Ergun S, Ergun D D, Akinci O, Taskin H E, Simsek G, Taskin M, Uzun H
Department of General Surgery, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Department of Biophysics, Medicine Faculty, Istanbul Aydın University, Istanbul, Turkey.
J Visc Surg. 2022 Feb;159(1):31-38. doi: 10.1016/j.jviscsurg.2020.11.009. Epub 2020 Dec 7.
Obesity is an excessive increase in body fat mass and triggers chronic inflammation which causes increased fat accumulation in the visceral fat tissue. The aim of this study was to analyze serum zinc (Zn), Zn-alpha 2 glycoprotein (ZAG), peroxisome proliferator-activated receptor-γ (PPAR-γ) and nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB) levels in morbidly obese patients before and after laparoscopic sleeve gastrectomy (LSG) and determine the association between alteration in body mass index (BMI), the % Excess Weight Loss (% EWL) and the biochemical parameters.
Thirty healthy individuals as a control group and 30 morbidly obese patients who had undergone LSG were enrolled in this study. Routine anthropometric and laboratory biochemical parameters in venous blood samples of groups at baseline and 1 and 12 months after LSG were recorded.
Significant weight loss was achieved at 1 and 12 months after LSG. At baseline serum ZAG and PPAR-γ levels were lower, while NF-кB levels were higher in morbidly obese patients compared with the control group. Serum ZAG and PPAR-γ levels increased while NF-кB levels decreased 1 month and 12 months after LSG. Decreased %EWL was negatively correlated with changes in NF-кB, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), fasting plasma glucose and insulin at 12 months after LSG in morbidly obese patients. However, %EWL was positively correlated with changes in ZAG.
Obesity was associated with down-regulated serum ZAG and PPAR-γ levels while up-regulated serum NF-кB. Our findings suggest that LSG ameliorates upregulating PPAR-γ expression, thereby inhibiting NF-κB-mediated inflammation by weight loss.
肥胖是身体脂肪量的过度增加，并引发慢性炎症，导致内脏脂肪组织中脂肪堆积增加。本研究的目的是分析病态肥胖患者在腹腔镜袖状胃切除术（LSG）前后血清锌（Zn）、锌α2糖蛋白（ZAG）、过氧化物酶体增殖物激活受体γ（PPAR-γ）和活化B细胞核因子κB（NF-κB）水平，并确定体重指数（BMI）变化、超重减轻百分比（%EWL）与生化参数之间的关联。
本研究纳入30名健康个体作为对照组和30名接受LSG的病态肥胖患者。记录两组在基线、LSG后1个月和12个月时静脉血样本中的常规人体测量和实验室生化参数。
LSG后1个月和12个月体重显著减轻。与对照组相比，病态肥胖患者基线时血清ZAG和PPAR-γ水平较低，而NF-κB水平较高。LSG后1个月和12个月，血清ZAG和PPAR-γ水平升高，而NF-κB水平降低。病态肥胖患者术后12个月时，%EWL降低与NF-κB、胰岛素抵抗稳态模型评估（HOMA-IR）、空腹血糖和胰岛素的变化呈负相关。然而，%EWL与ZAG的变化呈正相关。
肥胖与血清ZAG和PPAR-γ水平下调以及血清NF-κB上调有关。我们的研究结果表明，LSG通过减轻体重改善PPAR-γ表达上调，从而抑制NF-κB介导的炎症。
