Background: In the last two decades, extreme obesity and its comorbidities have often been treated with bariatric surgery. Objective: Our goal was to compare the levels of GLP-1 in individuals who are severely obese three months after undergoing any of the three more frequent bariatric methods: sleeve gastrectomy (SG), Roux en Y gastric bypass (RYGB), or intragastric balloon (IGB). Patients and Methods: This is prospective research being done at Benha University Hospital for people with obesity and type 2 diabetes who have been recruited 3 months prior to having any bariatric surgeries. Patients were subjected to measurement of WC, BMI and laboratory assay of HbA1c, fasting plasma glucose (FPG), fasting insulin, HOMA-IR, ALT, AST, glucagon-like peptide-1 (GLP-1) and lipid profile before and after 3 months of procedures. Results: There was significant improvement of FPG, and HbA1c in RYGB operation in comparison with other bariatric procedures. Fasting insulin was substantially lower in the RYGB surgery than the in SG and IGB (p ˂ 0.05) with substantial improvements of HOMA-IR for RYGB surgery (p ˂ 0.05). In RYGB surgery, there was highly substantial increase in GLP-1 levels compared to SG and IGB procedures (p <0.001). The change in BMI were significant (p ˂0.001) in RYGB but waist circumference did not change significantly after 3 months of any of three procedures.
Conclusion:Our results demonstrated that GLP-1 values were increased after RYGB compared to SG and IGB after three months of the procedures.
Background: One of the most important complications of Type 2 diabetes mellitus (T2DM) is atherosclerotic cardiovascular disorders (ASCVD), a disease that affects a large percentage of the population and considered a healthcare burden. Objective: Our aim to establish a probable relationship between lipoprotein (a) [Lp (a)] and T2DM and to demonstrate it as a marker of (ASCVD). Patients and Methods: This case-control study included 200 subjects; 150 diabetic patients and 50 age and gender matched healthy subjects. Thorough history taking of T2DM with assessment of vascular diabetic complications was done. The fasting plasma glucose, HbA1c, lipid profile, s. creatinine and Lp (a) level were performed to all participants. Results: Lp (a) levels were significantly low in diabetic patients (19.8 ± 13.4 mg/dl) compared to control group (32.6 ± 20.8 mg/dl) (p <0.001). Lp (a) level was significantly higher in diabetics with macro-vascular complications (22.7 ± 14.4 mg/dl) than diabetics with micro-vascular complications (11.7 ± 6.5 mg/dl). Lp (a) level among diabetics with macro-vascular complications was insignificant higher than diabetics without vascular complications (p= 0.08). Conclusion: Lp (a) is strongly associated with T2DM and its vascular complications that needs further research especially genetic study.
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