Effects of Weight Reduction After Sleeve Gastrectomy on Metabolic Variables in Saudi Obese Subjects in Aseer Province of Kingdom of Saudi Arabia
Effects of Weight Reduction After Sleeve Gastrectomy on Metabolic Variables in Saudi Obese Subjects in Aseer Province of Kingdom of Saudi Arabia
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DOI：
10.1007/s11695-017-2579-8
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发表时间：
2017-08-01
期刊：
影响因子：
2.9
通讯作者：
Haider, Syed Saleem
中科院分区：
文献类型：
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作者：
Bawahab, Mohammed A.;Assiri, Abdullah S.;Haider, Syed Saleem
本研究的目的是调查氧化应激的发生，保护性抗氧化酶的状态，炎症生物标志物，以及血液中的一些代谢健康变量，并比较正常对照组和接受袖状胃切除术诱导的体重减轻的肥胖患者在1年随访期间的结果。2012年1月至2013年1月，在沙特阿拉伯王国的Aseer中心医院和Abha私立医院对50名正常人进行了一项前瞻性研究。（BMI = 22-25 kg/m2）对照组和50例肥胖（BMI = 45-50 kg/m2）患者。纳入了20例男性和80例女性患者的亚组，年龄为20-45岁。采用Beckman Coulter UniCel全自动血细胞分析仪测定外周血细胞计数。采用分光光度法测定氧化应激的发生、血液中抗氧化酶系统的状态、血清肝酶水平、心血管危险因素和血清钠、钾、铜和锌水平。第1组（肥胖组：术前）与正常对照组比较，炎症标志物显著升高（p < 0.05），肝酶显著升高（p <0.05），血清总胆红素显著降低（p <0.05）。血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和空腹血糖（FBG）显著升高（p < 0.05），高密度脂蛋白胆固醇（HDL-C）显著降低（p < 0.05）。血清尿素和肌酐含量显著降低（P < 0.05）。血清铜、锌水平显著升高（P < 0.05）。第二组：袖状胃切除术（肥胖：术后）与术前肥胖组相比，该组显示体重（-32%）和BMI（-29%）显著降低。血清丙二醛（一种应激指标）被显著抑制（p < 0.001），而抗氧化酶：超氧化物歧化酶（Cu-Zn SOD）、谷胱甘肽过氧化物酶（GPx）、谷胱甘肽-S-转移酶（GST）、葡萄糖-6-磷酸脱氢酶（G6 PDH）和维生素C的活性则显著升高（p < 0.001）。此外，在接近正常的紊乱的代谢变量显着改善是明显的。血液中的炎性生物标志物和血清中的肝酶显著降低（p < 0.001）。血清中的TC、TG、LDL-C、FBG和HDL-C水平显示出显著降低（p < 0.05），向正常逆转。血清白蛋白和总胆红素浓度显著升高（P < 0.001）。血清钠、钾、铜、锌和TSH水平显著降低（p < 0.001）。肥胖是一种多因素引起的慢性疾病，导致全身代谢紊乱。因此，这种不平衡可能与保护性抗氧化剂的抑制和氧化应激的发生有关。袖状胃切除术的分期概念是一种安全有效的方法，在1年的随访期内，在维持体重减轻和恢复组织中变量的正常代谢方面具有显著疗效。
The objectives of this study were to investigate the occurrence of oxidative stress, status of protective antioxidants enzymes, inflammatory biomarkers, and some metabolic health variables in the blood and to compare the results between those of the normal controls and obese patients submitted to sleeve gastrectomy-induced weight loss over a 1-year follow-up period.A prospective study was conducted in Aseer Central Hospital and Abha Private Hospital in the Kingdom of Saudi Arabia from January 2012 to January 2013 on 50 normal (BMI = 22-25 kg/m(2)) control subjects and 50 obese (BMI = 45-50 kg/m(2)) patients. A subset of 20 men and 80 women patients, aged 20-45 years, was included. The systemic blood cell counts were determined by Beckman Coulter UniCel analyzer. The occurrence of oxidative stress, the status of antioxidant enzyme system in the blood, levels of serum hepatic enzymes, cardiovascular risk factors, and serum sodium, potassium, copper, and zinc levels were determined by spectrophotometric procedures. The concentration of TSH and T-4 were analyzed by Siemens Immunoassay System.Group 1 (Obese: preoperative) This group compared with the normal controls exhibited significant (p < 0.05) increase in inflammatory biomarkers, a significant (p < 0.05) rise in hepatic enzymes, a significant (p < 0.05) decrease in serum total bilirubin. Concentration of serum total cholesterol (TC), triacylglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and fasting blood glucose(FBG) were significantly (p < 0.05) increased, but HDL cholesterol (HDL-C) was significantly depleted (p < 0.05). Serum urea and creatinine contents were significantly (p < 0.05) decreased. Serum copper and zinc levels were significantly (p < 0.05) increased. Group 2: Sleeve Gastrectomy Surgery (Obese: postoperative) This group compared with the obese group, preoperatively, demonstrated a profound reduction in body weight (-32%) as well as in BMI (-29%). Serum malondialdehyde, a stress index, was significantly (p < 0.001) inhibited and conversely, activities of antioxidant enzymes: superoxide dismutase(Cu-Zn SOD), glutathione peroxidase (GPx), glutathione-S-transferase (GST), glucose-6-phosphate dehydrogenase (G6PDH), and vitamin C, were remarkably (p < 0.001) increased. Furthermore, remarkable improvements in deranged metabolic variables approaching normality were discernible. Inflammatory biomarkers in the blood and hepatic enzymes in serum were significantly (p < 0.001) decreased. Levels of TC, TG, LDL-C, FBG, and HDL-C in serum exhibited significant (p < 0.05) reductions, a reversal toward normality. Serum albumin and total bilirubin concentrations were significantly increased (p < 0.001). Serum sodium, potassium, copper, zinc, and TSH levels were significantly (p < 0.001) decreased.Obesity is a chronic disease of multifactorial origin and resulted in perturbations of whole body metabolism in this study. It is thus likely that this imbalance was associated with an inhibition in protective antioxidants and occurrence of oxidative stress. The staging concept of sleeve gastrectomy is a safe and effective approach with remarkable efficacy in sustaining weight loss and bringing back normal metabolism of variables in tissues over a 1-year follow-up period.