Pancreas volume reduction and metabolic effects in Japanese patients with severe obesity following laparoscopic sleeve gastrectomy.
This study aimed to assess the relationship between the metabolic effect after laparoscopic sleeve gastrectomy (LSG) in morbidly obese Japanese patients, with or without type 2 diabetes mellitus (T2DM), and improved pancreatic steatosis (PS). The study enrolled 27 morbidly obese Japanese patients who were undergoing LSG. Their clinical and metabolic effects were evaluated at baseline and six months after LSG. Pancreas volume (PV), pancreatic attenuation (PA), and splenic attenuation (SA) were measured using a 64-row computed tomography (CT). Changes in PV, PA-SA, and PA/SA were evaluated. The mean body-weight loss, body mass index loss, and percentage of excess weight loss (%EWL) were -34.4 kg (p < 0.001), -11.0 kg/m2(p < 0.001), and 43.7%, respectively. The mean PV was 96.7 mL at baseline, and it decreased six months after LSG (-16.3mL, p < 0.001). The mean PA significantly increased six months after LSG (9.5 HU, p < 0.001). PA-SA (-23.2 HU vs. -13.3 HU, p = 0.003), and PA/SA (0.54 vs. 0.73, p < 0.001) also significantly increased six months after LSG. In T2DM patients, decreased PV correlated with decreased fasting blood sugar, decreased insulin, and reduced liver volume. In conclusion, PV significantly decreased after LSG in morbidly obese Japanese patients, and that decrease correlated with improvements in PS. In addition, PS plays an important role of development and progression of insulin resistance and T2DM.
Department of Surgery, Iwate Medical University, Morioka 020-8505, Japan.
Akira
A
Umemura
Department of Surgery, Iwate Medical University, Morioka 020-8505, Japan.
Akira
A
Sasaki
Department of Surgery, Iwate Medical University, Morioka 020-8505, Japan.
Hiroyuki
H
Nitta
Department of Surgery, Iwate Medical University, Morioka 020-8505, Japan.
Shigeaki
S
Baba
Department of Surgery, Iwate Medical University, Morioka 020-8505, Japan.
Taro
T
Ando
Department of Internal Medicine, Division of Diabetes and Metabolism, Iwate Medical University, Morioka 020-8505, Japan.
Takashi
T
Kajiwara
Department of Internal Medicine, Division of Diabetes and Metabolism, Iwate Medical University, Morioka 020-8505, Japan.
Yasushi
Y
Ishigaki
D052242:Adiponectin / Q000097:blood; D000328:Adult; D001786:Blood Glucose; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan; D020738:Leptin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D009929:Organ Size / Q000502:physiology; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D008055:Lipids
Ectopic fat; Laparoscopic sleeve gastrectomy; Pancreas volume; Type 2 diabetes mellitus