Online ISSN: 2515-8260

Keywords : bariatric surgery

Mini-Gastric Bypass versus Sleeve Gastrectomy in Treatment of Type IIDiabetes Mellitus; a Randomized Comparative Study

Abdelshafy Mostafa Abdelshafy, Ali HelmyElshewy, Emad Mohammed Salah, Osama Abdelaziz Mohammed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 116-129

Introduction Although, the primary goal of bariatric surgery is body weight control,
other various beneficial effects have been confirmed especially the improvement in type
2 diabetes mellitus and associated comorbidities after surgery.
Patients and Methods:
A prospective study to compare the effect of sleeve gastrectomy and minigastric bypass
on obese patients with type II DM, divided into 2 groups, each containing 22 patients.
The follow-up was 12 months for both groups. Duration of surgery was different in both
groups with Mean ± SD 89.5 ± 15 in SG group and 105 ± 11.1 in MBG. There was 2
cases had intraoperative bleeding that managed immediately intraoperative. Leak test was
done and 2 patients were positive in MGB and intraoperative repair was done One case of
leakage was detected after SG and managed nonsurgically with percutaneous drainage for
intraabdominal collection and Mega stent insertion. Both surgical procedures achieved
T2DM remission. Both FPG and HbA1c at 1 year are significantly lower in diabetic
patients treated by MGB when compared to SG patients (SG from 201 ± 17.8 to 98.8 ±
12.7, MGB from 214.2 ± 27.6 to 83.9 ± 6.3 for FPG); (SG from 7.6 ± 0.71 to 5.5 ± 0.41
,MGB from 7.9 ± 0.53 to 5.3 ± 0.38 for HbA1c).
MGB and SG achieved T2DM remission, but MGB provided a better performance than
SG at 1 year.

The change in Sex Hormone Binding Globulin and free androgen index levels after bariatric surgery in obese patients with polycystic ovary syndrome

Rania S. Ezzat; Mohamed Elsayed; Hend S. Saleh; Wael Abdalla; Walid A. Abdessalam

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 6895-6902

Background: There are limited data about the impact of bariatric procedures on androgen milieu,
sex hormone binding globulin (SHBG) and free androgen index (FAI) in obese women with
polycystic ovary syndrome. Since the changes in these levels can amenably affect fertility in this
group of patients, it is necessary to study such effects.
Objective: to study the impact of bariatric surgery on androgen hormone levels, SHBG and FAI in
obese women with polycystic ovary syndrome (PCOS) and infertility.
Study design: A cohort study. Patients and Methods: 36 obese women with PCOS and infertility,
attending at Zagazig University Hospitals, outpatient clinic, who underwent bariatric surgery
(gastric sleeve or gastric bypass) for excess weight loss. Evaluation of serum free and total
testosterone levels, Sex hormone binding globulin (SHBG) by ELISA and calculation of free
androgen index (FAI), before operation and compared to 6 months and 1 year after operation.
Results: Before bariatric surgery, all women had abnormally high levels of free and total
testosterone, low sex hormone binding globulin, and high free androgen index. After surgery,
levels of free and total testosterone dropped significantly, with a rise in SHBG and a significant
drop in FAI (P < 0.001) 6-month and 1-year after bariatric procedure.
Conclusion: excess weight loss by bariatric surgery leads to normalization of androgenic milieu,
and improves SHBG and FAI in PCOS patients.