Impact of laparoscopic sleeve gastrectomy on body mass index, ghrelin, insulin and lipid levels in 100 obese patients

Abstract

Introduction: A high percentage of patients benefit from bariatric procedures in terms of metabolic effect and substantial body mass reduction. These procedures improve glucose metabolism leading to the amelioration or complete resolution of type 2 diabetes, reduction of insulin resistance and alleviation of metabolic syndrome effects. Aim: To assess the impact of laparoscopic sleeve gastrectomy (LSG) on the plasma levels of ghrelin, insulin, glucose, triglycerides, total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) fractions as well as aspartate and alanine transaminases in patients with obesity. Material and methods: One hundred patients who underwent laparoscopic sleeve gastrectomy in our centre between 2005 and 2009 were included in the study. Among them were 48 males with an average age of 47.93 ±9.24 years and 52 females with an average age of 44.19 ±9.33 years. Percentage excess weight loss (%EWL), percentage excess body mass index (BMI) loss (%EBL), ghrelin, insulin, glucose, triglycerides, cholesterol, HDL, LDL, alanine transferase (ALT), and asparagine transferase (AST) were measured preoperatively and on the 7th day then 1, 3 and 6 months after the surgery. Results: Statistically significant reduction in postoperative BMI, plasma levels of glucose and insulin as well as the homeostatic model assessment insulin resistance (HOMA IR) score was noted in comparison to the preoperative values. The ghrelin levels decreased. Lipid profile, AST and ALT levels varied depending on the particular time points. Conclusions: Laparoscopic sleeve gastrectomy reduces body mass and leads to the decrease of concentration of ghrelin in plasma as well as to the improvement of metabolism of insulin, glucose, cholesterol and triglycerides. The above changes alleviated symptoms of metabolic syndrome and obesity related co-morbidities.