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Some hormonal changes before and after vertical banded gastroplasty for severe obesity
Y I Yashkov1, L I Vinnitsky, M V Poroykova
1Department of Liver, Bile Ducts and Pancreatic Surgery, Russian Research Center of Surgery, Moscow.
Background:
Hormonal disturbances play a role in the development of obesity, but may be a consequence of obesity itself. In this study we assessed the influence of the surgically-induced weight loss on some important hormonal abnormalities in the morbidly obese patients.
Material And Methods:
Fasting serum prolactin, insulin, cortisol and thyroid hormones: free thyroxin (FT4), free triiodothyronine (FT3) and thyrotropin (TTH), have been studied by radioimmune methods before vertical banded gastroplasty (VBG) and after operation in the early (10-14 days) and late period when excess weight loss (EWL) 51.7-57.1% had been achieved.
Results:
On the 10-14 day after VBG, prolactin increased significantly in women (p<0.05), but decreased after weight loss (p<0.01). Fasting insulin was lowered significantly (p<0.05) soon after VBG in the hyperinsulinemic (51.7% of the total group) and diabetic (n-9) patients. After weight loss, insulin decreased significantly (p<0.0001) vs. preoperative. Concentration of cortisol was unchanged both in the early and in the late postoperative period. On the days 10-14, significant elevation of TTH and decrease of FT3 (p<0.05) have been noted. After essential weight loss TTH dropped significantly vs. preoperative (p<0.05) with no changes in FT3 and FT4 concentration.
Conclusions:
VBG and consequent weight loss favorably influence the hormonal abnormalities in the morbidly obese. Further studies are needed to make clear a relationship between this and other parameters of metabolic syndrome. The hormonal abnormalities may influence the indications for surgery in less than morbidly obese patients with metabolic syndrome.