الفهرس 
Pathophysiology of GLP-1 HormoneOnly 14 pages are availabe for public view
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Abstract
Obesity is a pan-endemic health problem in both developed and developing countries. The prevelance of obesity has dramatically increased over the last decades and is currently reaching epidemic proportions. Obesity is associated sometimes with many diseases like diabetes, hypertension and dyslipidemia that represent metabolic syndrome which is responsible for high incidence of morbidity and mortality.
There is a variety of methods used in management of metabolic syndrome like changing feeding habits, drugs and physical excercises. The results of medical treatment of obesity have been disappointing, on the otherhand surgical treatment of obesity has been shown to be effective.
Gastric bypass surgery causes substantial and long-term weight loss together with correction of the metabolic syndrome. This effect is unlikely to result from gastric restriction alone, and it has been proposed that a disruption of GLP-1 hormone that regulates stiety and which has an insulinotropic effect is also involved.
This study aimed at searching for the effect of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome and GLP-1 hormone, and was carried on 30 obese patients having metabolic syndrome. All patients were subjected to laparoscopic Lonroth’s gastric bypass that was converted to open in two cases. The study was carried in the department of General Surgery at Ain Shams University hospitals and Ahmed Maher Teaching hospital over a period of two years.
The patients were subjected to preoperative full medical history taking, clinical examination, calculation of BMI, measurement of blood pressure, laboratory investigations including fasting (blood sugar, lipid profile, serum GLP1 and serum insulin) and HOMA-IR calculation. All these parameters were re-assessed after one year.
The recorded intra-operative complication was hepatic injury that was recorded in one case (3.33%). The early post-operative complications were fever and chest infection in 4 cases (13.3%), vomiting in 2 cases (6.66%) and wound infection in one (3.33%) of the two cases who were converted to open. The late post-operative complications were inscisional hernia in one (3.33%) of the 2 cases who were converted to open, and anemia in one case (3.33%).
This prospective study showed that RYGBP is associated with significant decrease of mean BMI, high significant increase in serum fasting GLP-1 level one year after the surgical procedure with improvement of metabolic syndrome parameters especially type II diabetes mellitus and hypertension.
Also, this study showed that there is inverse correlation between postoperative fasting serum GLP-1 and BMI, fasting blood glucose and HOMA-IR but a positive correlation between fasting serum GLP-1 and fasting serum insulin.
So, short-limb RYGBP achieved the required weight loss in obese patients with avoidance of late postoperative metabolic complications together with improvement of metabolic syndrome.
Finally, understanding the beneficial and detrimental consequences of bariatric surgery as strategy to treat obesity and metabolic syndrome is essential for patients and physicians to make informed decisions about treatment options.