Effects Of Sleeve Gastrectomy On Oxidative Stress And Inflammatory Factors In Obese Type 2 Diabetes

Objective:To evaluate the clinical efficacy of sleeve gastrectomy in the treatment of obese type 2 diabetes patients,and to explore the correlation between it and fat oxidative stress and fat inflammatory mediators.Methods:A retrospective analysis was conducted of 46 obese patients who underwent laparoscopic sleeve gastrectomy（LSG）at the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2020 to June2022 and completed preoperative and postoperative follow-up visits for1,3,and 6 months,with complete blood samples retained.Among them,23 were obese patients with T2DM,and 23 were simple obese patients.Partialclinical data of the patients before and after surgery were collected and statistically analyzed,During the operation,the adipose tissue of the omentum at the lowest point of the abdominal midline was taken as a specimen,and subsequently HE staining was used for pathological observation;Serum lipid oxidative stress indicators（Nox-4,H₂O₂）,antioxidant protein（Mn SOD）,and adipose inflammatory factor indicators（MCP-1,IL-6,IL-1β,TNF-α）were measured by ELISA before and 1,3,and 6 months after surgery And analyze the correlation between postoperative time and changes in the above indicators.Results:Body weight,body mass index（BMI）,percentage of extra weight loss（EWL%）,percentage of total weight loss（TWL%）,fasting blood glucose（FPG）,glycosylated hemoglobin（Hb Alc）,total cholesterol（TC）,triglycerides（TG）,insulin resistance index（HOMA-IR）,and other indicators of patients in both groups improved significantly over time（P<0.05）,while fasting blood glucose（FPG）,glycosylated hemoglobin（Hb Alc）There was a statistically significant difference in total cholesterol（TC）among the groups（P<0.05）,while there was no statistically significant difference in the other indicators mentioned above（P>0.05）;There was no significant difference in weight loss between the two groups（P>0.05）;There was a statistical correlation between the improvement of blood glucose and the time change（P<0.05）;Nox-4,Mn SOD,MCP-1,IL-6,IL-1β,TNF-α,H₂O₂,There was a significant difference in expression levels between the two groups（P<0.01）;There was a statistical difference in expression levels with postoperative time（P<0.05）.There was no significant difference between the expression levels of Nox-4 and IL-6 and the postoperative time（P>0.05）.Conclusions:（1）LSG can effectively alleviate T2DM and dyslipidemia early after surgery;（2）Serum Nox-4,Mn SOD,MCP-1,IL-6,IL-1β,TNF-αin two groups of patients after sleeve gastrectomy The expression level of H₂O₂had statistically significant differences;6 months after surgery There was a statistical difference in the expression level of Mn SOD,MCP-1,IL-1β,TNF-α,H₂O₂compared to preoperative,and there was no statistical difference in the expression levels of Nox-4 and IL-6 after surgery compared to preoperative.Changes in the levels of oxidative stress and inflammatory factors in obese patients with T2DM may have a certain correlation with insulin resistance.