袖状胃切除术、Roux-en-Y胃旁路术和单吻合口袖状回肠旁路术后患者的脂联素和瘦素水平。
Adiponectin and leptin levels of patients after sleeve gastrectomy, Roux-en-Y gastric bypass, and single anastomosis sleeve ileal bypass surgeries.
作者信息
Hosseini Seyed Vahid, Hosseini Seyed Ali, Khazraei Hajar, Lankarani Kamran B
机构信息
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
J Res Med Sci. 2023 May 29;28:42. doi: 10.4103/jrms.jrms_77_21. eCollection 2023.
BACKGROUND
Bariatric surgery is an appropriate treatment for obese patients with metabolic syndrome. Adipose tissue is an active endocrine tissue secreting leptin and adiponectin that affect body metabolism. Nowadays, a high incidence of metabolic syndrome with an increased risk of serious diseases has been detected in Shiraz. This study aimed to assess the levels of leptin and adiponectin as well as the adiponectin-to-leptin ratio in three different bariatric surgeries among obese patients in Shiraz. The results will play an important role in physicians' choice of surgery by distinguishing the effects of these three bariatric surgeries.
MATERIALS AND METHODS
The serum adiponectin and leptin levels were measured using enzyme-linked immunosorbent assay. Blood glucose, lipid profile, weight, and liver enzyme level were measured before and 7 months after surgery.
RESULTS
This clinical trial was conducted on 81 obese patients who underwent sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single anastomosis sleeve ileal (SASI) bypass surgeries. The results revealed a decrease in fasting blood sugar and triglyceride (TG) levels 7 months after the surgeries. In addition, decrease of body mass index (BMI) was more significantly in the SASI group (12.8 ± 3 4.95) compared to the Roux-en-Y gastric group (8.56 ± 4.61) ( = 0.026). Besides, a more significant improvement in liver function was observed in SG ( < 0.05). Furthermore, the results revealed a significant difference among the three groups regarding the increase in the adiponectin level ( = 0.039). Decrease in the leptin level and increase in the adiponectin level were more significant after the RYGB surgery compared to the SG group ( < 0.05).
CONCLUSION
The three bariatric surgeries were effective in increasing the adiponectin level and decreasing the leptin levels. The surgeries also changed the metabolic risk factors including TGs, high-density lipoprotein, fasting blood glucose, and BMI.
背景
减重手术是治疗肥胖合并代谢综合征患者的一种合适方法。脂肪组织是一种活跃的内分泌组织，可分泌影响身体代谢的瘦素和脂联素。如今，设拉子地区已检测到代谢综合征的高发病率以及严重疾病风险的增加。本研究旨在评估设拉子肥胖患者接受三种不同减重手术时的瘦素和脂联素水平以及脂联素与瘦素的比值。这些结果将通过区分这三种减重手术的效果，在医生选择手术方面发挥重要作用。
材料与方法
采用酶联免疫吸附测定法测量血清脂联素和瘦素水平。在手术前和术后7个月测量血糖、血脂、体重和肝酶水平。
结果
本临床试验对81例接受袖状胃切除术（SG）、Roux-en-Y胃旁路术（RYGB）和单吻合口袖状回肠（SASI）旁路手术的肥胖患者进行。结果显示，术后7个月空腹血糖和甘油三酯（TG）水平降低。此外，与Roux-en-Y胃组（8.56±4.61）相比，SASI组（12.8±3.495）的体重指数（BMI）下降更为显著（P = 0.026）。此外，SG组肝功能改善更为显著（P < 0.05）。此外，三组之间脂联素水平的升高存在显著差异（P = 0.039）。与SG组相比，RYGB手术后瘦素水平降低和脂联素水平升高更为显著（P < 0.05）。
结论
三种减重手术均能有效提高脂联素水平并降低瘦素水平。这些手术还改变了包括甘油三酯、高密度脂蛋白、空腹血糖和BMI在内的代谢危险因素。
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