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首页> 外文期刊>Surgical Endoscopy >Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 20-34.
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Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 20-34.

机译：腹腔镜治疗BMI 20-34的2型糖尿病患者后的激素评估。

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BACKGROUND: A group of patients with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 20-34 kg/m(2) were submitted to laparoscopic interposition of a segment of ileum into the proximal jejunum or into the proximal duodenum associated to a sleeve gastrectomy. The objective of this study is to evaluate the hormonal changes in the pre- and postoperative period. MATERIALS AND METHODS: Hormonal evaluation was done in 58 patients operated between April 2005 and July 2006. Mean age was 51.4 years (40-66 years). Mean BMI was 28.2 (20-34.8) kg/m(2). All patients had had the diagnosis of T2DM for at least 3 years. Mean duration of T2DM was 9.6 years (3-22 years). Two techniques were performed, consisting of different combinations of ileal interposition (II) associated to a sleeve gastrectomy (SG). The following hormones were assayed in the pre- and postoperative period (mean 16 months) at the baseline and following specific food stimulation (30, 60, 120 min): glucogen-like protein 1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), insulin, glucagon, C-peptide, amylin, cholecystokinin (CCK), pancreatic polypeptide (PPP), somatostatin, peptide YY (PYY), ghrelin, adiponectin, resistin, leptin, and interleukin-6 (IL-6). RESULTS: Thirty patients had II associated to sleeve gastrectomy (II-SG) and 28 had II with diverted sleeve gastrectomy (II-DSG). GLP1 exhibited an important rise following the two operations, especially after II-DSG (p < 0.001). GIP also exhibited an important rise, with both II-SG and II-DSG being equally effective (p < 0.001). Insulin and amylin showed a significant rise at 30 min. Glucagon decreased slightly. CCK measurements were very low after II-DSG. PPP was also slightly altered by the II-DSG. PYY showed an important increase with both operations (p < 0.001). Ghrelin showed a significant decrease following the two operations (p < 0.001). Somatostatin and IL-6 were not affected (p = 0.632). Both leptin and resistin blood levels decreased. Adiponectin showed a slight increase. Mean postoperative follow-up was 19.2 months. Both II-SG and II-DSG were effective in achieving adequate glycemic control (91.2%). CONCLUSIONS: There was a significant hormonal change following laparoscopic ileal interposition. These alterations may explain the promising good results associated to these operations for the treatment of T2DM in the nonmorbidly obese population.
机译：背景：一组2型糖尿病（T2DM）和体重指数（BMI）20-34 kg / m（2）的患者接受腹腔镜检查，将回肠段插入空肠近端或十二指肠近端进行袖式胃切除术。这项研究的目的是评估手术前后的荷尔蒙变化。材料与方法：2005年4月至2006年7月间，对58例手术患者进行了激素评估。平均年龄为51.4岁（40-66岁）。平均BMI为28.2（20-34.8）kg / m（2）。所有患者均诊断为T2DM至少3年。 T2DM的平均持续时间为9.6年（3-22年）。进行了两种技术，包括与套管胃切除术（SG）相关的回肠插入（II）的不同组合。在基线前后以及在特定的食物刺激（30、60、120分钟）之后，在手术前后（平均16个月）测定以下激素：糖原样蛋白1（GLP-1），葡萄糖依赖性促胰岛素肽（GIP），胰岛素，胰高血糖素，C肽，胰岛淀粉样多肽，胆囊收缩素（CCK），胰多肽（PPP），生长抑素，肽YY（PYY），生长素释放肽，脂联素，抵抗素，瘦素和白介素6（IL-6）。 。结果：30例II型伴有袖胃切除术的患者（II-SG）和28例伴有改行袖带胃切除术的患者（II-DSG）。在两次手术后，GLP1表现出重要的升高，尤其是在II-DSG之后（p <0.001）。 GIP也表现出重要的增长，II-SG和II-DSG均有效（p <0.001）。胰岛素和胰岛淀粉样多肽在30分钟时显着升高。胰高血糖素略有下降。 II-DSG后CCK测量值非常低。 II-DSG也对PPP进行了轻微更改。两种手术的PYY均显示出重要增加（p <0.001）。两次手术后，Ghrelin明显降低（p <0.001）。生长抑素和IL-6不受影响（p = 0.632）。瘦素和抵抗素的血液水平均下降。脂联素略有增加。术后平均随访19.2个月。 II-SG和II-DSG均可有效实现足够的血糖控制（91.2％）。结论：腹腔镜回肠插入后激素水平发生明显变化。这些改变可以解释与在无病肥胖人群中治疗T2DM的这些手术相关的有希望的良好结果。

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