Моdified biliopancreatic shunting in the treatment of metabolic syndrome and diabetes mellitus type II in patients with morbid obesity
Abstract
Objective. Studying of the impact of the biliopancreatic shunting (BPSH) operation on the metabolic syndrome (MS) course in patients with morbid obesity (MО).
Маterials and methods. The results of surgical treatment of 76 patients, suffering МО, to whom the BPSH operation was performed in the Institute, were analyzed. The patients, ageing 23 - 65 yrs old, have had the average body mass index (BMI) 57 (44 - 87) kg/m2. Аrterial hypertension have had 49 (64%), dyslipidemia - 53 (70%), the sleep apnea - 13 (17%), аsthma - 14 (18%), diabetes mellitus (DM) type II - 30 (39%) patients. The average time of follow-up have constituted 36 mo. Antropometric and clinical parameters, іndex of insulinresistence (НОМА -Нomeostasis Model Assessment), levels of insulin, glucose, С-peptide and cholesterol in 1, 3, 6 and 12 mo postoperatively were determined.
Results. In 3 mo after BPSH the average BMI have constituted 45.3 (34 - 59), in 6 mo - 36.1 (39 - 55), in 9 mo - 34.2 (33 - 42) kg/m2. Before the operation the НОМА index have constituted (7/6 ± 0/4) conventional units, the average level of a glycemia on an empty stomach - (7.8 ± 0.4) mmol/l, іnsulin - (21.2 ± 2.5) mcIU/ml, glycated hemoglobin (HbA1с) - (6.8 ± 0.3)%. In 36 mo after the operation the НОМА index, levels of glycemia on an empty stomach, of insulin on an empty stomach, С-peptide and HbA1с have had normalized. The levels of a general cholesterole and atherogenic lipids have been reduced gradually to normal values.
Conclusion. BPSH provides a long-standing and effective lowering of the body mass with correction of the MS components.
References
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