CHANGES IN GASTROPANCREATICODUODENAL HORMONES AND CYTOKINES IN BLOOD IN OBESE SUBJECTS BEFORE AND AFTER GASTRIC BYPASS SURGERY

DOI: 10.22138/2500-0918-2023-20-4-211-221

A.A. Xakimiy¹, Z. Dekenova¹, M.A.Vulf¹, N.I. Mironyuk¹,
E.V. Kirienkova¹, G.L. Kuznetsov², L.S. Litvinova¹

¹Federal State Autonomous Educational Institution of Higher Education «Immanuel Kant Baltic Federal University», Kaliningrad, Russian Federation
²State Budgetary Institution of Health Care of Kaliningrad region «Central City Clinical Hospital», Kaliningrad, Russian Federatiom

Abstract. Obesity is a worldwide epidemic of modern humanity and a serious public health problem. The increasing number of obese people increases their risk of cardiovascular diseases (CVD), type 2 diabetes mellitus (DM), and some types of cancer. In the development of pathologies associated with metabolic dysfunction, a significant role in the development of subclinical inflammation in adipose tissue, as well as impaired humoral regulation of carbohydrate metabolism (HMO). If conservative methods proved to be ineffective or insufficient, the most productive/effective surgical method of obesity control is laparoscopic gastric bypass surgery(GBS). The article is devoted to the analysis of changes in the content of gastropancreaticoduodenal hormones – insulin, ghrelin, and incretins, as well as adipokine leptin and proinflammatory molecules in the blood before and 18 months after gastric bypass, with an assessment of its effectiveness in the treatment of obesity and type 2 DM. Materials and Methods. The complex study involved 53 people who were divided into 4 groups: conditionally healthy donors, patients with obesity before GBS, patients after GBS with different body mass index (BMI): >35 and <30 kg/m². Carbohydrate and lipid metabolism parameters in blood serum were analyzed on an automatic biochemical analyzer. Proinflammatory molecules (IL-6, TNFa) were determined by solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) according to the manufacturer’s protocol. The levels of leptin, insulin, ghrelin, GIP, GLP-1 in plasma were measured by flow fluorimetry using commercial test systems (Bio-RlExPrоHumаn Diаbetеs 10-Plеx Аѕѕау, Bio-Rad, USA). Results. The study of metabolic parameters in obese patients 18 months after GBS indicates significant changes in humoral regulation of carbohydrate metabolism (CM) in comparison with preoperative patients. Thus, the decrease in the level of proinflammatory molecules — IL-6, TNFa and CRP in blood in patients after GBS indicates the regression of subclinical inflammation in adipose tissue; the decrease in the level of leptin and insulin in blood after GBS relative to the preoperative level is a consequence of the restoration of tissue sensitivity to insulin. We have interpreted the mechanisms of eating behavior disorders in obese patients before surgery and their subsequent recovery after GBS by analyzing the changes in the content of insulin, leptin, ghrelin and incretins in blood. Based on the obtained data, a hypothesis about the influence of the active process of lipolysis on the maintenance of the feeling of satiety in operated patients with BMI<30kg/m² was put forward.

Keywords: obesity, metabolic syndrome, gastric bypass surgery, eating behavior

There is no conflict of interest.
Contact details of the corresponding author:
Larisa S. Litvinova
larisalitvinova@yandex.ru
Received 17.07.2023
For citation:
Xakimiy A., Dekenova Z., Vulf M.A., Mironyuk N.I., Kirienkova E.V., Kuznetsov G.L., Litvinova L.S. Changes in gastropancreaticoduodenal hormones and cytokines in blood in obese subjects before and after gastric bypass surgery [Online] Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2023, Vol. 20, no. 4, pp. 211–221. DOI: 10.22138/2500-0918-2023-20-4-211-221 (In Russ)

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Authors
Asilbek A. Xakimiy
Immanuel Kant Baltic Federal University
5th year student, Graduate School of Medicine
asilbekhakimii@gmail.com
Kaliningrad, Russian Federation

Zhanel Dekenova
Immanuel Kant Baltic Federal University
5th year student, Graduate School of Medicine
gandek601@gmail.com
Kaliningrad, Russian Federation

Maria A. Vulf
Immanuel Kant Baltic Federal University
Candidate of Biological Sciences, Senior Researcher at the Center for Immunology and Cellular Biotechnologies, Senior Lecturer of the Department of Fundamental Medicine, ESC «Institute of Medicine and Life Sciences (MEDBIO)»
mary-jean@yandex.ru
Kaliningrad, Russian Federation

Natalia I. Mironyuk
Immanuel Kant Baltic Federal University
Candidate of Medical Sciences, Endocrinologist of the Center for Immunology and Cellular Biotechnologies ESC «Institute of Medicine and Life Sciences (MEDBIO)», LLitvinova@kantiana.ru or myronyuk_ni@mail.ru;
Kaliningrad, Russian Federation

Elena V. Kirienkova
Immanuel Kant Baltic Federal University
Doctor of Medical Sciences, Senior Researcher of the Center of Immunology and Cell Biotechnology, Professor of the Department of Fundamental Medicine, ESC «Institute of Medicine and Life Sciences (MEDBIO)»
elenamed@list.ru
Kaliningrad, Russian Federation

Georgy L. Kuznetsov
Central City Clinical Hospital, Kaliningrad, Russia;
Candidate of Medical Sciences, Deputy Chief Physician for Surgery
kuzma163@yandex.ru
Kaliningrad, Russian Federation

Larisa S. Litvinova
Immanuel Kant Baltic Federal University
Doctor of Medical Sciences, Director of the Center for Immunology and Cellular Biotechnologies, Professor of the Department of Fundamental Medicine, ESC «Institute of Medicine and Life Sciences (MEDBIO)»
larisalitvinova@yandex.ru
Kaliningrad, Russian Federation