title: Effects of Weight Reduction After Sleeve Gastrectomy on Metabolic Variables in Saudi Obese Subjects in Aseer Province of Kingdom of Saudi Arabia.
abstract: The objectives of this study were to investigate the occurrence of oxidative stress, status of protective antioxidants enzymes, inflammatory biomarkers, and some metabolic health variables in the blood and to compare the results between those of the normal controls and obese patients submitted to sleeve gastrectomy-induced weight loss over a 1-year follow-up period.
  
  
  
  A prospective study was conducted in Aseer Central Hospital and Abha Private Hospital in the Kingdom of Saudi Arabia from January 2012 to January 2013 on 50 normal (BMI = 22-25 kg/m2) control subjects and 50 obese (BMI = 45-50 kg/m2) patients. A subset of 20 men and 80 women patients, aged 20-45 years, was included. The systemic blood cell counts were determined by Beckman Coulter UniCel analyzer. The occurrence of oxidative stress, the status of antioxidant enzyme system in the blood, levels of serum hepatic enzymes, cardiovascular risk factors, and serum sodium, potassium, copper, and zinc levels were determined by spectrophotometric procedures. The concentration of TSH and T4were analyzed by Siemens Immunoassay System.
  
  
  
  Group 1 (Obese: preoperative) This group compared with the normal controls exhibited significant (p < 0.05) increase in inflammatory biomarkers, a significant (p < 0.05) rise in hepatic enzymes, a significant (p < 0.05) decrease in serum total bilirubin. Concentration of serum total cholesterol (TC), triacylglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and fasting blood glucose(FBG) were significantly (p < 0.05) increased, but HDL cholesterol (HDL-C) was significantly depleted (p < 0.05). Serum urea and creatinine contents were significantly (p < 0.05) decreased. Serum copper and zinc levels were significantly (p < 0.05) increased. Group 2: Sleeve Gastrectomy Surgery (Obese: postoperative) This group compared with the obese group, preoperatively, demonstrated a profound reduction in body weight (-32%) as well as in BMI (-29%). Serum malondialdehyde, a stress index, was significantly (p < 0.001) inhibited and conversely, activities of antioxidant enzymes: superoxide dismutase(Cu-Zn SOD), glutathione peroxidase (GPx), glutathione-S-transferase (GST), glucose-6-phosphate dehydrogenase (G6PDH), and vitamin C, were remarkably (p < 0.001) increased. Furthermore, remarkable improvements in deranged metabolic variables approaching normality were discernible. Inflammatory biomarkers in the blood and hepatic enzymes in serum were significantly (p < 0.001) decreased. Levels of TC, TG, LDL-C, FBG, and HDL-C in serum exhibited significant (p < 0.05) reductions, a reversal toward normality. Serum albumin and total bilirubin concentrations were significantly increased (p < 0.001). Serum sodium, potassium, copper, zinc, and TSH levels were significantly (p < 0.001) decreased.
  
  
  
  Obesity is a chronic disease of multifactorial origin and resulted in perturbations of whole body metabolism in this study. It is thus likely that this imbalance was associated with an inhibition in protective antioxidants and occurrence of oxidative stress. The staging concept of sleeve gastrectomy is a safe and effective approach with remarkable efficacy in sustaining weight loss and bringing back normal metabolism of variables in tissues over a 1-year follow-up period.
authors.affiliation: Department of Surgery, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Bawahab
authors.affiliation: Department of Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Abdullah S
authors.initials: AS
authors.lastname: Assiri
authors.affiliation: Department of Surgery, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Walid Abdel
authors.initials: WA
authors.lastname: Maksoud
authors.affiliation: Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Ayyub
authors.initials: A
authors.lastname: Patel
authors.affiliation: Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Osama
authors.initials: O
authors.lastname: Kadoumi
authors.affiliation: Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Gaffar Sarwar
authors.initials: GS
authors.lastname: Zaman
authors.affiliation: Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.
authors.forename: Riyad Mohammed Khalil
authors.initials: RMK
authors.lastname: Alessih
authors.affiliation: Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia. syedsaleemhaider@gmail.com.
authors.forename: Syed Saleem
authors.initials: SS
authors.lastname: Haider
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery*; D018384:Oxidative Stress; D011446:Prospective Studies; D012307:Risk Factors; D012529:Saudi Arabia; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL
keywords: Biochemical markers; Obesity; Oxidant stress-antioxidant enzymes; Sleeve gastrectomy; Weight loss