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Impacts of laparoscopic bariatric surgery on GLP-1 and Ghrelin level in patients with type 2 diabetes mellitus / 中华外科杂志
Chinese Journal of Surgery ; (12): 323-327, 2013.
Article in Chinese | WPRIM | ID: wpr-247844
ABSTRACT
<p><b>OBJECTIVES</b>To investigate the impacts of laparoscopic bariatric surgery on fasting glucagon-like peptide-1 (GLP-1) and Ghrelin level in patients with type 2 diabetes mellitus (T2DM), and the mechanism in surgical treatment of T2DM.</p><p><b>METHODS</b>From March 2010 to August 2011, 44 patients with T2DM underwent laparoscopic bariatric, including laparoscopic Roux-en-Y gastric bypass (LRYGB, n = 14), laparoscopic mini-gastric bypass (LMGB, n = 11), laparoscopic sleeve gastrectomy (LSG, n = 9) and laparoscopic adjustable gastric banding (LAGB, n = 10). The curative effects, changes of metabolism and gastrointestinal hormones were analyzed respectively.</p><p><b>RESULTS</b>Within 6 months after surgery, the clinical complete remission of T2DM was 11, 8, 6, 3 cases in LRYGB, LMGB, LSG, LAGB group respectively; the clinical partial remission was 3, 3, 2, 4 cases respectively. The inefficacy was 1, 3 patients in LSG and LAGB group respectively. The effects of surgery within 6 months postoperative among 4 groups were different (χ(2) = 8.162, P < 0.05). The levels of body mass index (F = 275.29) and homeostasis model assessment of insulin resistance (F = 40.09) of 4 groups were declined in 6 months postoperatively (P < 0.01). The extents of decrease were no significance among 4 groups. Compared to preoperative level, GLP-1 in LRYGB ((116 ± 33) vs. (66 ± 20) ng/L and LMGB group ((103 ± 22) vs. (65 ± 16) ng/L) was higher in the first month after surgery (F = 21.76 and 139.21, P < 0.05). The changes in LSG and LAGB group were no significance (P > 0.05). The level of Ghrelin in LRYGB, LMGB, LSG group at the first week after surgery were (208 ± 79), (275 ± 102) and (258 ± 91) ng/L respectively, and they were lower than preoperative (there were (398 ± 114), (439 ± 96) and (446 ± 105) ng/L, F = 55.08, 49.96 and 46.47, all P < 0.01). But the level of Ghrelin in LRYGB and LMGB groups rebounded in the first postoperative month. The postoperative level of Ghrelin was higher in LAGB group (F = 29.24, P = 0.001).</p><p><b>CONCLUSIONS</b>There are difference efficacies and impacts on gastrointestinal hormones among different modes of bariatric surgery. The change of gastrointestinal hormones is plausible mechanism of T2DM remission after surgery.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Obesity, Morbid / Endoscopy, Gastrointestinal / Laparoscopy / Diabetes Mellitus, Type 2 / Glucagon-Like Peptide 1 / Ghrelin / Gastrectomy / Metabolism / Methods Limits: Adult / Female / Humans / Male Language: Chinese Journal: Chinese Journal of Surgery Year: 2013 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: General Surgery / Obesity, Morbid / Endoscopy, Gastrointestinal / Laparoscopy / Diabetes Mellitus, Type 2 / Glucagon-Like Peptide 1 / Ghrelin / Gastrectomy / Metabolism / Methods Limits: Adult / Female / Humans / Male Language: Chinese Journal: Chinese Journal of Surgery Year: 2013 Type: Article