腹腔镜胃旁路术后血清瘦素、脂联素变化与胰岛素抵抗的关系

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Abstract Objective To investigate the relationships between expressions of serumadiponectin,leptin, and insulin resistance in T2DM patients with obesity following laparoscopic Roux-en-Y gastric bypass (LRYGB).Methods The clinical data on 52 cases of T2DM patients (BMI 28-35 kg/m2) treated with LRYGB between March 2011 and February 2012 was retrospectively analyzed. Levels of adiponectin, letptin, OGTT, HbA1c, triglycerides and cholesterol were detected before surgery and at 1, 3, 6, 12 months postoperatively during one year follow-up. Oral glucose tolerance test and insulin release test were also conducted.Results (1) During the follow-up, the cure rate of T2DM and obesity was 86.5% (45/52) and 67.3% (35/52)respectively. (2)Compared with the preoperative mean level(4.36±2.16) μg/ml, adiponectin decreased to(2.93±1.37) μg/ml within 3 months of follow-up, but increased gradually to[(7.36±3.70) μg/ml,P=0.028]till postoperative 12 months. (3) Leptin decreased gradually from base line(20.79±8.75 ng/ml) until 12 months after surgery [(5.06±2.46) ng/ml,P=0.005]. (4)Fasting blood glucose decreased gradually from base line(10.00±3.5) mmol/L until 12 months after surgery [(6.48±0.5) mmol/L,P=0.003]. Compared with the preoperative fasting insulin level (24.8±9.8) pmol/L, the level decreased to [(6.9±2.0) pmol/L,P=0.03] after 12 months. Compared with the preoperative HbA1c level (8.0%±1.5%), the level decreased to (6.5%±0.9%, P=0.002) after 12 months. Compared with the preoperative HOMA-IR level (10.25±5.01), there was a significant decrease after 12 months (2.64±0.98, P=0.003) (5)Preoperative TG was (3.50±1.46) mmol/L and decreased to [(1.14±0.38) mmol/L, P=0.03] in 12 months. Preoperative CH was (5.14±1.18) mmol/L and decreased to [(4.01±0.49) mmol/L, P=0.04] after 12 months.Conclusions The improvement of the pattern of cytokine production, as evidenced by postoperative rise in serum adiponectin and drop in leptin concentration, plays an important role in enhanced insulin resistance after LRYGB.

Key words： type 2 diabetes gastric bypass adiponectin leptin insulin resistance

Received: 10 January 2018

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	Articles by authors
	GUO Xiaobo
	HAN Hui
	MIAO Shan
	ZHANG Ye
	LIU Xinwei
	GAO Hongkai.

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GUO Xiaobo,HAN Hui,MIAO Shan等. Relationships between expressions of serum adiponectin,leptin, and insulin resistance in type 2 diabetes patients with obesity following laparoscopic gastric bypass[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(6): 615-618.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2018/V29/I6/615

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