Abstract:
Obesity is a growing public health problem worldwide. Bariatric surgical procedures
achieve the most sustainable and ecacious outcomes in the treatment of morbid obesity. However,
little is known about the underlying molecular pathways modulated by these surgical interventions.
Since leptin resistance is implicated in the pathogenesis of obesity, we herein report the e ects of
laparoscopic sleeve gastrectomy (LSG) on the serum levels of leptin and leptin receptor, in addition
to its overall e ect on leptin resistance. This was an interventional and follow-up clinical study.
In the first part, patients attending the general surgery outpatient clinics at our university hospital
were first stratified according to their Body-Mass Index (BMI) into cases (n = 38) with BMI 35
who were scheduled to undergo LSG, and controls (n = 75) with a normal BMI. Serum leptin and
leptin receptor levels were measured by sandwich ELISA technique. A leptin resistance index was
estimated by adjusting leptin to BMI ratio to leptin receptor concentration. In the second part of the
study, cases who underwent LSG were followed up one year postoperatively to assess their BMI and
serum leptin and leptin receptor levels. Leptin to BMI ratio was significantly higher, while serum
leptin receptor was significantly lower, in obese patients compared to controls. This translated into a
significantly higher leptin resistance index in obese patients. LSG resulted in a significant reduction
of BMI, leptin to BMI ratio, and leptin resistance index, as it significantly increased leptin receptor
levels. In conclusion, LSG showed significant decrease in leptin resistance in obese patients after one
year. Further studies are needed to determine the clinical impact of this finding on LSG outcomes.