19±9.33岁)。在术前以及术后第7天、1个月、3个月和6个月时,记录有效体重减轻百分比、有效体重指数(BMI)降低值、胃饥饿素、胰岛素、葡萄糖、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、ALT、AST和胰岛素抵抗指数(HOMA IR)值。与术前值相比,LSG和LAGB术后,BMI、血清胰岛素、葡萄糖和HOMA IR均有统计学意义的降低。LAGB术后,患者胃饥饿素升高,而LSG术后胃饥饿素降低。在这两种情况下,LSG组葡萄糖与BMI降低之间以及胰岛素与BMI降低之间的相关性更为有利。脂质参数、AST和ALT在特定时间点有所下降或升高。两种手术技术均能导致体重减轻,进而引起胃饥饿素浓度变化,以及胰岛素、葡萄糖、胆固醇和甘油三酯代谢的改善。它们可减轻代谢综合征及肥胖的多种合并症。

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