Preoperative Level of Leptin Can Be a Predictor of Glycemic Control for Patients with Diabetes Undergoing Bariatric Surg
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ORIGINAL CONTRIBUTIONS
Preoperative Level of Leptin Can Be a Predictor of Glycemic Control for Patients with Diabetes Undergoing Bariatric Surgery Luisa Ortiz Cabrera 1 & Eduardo Neubarth Trindade 1,2 & Carine Leite 3,4 Manoel Roberto Maciel Trindade 1,2,5
&
Everton Hiraiwa Abegg 5 &
Received: 5 May 2020 / Revised: 23 September 2020 / Accepted: 24 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Bariatric surgery is a first-line treatment for patients with obesity and diabetes. It is uncertain whether leptin has an influence on glycemia in the postoperative period. Methods A cohort study of thirty-eight individuals with obesity and diabetes who underwent laparoscopic Roux-en-Y gastric bypass was undertaken. The levels of leptin, glucose, and glycosylated hemoglobin were verified in the preoperative period and in the first and third postoperative months. Results The majority of patients were women (81.6%), and the mean age was 47.3 years (SD 8.8). The mean BMI was reduced by 17.75% (from 47.3 to 38.9 kg/m2) and the mean glycemia by 26.76%. Preoperative leptin had a moderate positive correlation with glucose level at the third month (Pearson r = 0.46, P = 0.02), but not with HbA1c. Patients with leptin above 27.34 ng/mL had a higher glucose level at the end of observation (101.9 versus 88.9, t test, P = 0.042). Conclusion The search for factors that influence diabetes control after bariatric surgery is of major importance in clinical practice. Our study reported a level of leptin that can predict the prognosis of glycemic control after the intervention. This finding still needs to be validated and confirmed in other populations. Keywords Leptin . Diabetes . Obesity . Bariatric surgery
Introduction Obesity is a major health concern mostly because it is an important risk factor for many metabolic diseases such as diabetes [1]. Bariatric surgery has emerged as a first-line treatment for the association of these two comorbidities. Individuals achieve diabetes remission in up to 80% of cases after the intervention [2]. There is evidence to indicate the
* Carine Leite
1
Post-Graduate Program on Surgery, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
2
Department of Surgery, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
3
Department of Gastroenterology, Moinhos de Vento Hospital, Porto Alegre, RS, Brazil
4
Porto Alegre, Brazil
5
School of Medicine, UFRGS, Porto Alegre, RS, Brazil
procedure even in patients with a body mass index (BMI) between 30 and 35 kg/m2 if diabetes is refractory to medical treatment [3]. Bariatric surgery also results in other metabolic changes such as a reduction in leptin levels [4] since it is produced mainly by adipose tissue [5]. Adipocytes synthesize this hormone according to their triglyceride stores, so the levels are proportional to total body fat mass [6]. Leptin has an anorexigenic function, mainly by acting on the hypothalamic feeding center. In this location promotes decreased expr
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