Clinical And Laboratory Studies Of Laparoscopic Adjustable Gastric Banding On Metabolic Syndrome

Objectives①To evaluate the therapeutic effects of laparoscopic adjustable gastric banding(LAGB) -induced weight loss on metabolic syndrome.②To assess the correlations between the weight loss and serum levels of leptin,adiponectin, ghrelin and resistin,and to identify the potential predictors of the effects.Methods15 consecutive patients with MS(defined by IDF criteria 2005 ) underwent LAGB in our single center and took a subsequent six-month follow-up.The clinical data related to MS,ie,body weight,BMI,blood pressure and metabolic parameters of glucose,lipids were analyzed and the plasma levels of leptin, resistin,Ghrelin and adiponectin were determined before and 1,3 and 6 months postoperatively.The results were statistically analyzed using SPSS v11.5 for windows.ResultsAll operations were successful without conversions and deaths.The mean operative time was 71.34 minutes(range,41- 103).The mean blood loss was 13.5ml(range,5～40).The mean postoperative stay was 3.26 days(range,2～5).There were no major operative complications.1,3,6 months postoperatively,the weight loss was 3.48±1.73kg,9.65±3.69kg,18.32±5.10kg,and the EWL%were(9.53±4.58)%,(26.87±11.89)%,(51.48±16.54)%,respectively.Thus significant changes of the metabolic parameters were observed.These improvements resulted in a 93.3%resolution of the MS 6 months after LAGB.Meanwhile,the HOMA-IR dropped from 2.93±0.98 preopratively to 2.21±0.86 mU/L,1.86±0.82 mU/L,1.56±0.74mU/L after LAGB,showing a great improvement in insulin resistance.Following LAGB,the levels of leptin dropped significantly,whereas adiponectin increased significantly.Howerver,the levels of serum Ghrelin and resistin changed insignificantly.By multivariate regression analysis,the preoprative level of resistin correlated with the weight loss.Conclusions①LAGB is a minimal invasive,safe and effective procedure for metabolic syndrome.②Significant weight loss 6 months after LAGB can greatly improve all aspects of MS and result in a cure rate of 93.3%.③Insulin resistance improves significantly after LAGB and correlates with high adiponectin levels and low leptin levels.④The preoperative level of resistin may be a predictor of the extent of the weight loss after surgery.