Study On The Effect Of Laparoscopic Weight Loss Surgery On The Risk Of Renal Damage In Patients With Metabolic Syndrome

Background: Metabolic Syndrome(MS)is a group of clinical metabolic abnormalities in which insulin resistance is a central part.It consists of a variety of metabolic abnormalities,including type 2 diabetes or impaired glucose regulation,obesity,hypertension,abnormal blood lipids,etc.According to the latest diagnostic criteria for MS in China,MS can be diagnosed by any of the three or more indicators,such as hyperglycemia,obesity,hypertension and abnormal blood lipids.With the continuous improvement of people's living standards,the incidence of MS in China has been increasing year by year.Statistics have shown that one of every eight adults in China's urban population suffers from MS.At present,many studies believe that MS can cause significant damage to renal function,and lead to the occurrence of end-stage renal disease in the late stage.Although advanced stages may lead to kidney failure or uremia,the whole course of the disease develops slowly and last long.After decades of continuous research by scholars around the world,it has been found that laparoscopic weight loss surgery can not only delay or stop the disease process,but also even reverse the damage of renal function.However,the reports of many large research institutions are only for Westerners,there are few clinical studies on domestic patients with MS.Objective: This article analyzed samples of the part of patients with metabolic syndrome retrospectively,discussed the impact of surgery and different surgical methods,such as laparoscopic sleeve gastrectomy(LSG)and laparoscopic roux-en-Y gastric bypass(LRYGB)on the occurrence and development of kidney damage in patients with metabolic syndrome.Method: This study analyzed clinical data of 37 cases of patients with metabolic syndrome in preoperative and postoperative of 6 months,including body mass index(BMI),glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),blood s?gar 2hours after meal(2hPG),lipid metabolic index,urea,uric acid(UA)and glomerular filtration rate(GFR),urine trace albumin creatinine ratio(ACR),serum creatinine(Cre),creatinine clearance(CCL),compared the changes of index above in all samples before and after surgery,and observed the effect of laparoscopic weight loss surgery on renal function and the incidence of postoperative complications in patients with metabolic syndrome.Then we discussed the improvement of renal function in three different renal function.Finally,according to the different surgical method,the papients were devided into two groups and we discussed the similarities and differences of LSG and LRYGB.Result: All data were compared without grouping,and it was found that at 6 months after surgery,W(kg),BMI(kg/m2),FPG(mmol/L),2hPG(mmol/L),HbA1c(%),Urea(mmol/L),ACR(?g/mg),CCL(ml/min),SBP(mmHg)and DBP(mmHg)were significantly decreased(P<0.05),UA(?mol/L)were significantly decreased(0.01<P<0.05).TC(mmol/L),TG(mmol/L),HDL-C(mmol/L)and LDL-C(mmol/L)of the ultrafiltration group 6 months after surgery were significantly lower than that before surgery(P<0.05).TC(mmol/L),TG(mmol/L),HDL-C(mmol/L)and LDL-C(mmol/L)of the ultrafiltration group 6 months after surgery were significantly lower than that before surgery(P<0.05).TC(mmol/L),TG(mmol/L),HDL-C(mmol/L)and LDL-C(mmol/L)of the normal group and CKD group had no significant changes(P > 0.05).In the ultrafiltration group,GFR(ml/min)decreased at 6 months after surgery(P<0.05);in the normal group,GFR(ml/min)remained stable at 6 months after surgery(P>0.05);in the CKD group,there was no significant difference in GFR(ml/min)at 6 months after surgery(P>0.05).There was no significant difference of?FPG(mmol/L),?HbA1c(%),?Urea(mmol/L),?UA(umol/L),?ACR(ug/mg),?SBP(mmHg)and ?DBP(mmHg)(P>0.05)between the two kinds of operative methods.There was obvious difference of ?W(kg),?BMI(kg/m2),?2hPG(mmol/L)(P<0.05)in LSG and LRYGB group.Comparing LRYGB to LSG,?CCL(ml/min)had obvious difference(P<0.05),?GFR(ml/min),?Cre(umol/L)had no significant change(P > 0.05).There was no difference in the incidence of postoperative complications between the two groups(P=0.317).Conclusion: 1.Weight loss surgery may be an option to prevent renal damage in patients with MS.2.For patients with MS,weight loss surgery has a positive impact on renal function,and can significantly improve condition of renal ultrafiltration,and its short-term curative effect is significant and security is high.3.Weight loss surgery can improve abnormal lipid metabolism,reduce body weight and uric acid in blood to some extent.4.LSG is superior to LRYGB in improving renal function.