Effects of sleeve gastrectomy on parameters of lipid and glucose metabolism in obese women - 6 months after operation.

Abstract

IntroductionSurgical intervention in obesity is today the most effective treatment method in high level obesity management with long-term clinical results and satisfaction of operated patients. Bariatric interventions not only ensure body weight reduction, but may influence lipid and saccharide metabolism as well.AimTo monitor the dynamics of changes in selected lipid and glucose metabolism parameters after laparoscopic sleeve gastrectomy (LSG) in obese women.Material and methodsDuring the period from September 2010 to June 2011, 35 women, operated on by sleeve gastrectomy, were monitored within a pilot open study. Parameters of lipid and glucose metabolism were measured, and body composition was evaluated, using dual X-ray absorptiometry (DXA). Laboratory parameters were assessed prior to LSG and at 3 and 6 months after the surgery.ResultsData of the 35 study subjects are presented. Average age was 41.9 years (27-68 years). Six months after LSG, body weight reduction was achieved from 117.7 ±17.1 kg to 91.2 ±17.2 kg (p < 0.001). The body mass index (BMI) dropped from 42.7 ±4.7 kg/m2 to 33.0 ±4.9 kg/m2 (p < 0.001). The excess weight loss (EWL) was 49.01%. High density lipoprotein (HDL) cholesterol increased from 1.29 mmol/l to 1.39 mmol/l (p < 0.025). Triacylglycerols dropped from 1.97 mmol/l to 1.31 mmol/l (p < 0.001). Glycated hemoglobin dropped from 4.03% to 3.59% (p < 0.001), and C-peptide decreased from 1703 pmol/l to 1209 pmol/l (p < 0.002). The observed changes of low density lipoprotein (LDL) cholesterol, total cholesterol or fasting glucose levels were not significant. Six months after LSG, both weight and BMI significantly decreased.ConclusionsSix months after the operation, glucose homeostasis was improved. Despite the rather short-term monitoring period, our study did confirm LSG to influence not only total weight loss and fat tissue reduction but to improve risk factors, mainly glucose homeostasis and dyslipidemia, as well.

Laparoscopic sleeve gastrectomy: a study of efficiency in treatment of metabolic syndrome components, comorbidities and influence on certain biochemical markers.

“…When focusing on particular MS components, results achieved in our observation lead to the conclusion that undergoing the LSG operation not only effectively treats existing NIDDM cases, but also enforces normalization of glucose metabolism parameters and prevents development of NIDDM by treating the insulin resistance phenomenon. This conclusion is also confirmed in other publications [28][29][30]. Observations of a positive clinical impact in treatment were made also in AH cases during our follow-up and are confirmed in other studies; therefore, bariatric procedures may be considered as a therapeutic solution also in this aspect of MS [31].…”

An Evaluation of Knowledge regarding Surgical Treatment of Obesity among Final Year Medical Students and Recent Graduate Physicians from King Abdulaziz University

“…Significant reduction of hypertension and the normalization of lipid disorders, which are, together with diabetes, criteria for the diagnosis of metabolic syndrome was observed after bariatric treatment. Consequently, results in a reduction of the risk of cardiovascular disease [13][14][15][16][17][18]. Thus , it gives bariatric surgeons a leading role in the treatment of morbidly obese patients.…”

The effect of laparoscopic sleeve gastrectomy on morbid obesity and obesity-related comorbidities: A cohort study

“…Poorly predigested food, which is directly transiting from the sleeve to the distal bowel, improves glucose metabolism by stimulating intestinal cells to secrete glucagon like peptide 1 (GLP 1) and/or other incretions. According to some other studies, insulin secretion is also improved following the improvement of the glucose tolerance (24). Basso speculates the gastric hypothesis on the LSG mechanism of action that decreased HCl production may innervate antrum to produce gastrin releasing peptide that is responsible for early phase secretion of GLP 1 (25).…”