| Objective: Red blood cell distribution width(RDW)and mean platelet volume(MPV)are relatively recognized markers of inflammation in recent years,which are applied to the assessment and prediction of a variety of diseases.In order to investigate the changes of the levels of RDW and MPV and the prediction effects of them in metabolic surgery,we observed the changes of metabolic indexes,RDW and MPV levels,and the prediction effects of the baseline levels of RDW and MPV on weight loss in one month after metabolic surgery.Methods: We retrospectively analyzed simple obesity(OB)patients(42 cases)and diabetes and glucose reguation(DM/IGR)patients(84 cases)who received metabolic surgery in the department of general surgery from July 2010 to November 2016.We Collected body weight(BW),body mass index(BMI),fasting glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin,glycosylated hemoglobin(Hb A1c)and blood routine index.SPSS17.0 software was used to analyze the clinical data.Results:(1)There were no statistical different in gender composition ratio,ages,surgical methods,the levels of body measurement indexes,RDW and MPV in patients of OB group and obese with DM/IGR group.The glycometabolism indexes of in OB patients were significantly lower than those in obese patients with DM/IGR.(2)One month after surgery,BW,BMI,Hb A1 c,FINS and HOMA-IR of OB patients were significantly decreased compared with that before surgery,MPV level was significantly higher than that before surgery,and levels of FPG and RDW showed no statistical difference compared with that before surgery.The levels of BW,BMI,Hb A1 c,FPG,FINS,and HOMA-IR in the obese patients with DM/IGR were significantly lower than those before surgery,while the levels of RDW and MPV were significantly higher than those before surgery.(3)One month after surgery,the levels of Hb A1 c and FPG in the obese patients with DM/IGR were significantly higher than those in the OB group,and the differences in other indicators between the two groups had no statistical differences.(4)Extra weight loss(EWL)and changes of Hb A1 c,FPG,FINS,HOMA-IR in OB patients were significantly less than obese patients with DM/IGR in one month after metabolic surgery.There were no statistical difference between the rest of the indicators.(5)One month after metabolic surgery,EWL and excess body mass index loss(%EBMIL)in high level of RDW in obese patients with DM/IGR were significantly lower than those in low level group.RDW level in different layers of ?BW,%BW and ?BMI in obese patients with DM/IGR and MPV level in different layers of different weight indexes between two groups of patients had no significant differences.(6)In OB group,%BW and ?BMI one month after surgery on low layer of RDW before surgery was significantly higher than those on the high layer,while ?FINS and ?HOMA-IR were significantly lower than those on the high layer.?Hb A1 c one month after surgery on low layer of RDW before surgery was significantly higher than those on the high layer in obese patients with DM/IGR.(7)?FPG one month after surgery on low layer of MPV before surgery was significantly higher than those on the high layer in OB group.There was no significant difference in weight indexes and glycometabolism indexes between high and low layers of MPV before surgery in obese patients with DM/IGR.Conclusions:(1)In obese patients with DM/IGR,the inflammatory state of the body may be aggravated one month after metabolic surgery.(2)One month after metabolic surgery,RDW level may indirectly evaluate the short-term effect of metabolic surgery in obese patients with DM/IGR.(3)Preoperative baseline RDW level can be used as a predictor of short-term outcomes after metabolic surgery.Objective: To observe the changes of the levels of the metabolic indexes,RDW and MPV after different metabolic surgeries in obese patients with DM/IGR and the prediction effects of the baseline levels of RDW and MPV on the results of the weight loss during 12 months of metabolic surgery.Methods: we retrospectively analyzed 98 cases of obese patients with DM/IGR who were admitted to the hospital for Roux-en-y gastric bypass(RYGB)and Sleeve gastrectomy(SG)from July 2010 to November 2016.We Collected body weight(BW),body mass index(BMI),fasting glucose(FPG),fasting insulin(FINS),glycosylated hemoglobin,glycosylated hemoglobin(Hb A1c)and blood routine index.SPSS17.0 software was used to analyze the clinical data.Results:(1)There were no significant differences in baseline data between RYGB group and SG group before surgery.(2)During the follow-up 12 months after the metabolic surgery,the body measurement indexes and glycometabolism indexes of the two groups were significantly decreased compared with those before surgery.Levels of RDW and MPV in the two groups were significantly higher than before one month after surgery,and then gradually decreased.12 months after surgery,RDW level in the RYGB group was significantly lower than that before surgery.There were significant differences in some indexes between the two groups at some follow-up time.(3)In the RYGB group,RDW level of patients in the high-layer %BW at 6 and12 months and in the high-layer %EBMIL at 12 months after surgery decreased significantly than those in corresponding low-layer.RDW levels of patients of RYGB group in the two layers of %EWL,?BW and ?BMI at 1 to 12 months and %EBMILat 12 months after surgery had not found statistical difference.(4)There were no significant differences in the levels of MPV in the two layers of %EWL,?BW,%BW,?BMI and %EBMIL at 1 to 12 months after surgery.(5)?BW,%BW and ?BMI 6and 12 months after surgery on high-layer MPV before surgery were significantly higher than those on low-layer in RYGB group,and other two weight indexes and glycometabolism indexes in all follow-up times had no significant difference in two layers of RDW before surgery.There was no significant difference in weight indexes and glycometabolism indexes between high and low layers of MPV before surgery in RYGB group and SG group.Conclusions:(1)The improvements of BW and BMI of obese patients with DM/IGR after RYGB surgery were better than SG at the early stage(3 months after surgery),but similar to SG at the later stage.(2)After metabolic surgery,obese patients with DM/IGR may experience short-term aggravation of inflammatory state in the body.(3)RDW level after surgery can better reflect the effect of RYGB surgery in obese patients with DM/IGR.(4)Preoperative baseline RDW level can preliminarily predict the effect of different metabolic surgeries in obese patients with DM/IGR.But preoperative baseline MPV level has no significant prediction effect on RYGB surgery in obese patients with DM/IGR,which may have certain predictive value for that in the early stage of SG surgery(3 months). |
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