Kim Eun Ran, Yun Ji Ho, Kim Hyo-Jin, Park Hyeon Young, Heo Yoonseok, Park Young Suk, Park Do Joong, Koo Soo Kyung
Division of Endocrine and Kidney Disease Research, Department of Chronic Disease Convergence, Korea National Institute of Health, Cheongju-si, Chungbuk, Republic of Korea.
Department of Surgery, School of Medicine, Inha University, Incheon, Republic of Korea.
Front Endocrinol (Lausanne). 2023 Jul 25;14:1171675. doi: 10.3389/fendo.2023.1171675. eCollection 2023.
Bariatric surgery (BS) has a superior effect on reducing body weight and fat in patients with morbid obesity. As a result, BS mitigates obesity-related complications such as type 2 diabetes (T2D). However, few studies have shown the mechanism underlying diabetes remission after surgery. This study aimed to investigate the differences in serum hormone and inflammatory cytokine levels related to diabetes before surgery and during 12 months of follow-up in Korean patients with obesity.
The study participants were patients with morbid obesity (n=63) who underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) between 2016 - 2017 at seven tertiary hospitals in Korea. The patients were followed for 1 year after surgery.
Sixty-three patients had significant weight loss after surgery and showed improvements in clinical parameters and hormonal and inflammatory profiles. Among them, 23 patients who were diabetic preoperatively showed different remission after surgery. The levels of inflammation-related clinical parameters changed significantly in the remission group, and serum inflammatory cytokine and hormones significantly decreased at certain points and showed an overall decreasing trend.
Our study found postoperative changes of factors in blood samples, and the changes in hormones secreted from the three major metabolic tissue (pancreas, adipose, and gut) along with the differences in multi-origin inflammatory cytokines between remission and non-remission groups provide a path for understanding how the effect of BS in improving glucose metabolism is mediated.
减重手术（BS）对病态肥胖患者的体重和脂肪减少具有显著效果。因此，BS可减轻肥胖相关并发症，如2型糖尿病（T2D）。然而，很少有研究揭示手术后糖尿病缓解的潜在机制。本研究旨在调查韩国肥胖患者术前及术后12个月随访期间与糖尿病相关的血清激素和炎性细胞因子水平的差异。
研究参与者为2016年至2017年期间在韩国七家三级医院接受袖状胃切除术（SG）或Roux-en-Y胃旁路术（RYGB）的病态肥胖患者（n = 63）。患者术后随访1年。
63例患者术后体重显著减轻，临床参数、激素和炎症指标均有所改善。其中，23例术前糖尿病患者术后出现不同程度的缓解。缓解组炎症相关临床参数水平显著变化，血清炎性细胞因子和激素在某些时间点显著下降，并呈总体下降趋势。
我们的研究发现了血样中各因素的术后变化，三大代谢组织（胰腺、脂肪和肠道）分泌的激素变化以及缓解组与未缓解组多源性炎性细胞因子的差异为理解BS改善糖代谢的作用机制提供了途径。
