Alghamdi Hashim, Asiri Ashwag, Alzahrani Faris, Alamri Zainab, AbdelQadir Yossef Hassan, Shah Jaffer
Mnistry of Health, Abha Maternity and Children Hospital, Abha, Saudi Arabia.
Department of Child Health, College of Medicine, King Khaled University, Abha, Saudi Arabia.
Front Surg. 2022 Nov 23;9:1056458. doi: 10.3389/fsurg.2022.1056458. eCollection 2022.
Despite the growing popularity of laparoscopic sleeve gastrectomy (SG) for managing severe obesity in children, adolescents, and adults, there is a paucity of studies reporting the effects of SG on metabolic and hormonal outcomes in pediatric populations.
In this single-centre, retrospective study, we assessed nutritional biomarkers (hemoglobin, ferritin, iron profile, Vitamin B12, Vitamin D, and calcium), glucose homeostasis indicators (C-peptide, HbA1C, and random blood glucose), blood lipids (triglycerides and cholesterol components), hormones involved in the hypothalamic-pituitary-adrenal axis (cortisol and adrenocorticotropic hormone), and thyroid hormones (T3, T4, thyroid-stimulating hormone, and parathyroid hormone) preoperatively and 12-month after SG in children aged 5-15 years.
This study included 64 adolescents (mean age = 11.2 ± 2.3 years) who underwent laparoscopic SG. Significant reduction in circulatory C-peptide (-62.1%; = 0.005), HbA1C (-10.9%; = 0.001), random blood glucose (-15.4%; = 0.036), and triglycerides (-39.4%; = 0.003) were observed postoperatively at 12 months compared to baseline. Although we did not observe any changes in cortisol levels, adrenocorticotropic hormone levels declined significantly by -40.9% postoperatively (= 0.033). However, cholesterol components, thyroid hormones, and nutritional biomarkers remained unchanged from baseline.
Consistent with prior literature, our study demonstrates improvement or resolution of diabetes and hypertriglyceridemia in the year following SG. However, given that blood cholesterol components, nutritional biomarkers, and thyroid profiles remained unchanged warrants long-term monitoring of nutritional, metabolic, and endocrine factors in adolescents undergoing laparoscopic SG. To the best of our knowledge, this is the first study reporting the effects of SG on thyroid and hypothalamic-pituitary-adrenal axis hormones in pediatric populations.
尽管腹腔镜袖状胃切除术（SG）在治疗儿童、青少年和成人重度肥胖方面越来越受欢迎，但关于SG对儿科人群代谢和激素结果影响的研究却很少。
在这项单中心回顾性研究中，我们评估了5至15岁儿童在术前和SG术后12个月时的营养生物标志物（血红蛋白、铁蛋白、铁指标、维生素B12、维生素D和钙）、葡萄糖稳态指标（C肽、糖化血红蛋白和随机血糖）、血脂（甘油三酯和胆固醇成分）、参与下丘脑 - 垂体 - 肾上腺轴的激素（皮质醇和促肾上腺皮质激素）以及甲状腺激素（T3、T4、促甲状腺激素和甲状旁腺激素）。
本研究纳入了64名接受腹腔镜SG的青少年（平均年龄 = 11.2 ± 2.3岁）。与基线相比，术后12个月时循环C肽（-62.1%；P = 0.005）、糖化血红蛋白（-10.9%；P = 0.001）、随机血糖（-15.4%；P = 0.036）和甘油三酯（-39.4%；P = 0.003）显著降低。尽管我们未观察到皮质醇水平有任何变化，但促肾上腺皮质激素水平术后显著下降了-40.9%（P = 0.033）。然而，胆固醇成分、甲状腺激素和营养生物标志物与基线相比保持不变。
与先前文献一致，我们的研究表明SG术后一年糖尿病和高甘油三酯血症有所改善或得到缓解。然而，鉴于血液胆固醇成分、营养生物标志物和甲状腺指标保持不变，有必要对接受腹腔镜SG的青少年的营养、代谢和内分泌因素进行长期监测。据我们所知，这是第一项报告SG对儿科人群甲状腺和下丘脑 - 垂体 - 肾上腺轴激素影响的研究。
