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
