All authors have read and agreed to the published version of the manuscript. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Institutional Review Board Statement This study was conducted in accordance with the amended Declaration of Helsinki. 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0C0.1, 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy. = 50)= 50)Value 0.05 were considered statistically significant. Analyses were performed using R, which is a free software environment for statistical computing and graphics (www.r-project.org, version 3.4.0, accessed on 1st May 2017). 3. Results 3.1. Clinical Characteristics of Study Populations The general characteristics of the patients with obesity before and after weight loss are presented in Table 2. The median age was 36.5 years (range 18C56), and 86% of the study cohort were women. It is worth noting that after observation, the incidence of carbohydrate metabolism disorders and hypertension decreased significantly, and all laboratory tests improvedresults in Table 2 and in Figure 1. During the follow-up visit, patients received previously started angiotensin converting enzyme inhibitors (in 16/32%), diuretics (in 6/12%), dihydropyridine calcium antagonists (in 5/10%) and also a statin or fibrate (in 18/36%) due to primary prevention. One patient with type 2 diabetes mellitus was taking insulin, while two patients with persistent impaired glucose tolerance were receiving metformin. None of the subjects received beta-blockers or other medications that affected heart rhythm. Open in a separate window Figure 1 The values of fasting insulin level (chart A), homeostatic model assessment for insulin resistance HOMA-IR CD38 inhibitor 1 (chart B), SDNN (chart C) and SDANN (chart D) in 50 patients before and after weight loss. Charts present medians with ranges values, while detailed results are shown in Table 2 (= 50)= 50)Value(%)27 (54%)16 (32%)0.04Disorders of carbohydrate metabolism (together), (= 0.04; Figure 2) and also nearly significant correlations for increase of SDNN (r = 0.267, = 0.05) and SDANN (r = 0.256, = 0.07). However, no correlations between the increase of HRV and WC reduction or HOMA-IR reduction were observed in patients after follow-up. Open in a separate window Figure 2 Correlation between the reduction in body mass index and the increase in SDNN-I value (r = 0.281, = 0.04) in all 50 patients after follow-up period. In addition, no significant differences in parameters of carbohydrate metabolism, HRV and HRT were observed after follow-up in patients divided according to the degree of weight reduction expressed by median of final BMI or final WCresults in Table 3. There were also no significant differences in the improvement of patients HRV parameters according to the median follow-up period ( 15 vs. 15 months)detailed data are not shown. Table 3 Comparison of indices of carbohydrate CD38 inhibitor 1 metabolism, time-domain heart rate variability and heart rate turbulence in groups divided according to the median reduction of body mass index and the median reduction of waist circumference. = 24)= 26)value= 24)= 26)value 0.001). Other parameters used in the univariate analysis included age, BMI reduction and WC reduction (the detailed values of the corrections applied are not presented). Due to the results of the univariate analysis, the previously planned multivariate analysis was not performed. 4. Discussion Obesity is a multi-factorial disease, and obesity-related diseases increase the incidence of disability and mortality [1,2,22]. The main finding of our study is that the weight loss after LSG resulted in a multi-profile improvement in carbohydrate metabolism and blood pressure control, as well as overall cardiac ANS function. In addition, these health benefits were observed irrespective of degree of weight loss. Various techniques of bariatric surgery are used for effective treatment of morbid obesity, such as Roux-en-Y gastric bypass, sleeve gastrectomy or biliopancreatic diversion with duodenal switch. In most patients, all types of bariatric surgery procedures improve metabolic status, reduce the incidence of hypertension and decrease long-term mortality [2,22]. Multiple studies and meta-analyses suggest that weight loss following bariatric surgery is associated with significant optimization of glycemia, insulin, lipids and other metabolic and hormonal changes that improve the overall metabolic profile [2,9,22]. Several hypotheses have been put forward trying to explain separately variable improvement, and one of the issues analyzed is the part of the ANS function in this process [13,23]. However, these mechanisms are extremely complex and still not fully recognized [2,7,11,24]. Recently, one of the desired methods is definitely LSG with relatively few postoperative complications. As numerous.It has also been hypothesized that changes in the vagal-modulated neuroendocrine system have an additional effect on the beneficial effects after bariatric surgery [6,10,13,25]. 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic firmness indices was correlated with reduction of BMI (SDNN-I r = 0.281 = 0.04; SDNN r = 0.267 = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0C0.1, 0.001). The incidence of arrhythmias was low and related before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate rate of metabolism and autonomic function is definitely observed in relatively Rabbit polyclonal to Shc.Shc1 IS an adaptor protein containing a SH2 domain and a PID domain within a PH domain-like fold.Three isoforms(p66, p52 and p46), produced by alternative initiation, variously regulate growth factor signaling, oncogenesis and apoptosis. young individuals after excess weight loss due to laparoscopic sleeve gastrectomy. = 50)= 50)Value 0.05 were considered statistically significant. Analyses were performed using R, which is a free software environment for statistical computing and graphics (www.r-project.org, version 3.4.0, accessed on 1st May 2017). 3. Results 3.1. Clinical Characteristics of Study Populations The general characteristics of the individuals with obesity before and after excess weight loss are offered in Table 2. The median age was 36.5 years (range 18C56), and 86% of the study cohort were women. It is well worth noting that after observation, the incidence of CD38 inhibitor 1 carbohydrate rate of metabolism disorders and hypertension decreased significantly, and all laboratory checks improvedresults in Table 2 and in Number 1. During the follow-up check out, individuals received previously started angiotensin transforming enzyme inhibitors (in 16/32%), diuretics (in 6/12%), dihydropyridine calcium antagonists (in 5/10%) and also a statin or fibrate (in 18/36%) due to primary prevention. One individual with type 2 diabetes mellitus was taking insulin, while two individuals with prolonged impaired glucose tolerance were receiving metformin. None of the subjects received beta-blockers or additional medications that affected heart rhythm. Open in a separate window Number 1 The ideals of fasting insulin level (chart A), homeostatic model assessment for insulin resistance HOMA-IR (chart B), SDNN (chart C) and SDANN (chart D) in 50 individuals before and after excess weight loss. Charts present medians with varies values, while detailed results are demonstrated in Table 2 (= 50)= 50)Value(%)27 (54%)16 (32%)0.04Disorders of carbohydrate rate of metabolism (together), (= 0.04; Number 2) and also nearly significant correlations for increase of SDNN (r = 0.267, = 0.05) and SDANN (r = 0.256, = 0.07). However, no correlations between the increase of HRV and WC reduction or HOMA-IR reduction were observed in individuals after follow-up. Open in a separate window Number 2 Correlation between the reduction in body mass index and the increase in SDNN-I value (r = 0.281, = 0.04) in all 50 individuals after follow-up period. In addition, no significant variations in guidelines of carbohydrate rate of metabolism, HRV and HRT were observed after follow-up in individuals divided according to the degree of weight-loss indicated by median of final BMI or final WCresults in Table 3. There were also no significant variations in the improvement of individuals HRV parameters according to the median follow-up period ( 15 vs. 15 weeks)detailed data are not demonstrated. Table 3 Assessment of indices of carbohydrate rate of metabolism, time-domain heart rate variability and heart rate turbulence in organizations divided according to the median reduction of body mass index and the median reduction of waist circumference. = 24)= 26)value= 24)= 26)value 0.001). Additional parameters used in the univariate analysis included age, BMI reduction and WC reduction (the detailed ideals of the corrections applied are not offered). Due to the results of the univariate analysis, the previously planned multivariate analysis was not performed. 4. Conversation Obesity is definitely a multi-factorial disease, and obesity-related diseases increase the incidence of disability and mortality [1,2,22]. The main getting of our study is that the excess weight loss after LSG resulted in a multi-profile.