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A pilot study investigating early postoperative changes of plasma polyunsaturated fatty acids after laparoscopic sleeve gastrectomy

Mutay Aslan14*, Ibrahim Aslan2, Filiz Özcan1, Ramazan Eryılmaz3, Cemal Ozben Ensari3 and Tuna Bilecik3

Author Affiliations

1 Department of Medical Biochemistry, Akdeniz University Medical Faculty, Antalya, Turkey

2 Endocrinology Clinic, Antalya Research and Education Hospital, Antalya, Turkey

3 Surgery Clinic, Antalya Research and Education Hospital, Antalya, Turkey

4 Department of Biochemistry, Akdeniz University Medical School, Antalya 07070, Turkey

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Lipids in Health and Disease 2014, 13:62  doi:10.1186/1476-511X-13-62

Published: 3 April 2014

Abstract

Background

This study aimed to determine early postoperative changes of plasma polyunsaturated fatty acids (PUFAs) following laparoscopic sleeve gastrectomy (LSG).

Methods

Ten obese patients (mean BMI: 51.10 ± 11.59 kg/m2) underwent LSG and eleven normal weight control patients (mean BMI: 24.37 ± 2.33 kg/m2) underwent laparoscopic abdominal surgery. Fasting blood samples were collected prior to surgery, at day 1 after surgery and after postoperation oral feeding. Plasma levels of arachidonic acid (AA, C20:4n6), dihomo-gamma-linolenic acid (DGLA, C20:3n6), eicosapentaenoic acid (EPA, C20:5n3) and docosahexaenoic acid (DHA, C22:6n3) were determined by an optimized multiple reaction monitoring (MRM) method using ultra fast-liquid chromatography (UFLC) coupled with tandem mass spectrometry (MS/MS). Prostaglandin E2 (PGE2) was measured in serum samples by enzyme immunoassay.

Results

A significant decrease was observed in insulin and HOMA IR levels in sleeve gastrectomy patients after postoperation oral feeding compared to preoperation. Plasma AA levels and AA/EPA ratio were significantly increased in sleeve gastrectomy patients after postoperation oral feeding compared to postoperation day 1. Serum PGE2 levels and AA/DHA ratio was significantly higher in sleeve gastrectomy patients at preoperation, postoperation day 1 and after postoperation oral feeding when compared to control group patients.

Conclusion

Increased peripheral insulin sensitivity associated with LSG may play a role in the significant increase of plasma AA levels in sleeve gastrectomy patients following postoperation oral feeding. The significant increase in PGE2 levels and AA/DHA ratio in sleeve gastrectomy group patients also confirms the presence of a proinflammatory state in obesity.

Keywords:
Laparoscopic sleeve gastrectomy; Polyunsaturated fatty acids; Insulin; Prostaglandin