Department of Endocrinology and Metabolism, School of Medicine, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China.
National Metabolic Management Center, Shanghai, China.
J Dermatol. 2019 Apr;46(4):338-342. doi: 10.1111/1346-8138.14783. Epub 2019 Feb 6.
Bariatric surgery is an effective method for severe obesity and its related comorbidities. This study was performed to explore the alterations of sex hormones and inflammatory markers following laparoscopic sleeve gastrectomy (LSG) among obese Chinese men with acanthosis nigricans (AN). Sixty-five obese men who underwent LSG were enrolled, comprising simple obesity without AN (OB group, n = 20) and obesity with AN (AN group, n = 45). There were 31 healthy male controls with normal body mass index (BMI) included. Anthropometry data, inflammatory markers, sex hormones and metabolic parameters were compared preoperatively and 12 months post-operatively. At baseline, patients in the AN group were associated with more severe metabolic abnormalities than the OB and control groups. Twelve months after surgery, AN patients obtained significant improvement in skin condition and reduction in AN score. BMI, fasting insulin (FINS), and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), tumor necrosis factor-α (TNF-α) and total testosterone (TT) were significantly changed in both groups, while interleukin (IL)-6, IL-8 and C-reactive protein were changed significantly only in the AN group. Moreover, FINS, HOMA-IR, TT and IL-6 levels were changed more in the AN group than those in the OB group. Multivariate regression analysis revealed that TT increase correlated significantly with reduction in FINS and HOMA-IR in both groups, but correlated with changes in IL-6 only in the AN group. In conclusion, LSG is effective in improving the skin condition of obese men with AN. The increased TT in AN patients correlated with amelioration of inflammatory state in addition to insulin resistance after LSG.
减重手术是治疗严重肥胖及其相关合并症的有效方法。本研究旨在探讨腹腔镜袖状胃切除术(LSG)对伴有黑棘皮病(AN)的中国肥胖男性患者的性激素和炎症标志物的影响。共纳入 65 例接受 LSG 的肥胖男性患者,包括单纯肥胖无 AN(OB 组,n=20)和肥胖伴 AN(AN 组,n=45)。另纳入 31 例体质量指数(BMI)正常的健康男性作为对照组。比较三组患者术前及术后 12 个月的人体测量学数据、炎症标志物、性激素及代谢参数。基线时,与 OB 组和对照组相比,AN 组患者的代谢异常更为严重。术后 12 个月,AN 患者的皮肤状况显著改善,AN 评分降低。两组患者的 BMI、空腹胰岛素(FINS)、稳态模型评估的胰岛素抵抗指数(HOMA-IR)、肿瘤坏死因子-α(TNF-α)和总睾酮(TT)均显著改变,而仅 AN 组的白细胞介素(IL)-6、IL-8 和 C 反应蛋白发生显著改变。此外,与 OB 组相比,AN 组的 FINS、HOMA-IR、TT 和 IL-6 水平变化更为显著。多变量回归分析显示,两组患者 TT 升高与 FINS 和 HOMA-IR 降低显著相关,但仅在 AN 组与 IL-6 变化相关。总之,LSG 可有效改善伴有 AN 的肥胖男性的皮肤状况。AN 患者术后 TT 增加与胰岛素抵抗和炎症状态的改善有关。