PMID- 18830747
OWN - NLM
STAT- MEDLINE
DCOM- 20091006
LR  - 20221207
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 23
IP  - 8
DP  - 2009 Aug
TI  - Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus 
      patients with BMI 20-34.
PG  - 1724-32
LID - 10.1007/s00464-008-0168-6 [doi]
AB  - 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.
FAU - DePaula, Aureo Ludovico
AU  - DePaula AL
AD  - Gastrointestinal Surgery, Hospital de Especialidades, Goiania, Brazil. 
      adepaula@uol.com.br
FAU - Macedo, A L V
AU  - Macedo AL
FAU - Schraibman, V
AU  - Schraibman V
FAU - Mota, B R
AU  - Mota BR
FAU - Vencio, S
AU  - Vencio S
LA  - eng
PT  - Journal Article
DEP - 20081002
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Gastrointestinal Hormones)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (IL6 protein, human)
RN  - 0 (Interleukin-6)
RN  - 0 (Peptide Hormones)
SB  - IM
CIN - Surg Endosc. 2011 Feb;25(2):655-6. PMID: 20614137
MH  - Adult
MH  - Aged
MH  - Anastomosis, Surgical
MH  - Body Mass Index
MH  - Diabetes Mellitus, Type 2/blood/physiopathology/*surgery
MH  - Duodenum/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Gastrectomy/*methods
MH  - Gastrointestinal Hormones/*blood/metabolism
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Ileum/*surgery
MH  - Interleukin-6/blood/metabolism
MH  - Jejunum/*surgery
MH  - Laparoscopy/*methods
MH  - Male
MH  - Middle Aged
MH  - Overweight
MH  - Peptide Hormones/*blood/metabolism
MH  - Postoperative Period
EDAT- 2008/10/03 09:00
MHDA- 2009/10/07 06:00
CRDT- 2008/10/03 09:00
PHST- 2008/04/19 00:00 [received]
PHST- 2008/09/02 00:00 [accepted]
PHST- 2008/10/03 09:00 [pubmed]
PHST- 2009/10/07 06:00 [medline]
PHST- 2008/10/03 09:00 [entrez]
AID - 10.1007/s00464-008-0168-6 [doi]
PST - ppublish
SO  - Surg Endosc. 2009 Aug;23(8):1724-32. doi: 10.1007/s00464-008-0168-6. Epub 2008 
      Oct 2.