Alshubrami Suad, Al-Regaiey Khalid, Alfadda Assim A, Iqbal Muhammad
Suad Alshubrami Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Current Address: Director of Academic and Training Affairs Continuous Professional, King Salman Specialist Hospital, Hail, Saudi Arabia.
Khalid Al-Regaiey Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Pak J Med Sci. 2020 Nov-Dec;36(7):1495-1499. doi: 10.12669/pjms.36.7.2329.
Bariatric surgery provides most substantial and sustainable weight loss measures in individuals with obesity. Caloric restriction is not only intervention, changes in hormonal secretions are also leading contributory mechanisms to reduce body weight and improve the glycaemic control. The aim of this study was to evaluate the impact of gastric sleeve surgery on plasma retinol binding protein 4 (RBP4) and adipsin levels among Saudi male obese population.
This prospective study was conducted in the Departments of Physiology and Surgery, College of Medicine, King Saud University. Thirty-three obese (BMI>38.3) male patients age ranged from 25 to 50 years were recruited. RBP4 and adipsin levels were analyzed before and 6-12 months after gastric sleeve surgery by ELISA along with plasma glucose, insulin, HOMA-IR and lipid profile.
Circulating RBP4 levels were not significantly changed by bariatric surgery (4382.85±40.35 ng before, and 4393.28±33.13 ng after surgery, p=0.842), neither did adipsin (2949.68±46.86 pg before, and 2917.90±41.90 pg after surgery, p=0.535). Segregation of study participants into two age groups, 25-35 and 35-50 years of age, revealed that before surgery older age group (35-50) had higher RBP4 levels compared to younger group (25-35) (p=0.016). However, after surgery RBP4 levels were decreased in older group but not to a significant level (p=0.174). In younger age group after surgery, there was a near significant increase in RBP4 levels (p=0.052). There were no significant changes in RBP4 levels in both age groups after surgery (p=0.461). For adipsin, there were no significant differences before and after surgery in both age groups. Insulin, BMI and HOMA-IR index were decreased after surgery, however there was no correlation with RBP4 and adipsin levels.
The present study findings do not suggest a role for RBP4 and adipsin in the improvement of insulin sensitivity in Saudi male obese population after gastric sleeve surgery. However, a decrease in RBP4 levels in older individuals after surgery needs further investigations to understand its effect on weight and glycemic control.
减肥手术为肥胖个体提供了最有效且可持续的体重减轻措施。热量限制不仅是一种干预手段，激素分泌的变化也是减轻体重和改善血糖控制的主要促成机制。本研究的目的是评估胃袖状切除术对沙特男性肥胖人群血浆视黄醇结合蛋白4（RBP4）和脂联素水平的影响。
这项前瞻性研究在沙特国王大学医学院的生理学和外科进行。招募了33名年龄在25至50岁之间的肥胖男性患者（BMI>38.3）。通过酶联免疫吸附测定法（ELISA）在胃袖状切除术前以及术后6至12个月分析RBP4和脂联素水平，同时检测血浆葡萄糖、胰岛素、稳态模型评估胰岛素抵抗（HOMA-IR）和血脂谱。
减肥手术并未使循环RBP4水平发生显著变化（术前为4382.85±40.35纳克，术后为4393.28±33.13纳克，p = 0.842），脂联素水平也未显著变化（术前为2949.68±46.86皮克，术后为2917.90±41.90皮克，p = 0.535）。将研究参与者分为两个年龄组，25至35岁和35至50岁，结果显示术前年龄较大的组（35至50岁）的RBP4水平高于较年轻的组（25至35岁）（p = 0.016）。然而，术后年龄较大组的RBP4水平有所下降，但未达到显著水平（p = 0.174）。在较年轻年龄组术后，RBP4水平有近乎显著的升高（p = 0.052）。术后两个年龄组的RBP4水平均无显著变化（p = 0.461）。对于脂联素，两个年龄组术前和术后均无显著差异。术后胰岛素、BMI和HOMA-IR指数均下降，但与RBP4和脂联素水平无相关性。
本研究结果并不表明RBP4和脂联素在胃袖状切除术后沙特男性肥胖人群胰岛素敏感性改善中起作用。然而，术后老年个体RBP4水平的下降需要进一步研究以了解其对体重和血糖控制的影响。
