Visceral Adipose Tissue Loss and Insulin Resistance 6 Months after Laparoscopic Gastric Banding Surgery: A Preliminary Study
Visceral Adipose Tissue Loss and Insulin Resistance 6 Months after Laparoscopic Gastric Banding Surgery: A Preliminary Study
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DOI：
10.1007/s11695-008-9642-4
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发表时间：
2009-01-01
期刊：
影响因子：
2.9
通讯作者：
Phelps, David R.
中科院分区：
文献类型：
--
作者：
Carroll, Joan F.;Franks, Susan F.;Phelps, David R.
内脏脂肪组织（VAT）增加被认为是心血管和代谢疾病的危险因素。关于腹腔镜胃束带手术（LGBS）后VAT损失是否与风险因素减少有关的数据有限。本研究确定了风险标志物的改善，特别是胰岛素抵抗，是否与LGBS （T2）后6个月的VAT降低有关。34例LGBS患者和17例正常体重对照者进行了初始和T2检测。空腹静脉血样本用于评估葡萄糖、胰岛素、血红蛋白A（1c）、血脂、c反应蛋白（CRP）和激素谱。使用稳态模型评估（HOMA）指数估计胰岛素抵抗。使用CT技术测量VAT。数据分析采用重复测量方差分析和回归分析。T2时的结果显示，患者的体成分、HOMA和血红蛋白A（1c）均有显著改善。血浆肾素和瘦素活性降低，胃饥饿素和GLP-1升高。VAT的降低与胰岛素、HOMA和葡萄糖的降低显著相关。虽然高密度脂蛋白胆固醇、甘油三酯、CRP和载脂蛋白A1/B比值也有所改善，但VAT降低仅与载脂蛋白A1/B比值增加显著相关。这些数据表明，在LGBS后6个月，许多心血管和代谢风险指标都有显著改善。然而，增值税的减少与胰岛素抵抗的减少密切相关。体重减轻与胰岛素敏感性改善的标志物无关。
Increased visceral adipose tissue (VAT) is thought to be a risk factor for cardiovascular and metabolic diseases. There are only limited data on whether VAT loss after laparoscopic gastric banding surgery (LGBS) is related to risk factor reduction. This study determined whether improvements in risk markers, in particular insulin resistance, were related to VAT reduction at 6 months after LGBS (T2).Thirty-four LGBS patients and 17 normal weight controls underwent initial and T2 testing. Fasting venous blood samples were taken to evaluate glucose, insulin, hemoglobin A(1c), lipids, C-reactive protein (CRP), and hormone profiles. Insulin resistance was estimated using the homeostasis model assessment (HOMA) index. VAT was measured using CT techniques. Data were analyzed using repeated measures ANOVA and regression analysis.Results at T2 showed that patients had significant improvements in body composition, HOMA, and hemoglobin A(1c). There were also reductions in plasma renin activity and leptin, and increases in ghrelin and GLP-1. Reductions in VAT were significantly correlated with reductions in insulin, HOMA, and glucose. While high density lipoprotein cholesterol, triglycerides, CRP, and the apolipoprotein A1/B ratio were also improved, VAT reduction was significantly correlated only with an increased apolipoprotein A1/B ratio.These data indicate that 6 months after LGBS there were significant improvements in many cardiovascular and metabolic risk markers. However, VAT reduction was most strongly associated with reductions in insulin resistance. Body weight loss was not associated with markers of improved insulin sensitivity.