胃隔間手術和血中生化指標相關性
Comparison with Biochemical Markers after Swedish adjustable
gastric band Operation
中文摘要 生活水準的提昇，生活壓力加上缺乏運動，使得肥胖人口不斷增加，病態性的肥 胖（BMI≧40 Kg/m2）增加人們生病和死亡的危險性也是造成許多疾病的危險因 子。(如：心臟血管疾病和營養代謝失調)。當無法以物理性減肥方式達到目的(如： 運動、飲食營養控制、藥物治療等)，外科胃隔間手術經常被用來達到減肥的最 終方法。此外，肥胖是脂肪細胞和控制食慾、維持身體能量平衡的蛋白（leptin） 經由一連串複雜的訊號傳遞造成身體能量失調的結果。在本實驗中，我們收集 16 位接受胃隔間手術的肥胖者和 10 位對照組，比較手術前後肥胖者體內 leptin 和 high sensitivity C-Reactive Protein (HS-CRP)的變化情形。手術前血中 leptin 濃 度（67.22±8.58）和手術後（20.33±5.28）比較明顯高出許多，BMI 下降的程度 （-35.64%）和 leptin 以及 HS-CRP 濃度下降也有相關性。HS-CRP 濃度大幅下 降的結果也說明胃隔間手術改善這些病人的健康情形。進一步我們也比較胃隔間 手術前後肝功能項目、腎功能項目、脂質檢測、心臟相關酵素活性和血糖。發現 肝功能、腎功能項目並沒有明顯的改變。但是胃隔間手術後明顯改善心臟相關酵 素、UA 和血糖的情況。我們也觀察到 TG 大幅度下降 50%。綜合以上的結論， leptin 應該是脂肪組織的指示劑。胃隔間手術不僅可以降低血中 leptin 濃度也可 以改善血中 UA、血糖和 TG 濃度。 英文摘要
Morbid obesity （BMI≧40 Kg/m2）is associated with increased risk of morbidity and mortality from chronic health conditions including cardiovascular diseases and
metabolic disorders. Swedish adjustable gastric band operation（SAGB）has been used to treat morbid obesity when conventional physical therapy including exercise, diet and medication fails to reduce the body weight of the patients. However, obesity is a consequence of positive energy balance which is controlled by a complex networks of signals originated from a number of tissues, including adipose tissue, leptin, a satiety hormone control appetite and energy balance of the body. In the present study, we examined serum leptin level and high sensitivity c-reactive protein （HS-CRP）before and one year after SAGB in sixteen morbid obese subjects and ten age-matched control. Average pre-operative serum leptin level was very high 67.22±8.58 as compare to 20.33±5.28 post-operatively, BMI decreased significantly （-35.64%） which was correlated with a decreased of serum leptin level, and dramatic decrease of HS-CRP. The improved postoperative HS-CRP suggested that SAGB improved that
general health conditions. To explore further, we examined the liver function tests （LFT）,renal function tests（RFT）,lipid profiles, cardiac enzyme activities and fasting glucose level before and after SAGB, which the LFT and RFT were not significantly changed, the cardiac enzymes, serum uric acid（UA） level, as well as fasting glucose level were significantly improved after SAGB. Consistently, there was a 50% reduction of serum triglyceride（TG）level one year after surgery. Taken together, serum leptin level may be predictive of the mass of adipose tissue. Reduction of body weight by SAGB not only reduce the serum the leptin level but also normalized serum UA, fasting glucose and TG levels which were abnormal before SAGB-induced active weight loss.
Keywords： Swedish adjustable gastric band operation, leptin, high sensitivity c-reactive protein, morbid obesity
