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Obesity Surgery

, Volume 27, Issue 8, pp 2005–2014 | Cite as

Effects of Weight Reduction After Sleeve Gastrectomy on Metabolic Variables in Saudi Obese Subjects in Aseer Province of Kingdom of Saudi Arabia

  • Mohammed A. Bawahab
  • Abdullah S. Assiri
  • Walid Abdel Maksoud
  • Ayyub Patel
  • Osama Kadoumi
  • Gaffar Sarwar Zaman
  • Riyad Mohammed Khalil Alessih
  • Syed Saleem HaiderEmail author
Original Contributions

Abstract

Objectives

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.

Materials and methods

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 T4 were analyzed by Siemens Immunoassay System.

Results

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.

Conclusions

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.

Keywords

Obesity Weight loss Sleeve gastrectomy Biochemical markers Oxidant stress-antioxidant enzymes 

Notes

Acknowledgements

We extend our sincerest thanks to the Directors of the Asser Central Hospital and Abha Private Hospital in Abha province of the Kingdom of Saudi Arabia and all the male and female study subjects who served as samples of this study for their cooperation.

Compliance with Ethical Standards

Funding

This work was supported by a grant from the Deanship of Scientific Research in King Khalid University (Grant no. KKU-MED-11-0090), Abha, Kingdom of Saudi Arabia.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

This research protocol was approved by the Ethics Committee on Human Research of King Khalid University, Abha, Kingdom of Saudi Arabia (Opinion REC# 2012-10-02/Project number KKU-MED-11-0090).

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Mohammed A. Bawahab
    • 1
  • Abdullah S. Assiri
    • 2
  • Walid Abdel Maksoud
    • 1
  • Ayyub Patel
    • 3
  • Osama Kadoumi
    • 3
  • Gaffar Sarwar Zaman
    • 4
  • Riyad Mohammed Khalil Alessih
    • 3
  • Syed Saleem Haider
    • 3
    Email author
  1. 1.Department of SurgeryCollege of Medicine, King Khalid UniversityAbhaKingdom of Saudi Arabia
  2. 2.Department of MedicineCollege of Medicine, King Khalid UniversityAbhaKingdom of Saudi Arabia
  3. 3.Department of Clinical Biochemistry, College of MedicineKing Khalid UniversityAbhaKingdom of Saudi Arabia
  4. 4.Department of Clinical Laboratory Sciences, College of Applied Medical SciencesKing Khalid UniversityAbhaKingdom of Saudi Arabia

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