Analysis of the low invasive surgical treatment effect and dynamic state of adipose cell origin hormone of morbid obesity patients

在本研究中，病态肥胖患者（BMI>=35 k g/m2，伴有合并症）行腹腔镜袖状胃切除术（LSG），脂肪细胞因子如生长激素释放肽和瘦素的动态分析（重点）在代谢综合征症状的发展中发挥重要作用。此外，为了分析与肥胖症患者的发病相关的分子机制，对胰岛素抵抗相关基因的基因多态性和进行分离培养的内脏脂肪原代培养细胞中的脂肪细胞因子分泌能力进行了研究，还进行了超重相关基因的甲基化分析和使用mRNA的微阵列分析（第二点）。经LSG治疗后，即使高瘦素和脂联素的低脂联素的血液动力学也明显改善，与对照组相比，有显著性变化。瘦素和脂联素的动态变化在体内和体外均呈现相同的动态变化，提示它们可能是内脏脂肪细胞依赖性产生的。超重相关基因多态性接受UCP 1的部分AG型，LSG病例接受GG型。尽管UCP 1的AG患者的BMI有升高的趋势，但在术后体重减轻效果方面没有观察到差异。瘦素和脂联素在体内和体外的动态变化呈现相同的动态变化，均为内脏脂肪细胞依赖性产生。因此，在脂肪细胞因子产生谱从一开始就被高度设定的病态肥胖症中，与基因多态性无关，脂肪细胞因子产生谱可能下降，并且无论LSG的基因多态性如何，从一开始就能够预期个体的效果。

In this research, for morbid obesity patients (BMI>=35 k g/m2 with comorbidities) underwent laparoscopic sleeve gastrectomy (LSG), the dynamic state of adipocytokines such as ghrelin and leptin which play an important role in development of symptoms of metabolic syndrome is analyzed (primary point). Furthermore, the purpose of analyzing the molecular mechanism in connection with an obesity patient's morbidity formation, the adipocytokine secretion ability in the gene polymorphism of an insulin resistance related gene and thevisceral fat primary culture cell which carried out separation cultivation is examined.And methylation analysis of an overweight related gene and microarray analysis using mRNA are also conducted (secondary point). By the LSG group, even if high leptin and adiponectin the blood kinetics of low adiponectin were clea r and compared with the control group, it was a significant change. The dynamic state of leptin and adiponectin showed the same dynamic state by in vivo and in vitro, and a possibility that these were produced by visceral fat cell dependence was suggested. Overweight related gene polymorphism accepted some AG of UCP1, and GG types with the LSG case. Although the tendency for BMI to be high was seen in the patients withAG of UCP1, a difference was not observed in the postoperative weight loss effect. The dynamic state of leptin and adiponectin showed the same dynamic state by in vivo and in vitro, and these were produced by visceral fat cell dependence. Therefore, in the morbid obesity to which the adipocytokines production profile was set highly from the first, irrespective of gene polymorphism, an adipocytokines production profile may fall and an effect may be able to expect an individual from the first irrespective of gene pol ymorphism by LSG.