Internal Medicine Clinic, Antalya Research and Education Hospital, Antalya, Turkey.
Endocrinology Clinic, SBU Antalya Research and Education Hospital, Antalya, Turkey.
Lipids Health Dis. 2018 Nov 24;17(1):269. doi: 10.1186/s12944-018-0917-z.
This study aimed to determine early postoperative changes of serum sphingomyelin (SM) and ceramide (CER) species following laparoscopic sleeve gastrectomy (LSG).
Twenty obese patients [mean body mass index (BMI) 45,64 ± 6,10 kg/m] underwent LSG and normal weight control patients (mean BMI 31,51 ± 6,21 kg/m) underwent laparoscopic cholecystectomy. Fasting blood samples were collected prior to surgery, at day 1 and day 30 after surgery. Circulating levels of C16-C24 SMs, C16-C24 CERs and sphingosine-1-phosphate (S1P) were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Serum activity of neutral sphingomyelinase (N-SMase) was assayed by standard kit methods, and ceramide-1-phosphate (C1P) levels were determined by enzyme-linked immunosorbent assay (ELISA). Lipid profile, routine biochemical and hormone parameters were assayed by standard kit methods. Insulin sensitivity was evaluated using homeostatic model assessment for insulin resistance (HOMA IR).
A significant decrease was observed in serum levels of very-long-chain C24 SM, very-long-chain C22-C24 CERs, HOMA-IR, N-SMase and C1P in LSG patients after postoperation day 1 and day 30 compared to preoperation levels. At 30 days postsurgery, BMI was reduced by 11%, fasting triglycerides were significantly decreased, and insulin sensitivity was increased compared to presurgery values. A significant positive correlation was found between HOMA-IR and serum levels of C22-C24 CERs in LSG patients.
We conclude that very long chain CERs may mediate improved insulin sensitivity after LSG.
本研究旨在确定腹腔镜袖状胃切除术（LSG）后血清神经酰胺（SM）和神经酰胺（CER）种类的早期术后变化。
20 例肥胖患者[平均体重指数（BMI）45.64±6.10kg/m]接受 LSG，正常体重对照组患者（平均 BMI 31.51±6.21kg/m）接受腹腔镜胆囊切除术。术前、术后第 1 天和第 30 天采集空腹血样。采用优化的多重反应监测（MRM）方法，结合超快速液相色谱（UFLC）串联质谱（MS/MS），测定循环中 C16-C24 SMs、C16-C24 CERs 和鞘氨醇-1-磷酸（S1P）的水平。采用标准试剂盒方法测定中性鞘氨醇酶（N-SMase）的血清活性，并用酶联免疫吸附试验（ELISA）测定神经酰胺-1-磷酸（C1P）水平。脂质谱、常规生化和激素参数采用标准试剂盒方法测定。采用稳态模型评估胰岛素抵抗（HOMA-IR）评估胰岛素敏感性。
与术前水平相比，LSG 患者术后第 1 天和第 30 天血清中非常长链 C24 SM、非常长链 C22-C24 CER、HOMA-IR、N-SMase 和 C1P 水平显著降低。术后 30 天，BMI 降低 11%，空腹甘油三酯显著降低，胰岛素敏感性较术前升高。LSG 患者的 HOMA-IR 与血清 C22-C24 CER 水平呈显著正相关。
我们的结论是，非常长链 CER 可能介导 LSG 后胰岛素敏感性的提高。
