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Possible reasons of insufficient efficacy of laparoscopic gastric bypass in surgical treatment of metabolic syndrome

https://doi.org/10.24884/0042-4625-2017-176-5-43-49

Abstract

OBJECTIVE. The study assessed an efficacy of laparoscopic gastric bypass (LRGB) in correction of main components of metabolic syndrome (MS). The authors revealed the possible reasons of insufficient efficacy of operation. MATERIAL AND METHODS. Results of LRGB were estimated in 228 patients who underwent operation during 5 years. Index of body mass, % EBMIL, lipid spectrum, level of glycemia, content of leptin and ghrelin were considered. RESULTS. The high efficacy of operation influence on MS was found in young age groups. Other groups had lower efficacy of operation. The reason was in gastrointestinal tract reconstruction that resulted in decrease of body mass, regress of associated diseases, change of key hormones which regulated energy metabolism, homeostasis of glucose and lipids. The ghrelin level didn’t have a determining value and didn’t influence on decrease of MT after operation. CONCLUSIONS. The operation effectively influenced on all possible components of MS, but the ghrelin content wasn’t determinative for long-term regulation of body mass loss and reduced the efficacy of operation.

About the Authors

M. B. Fishman
I. P.Pavlov First St. Petersburg State Medical University
Russian Federation


V. Yan
I. P.Pavlov First St. Petersburg State Medical University
Russian Federation


D. A. Sokolova
I. P.Pavlov First St. Petersburg State Medical University
Russian Federation


References

1. ВОЗ. Информационный бюллетень № 311 от января 2015 г. Источник: http://www.who.int/mediacentre/factsheets/fs311/ru.

2. Кроненберг Г. М., Меллмед Ш., Полонски К. С., Ларсен П. Р. Эндокринология по Вильямсу : Ожирение и нарушения липидного обмена : Пер. с англ. / Под ред. акад. РАН и РАМН И. И. Дедова, чл.-кор. РАМН Г. А. Мельниченко. М. : ГЭОТАР-Медиа, 2010. С. 80.

3. Buchwald H., Danette M., Oien. Metabolic/Bariatric surgery worldwide 2011 // Obesity Surgery. 2013. Vol. 23, (Issue 4). Р. 427-436.

4. Couce Marta E., Cottam D., Esplen J. et al. Is ghrelin the culprit for weight loss after gastric bypass surgery? A negative answer // Obes. Surg. 2006. Vol. 16. P. 870-878.

5. Cummings D. E., Weigle D. S., Frayo R. S. et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery // N. Engl. J. Med. 2002. № 346. Р. 1623-1630.

6. Faraj M., Havel P. J., Phelis S. et al. Plasma acylation-stimulating protein, adiponectin, leptin, and ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects // J. Clin. Endocrinol. Metab. 2003. Vol. 88. P. 1594-1602.

7. Fruhbeck G., Rotellar F., Hernandez-Lizoain J. L. et al. Fasting plasma ghrelin concentrations 6 months after gastric bypass are not determined by weight loss or changes in insulinemia // Obes. Surg. 2004. Vol. 14. P. 1208-1215.

8. Geloneze B., Tambascia M. A., Pilla V.F. et al. Ghrelin : a gutbrain hormone : effect of gastric bypass surgery // Obes. Surg. 2003. Vol. 13. P. 17-22.

9. Hanusch-Enserer, Cauza E., Brabant G., Dunky A. et al. Plasma ghrelin in obesity before and after weight loss after laparoscopical adjustable gastric banding // J. Clin. Endocrin. Metabolism. 2006. Vol. 89, № 7. P. 3352-3358.

10. Holdstock C., Engstrom B. E., Ohrvall M. et al. Ghrelin and adipose tissue regulatory peptides : effect of gastric bypass surgery in obese humans // J. Clin. Endocrinol. Metab. 2006. Vol. 88, № 7. P. 3177-3183.

11. Korner J., Bessler M., Cirilo L. J. et al. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, and insulin // J. Clin. Endocrinol. Metab. 2005. № 90. Р. 359-365.

12. Larsson H., Elmstahl S., Ahren B. Plasma leptin levels correlate to islet function independently of body fat in postmenopausal women // Diabetes. 1996. Vol. 45. Issue 11. P. 1580-1584.

13. Lee H. M., Wang G., Englander E. W. et al. Ghrelin, a new gastrointestinal endocrine peptide that stimulates insulin secretion : enteric distribution, ontogeny, influence of endocrine and dietary manipulations // Endocrinology. 2002. Vol. 143. P. 185-190.

14. McCowen K. C., Maykel J. A., Bistrian B. R. et al. Circulating ghrelin concentrations are lowered by intravenous glucose or hyperinsulinemic euglycemic conditions in rodents // J. Endocrinol. 2002. Vol. 175. P. 7-11.

15. Neovius M., Narbro K., Keating C. et al. Health care use during 20 years following bariatric surgery // JAMA. 2012. Vol. 308. Р. 1132-1141.

16. Rahmouni K., Haynes W.G., Morgan D. A., Mark A. L. Selective resistance to central neural administration of leptin in Agouti obese mice // Hypertension. 2002. Vol. 39. P. 486-490.

17. Reaven G. M. Banting lecture : role of insulin resistance in human disease // Diabetes. 1988. Vol. 37. P. 607-1595.

18. Ritter R. C. Gastrointestinal mechanisms of satiation for food // Physiol. Behav. 2004. Vol. 84. P. 237-249.

19. Stoeckli R., Chanda R., Langer I. et al. Changes of body weight and plasma ghrelin levels after gastric banding and gastric bypass // Obes. Res. 2004. Vol. 12. P. 346-350.

20. Tritos N. A., Mun E., Bertkau A. et al. Serum ghrelin levels in response to glucose load in obese subjects post-gastric bypass surgery // Obes. Res. 2003. Vol. 11. P. 919-924.


Review

For citations:


Fishman M.B., Yan V., Sokolova D.A. Possible reasons of insufficient efficacy of laparoscopic gastric bypass in surgical treatment of metabolic syndrome. Grekov's Bulletin of Surgery. 2017;176(5):43-49. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-5-43-49

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