Identificador: TDX:622
Autores: Sabench Pereferrer, Fàtima
Resumen:
Introduction: Bariatric surgery is the most effective treatment for patients who have morbid obesity and who comply with the criteria established to be eligible for treatment. Studies have shown that ghrelin is an important factor in regulating intake, and this has led to further studies into ghrelin levels and the various bariatric surgical techniques, because most grelin is synthesized in the gastric fundus. We should point out that sleeve gastrectomy involves the exeresis of almost the entire gastric fundus, which means that the ghrelin levels should theoretically be low after the intervention. Such good weight loss after sleeve gastrectomy may be partly due to the sudden decrease in ghrelin, which would clearly decrease intake. Sleeve gastrectomy and the metabolic implications of surgical intervention would be reflected in variations in the plasma levels of ghrelin, GLP-1, insulin and glycaemia, as well as changes in weight and calorie intake, which would depend on the physiopathological situations in which the surgical intervention takes place.These situations are: 1. Non-obese situations. 2. Exogenous obesity due to excessive calorie intake. 3. Genetically determined obesity. 4. Genetically determined obesity and type 2 diabetis mellitus.Aims: To analyse the effect of sleeve gastrectomy on weight for each experimental model. To analyse the effect of sleeve gastrectomy on intake volume for each experimental model and its relation to weight change. To analyse the effect of sleeve gastrectomy on glycaemia levels for each experimental model and its relation to weight change and intake volume. To analyse the effect of sleeve gastrectomy on levels of ghrelin, GLP-1 and plasma insulin for each experimental model.Methods: Sleeve gastrectomy in the various experimental models described. Model 2 has a control group that will not be intervened and they are only withdrawn from the cafeteria diet.Overall results/Conclusions: Sleeve gastrectomy affects metabolism and weight differently in non-obese rats (model 1) and rats with exogenous obesity (cafeteria diet model 2). While the non-obese group undergoes few changes during the first two weeks after the intervention, the weight of the exogenous obesity model normalises and all the endocrine-metabolic parameters studied are the same as those for non-obese rats. The only exception to this is GLP-1 which, as is well known, has an anorectic effect, and it remains high in the group of obese rats even though weight has normalised.Sleeve gastrectomy in genetically obese rats (model 3) has little effect on both calorie intake and weight. This is the only model in which weight increases after the intervention even though the intervention positions them below the theoretical weight for their age. It has also been observed that hyperinsulinism and hyperglycaemia tend to decrease after the gastrectomyIn model 4 (obese and diabetic rats), sleeve gastrectomy decreases intake and stabilizes weight at values that are close to the ideal weight for the age in this type of rats. The effect on the metabolic state is only slight but, unlike other animals, we have found increases in insulin after the intervention that do not manage to correct the state of hyperglycaemia.
Repositori URV