Endocrine Abstracts

Background: It is known that obesity-related renal damage,regardless of type 2 diabetes and hypertension, may improve by weight-loss modalities. In this study, we aimed to evaluate the effect of bariatric surgery on glycemic and lipid parameters, anthropometric measurements, renal parameters and urine NGAL (Neutrophil Gelatinase-Associated Lipocalin) levels in obese diabetic or nondiabetic patients who has not respond to medical treatment

Materials and methods: In our study, laparoscopic sleeve gastrectomy was performed in 10 diabetic and 9 non-diabetic patients between the ages of 18–65, BMI ≥40 kg/m², who were approved by the bariatric surgery committee. Anthropometric measurements, biochemical values, and spot urine examination in preoperative and postoperative 6th week were obtained from the routine polyclinic examination. Urinary NGAL levels were measured with spectrophotometry using enzymatic immunoassay method.

Results: In general, a significant decrease in weight, BMI, fasting plasma glucose, fasting plasma glucose (FPG) and HbA1c values were found in the patients at 6th month after surgery compared to preoperative status (P<0.001, P<0.001, P=0.003, P=0.001, P<0.001). There was also a significant decrease in systolic and diastolic blood pressures and HOMA-IR values (P=0.004, P=0.014, P=0.001). There was also a significant decrease in triglyceride values (P=0.005), but there were no significant changes in LDL, HDL and total cholesterol. Serum creatinine was significantly decreased (P=0.014), but microalbumin (mAlb), mAlb/creatinine, NGAL and NGAL/creatinin values were not significantly changed. In the comparison of diabetic and non-diabetic cases, the decrease in FPG was significantly higher in the diabetic group (P=0.005), but there was no significant difference between the groups in terms of percentage changes of other parameters.

Discussion: Bariatric surgery is an effective method for the treatment of obesity and many related parameters. However, the pathogenesis of obesity-related renal damage has not yet been clarified and stronger data are needed to say that NGAL is a predictor of renal damage in the chronic period.