Bariatrik cerrahi sonrası ortalama trombosit hacmindeki zamansal değişiklikler

Öz

Amaç: Obez bireyler üzerinde yapılan çalışmalar, kilo kaybı ile ortalama trombosit hacmi (MPV) değişiklikleri arasında bir ilişki olduğunu öne sürmüştür. Bu nedenle, bu çalışma, bariatrik cerrahi ile kilo kaybı yaşayan morbid obez hastalarda MPV'deki değişiklikleri incelemeyi amaçladı. Gereç ve Yöntemler: Ocak 2010 ile Kasım 2014 tarihleri arasında sleeve gastrektomi yapılan toplam 328 morbid obez hasta (morbid obez grup) retrospektif olarak değerlendirildi. Kontrol grubu, laparoskopik kolesistektomi geçiren 53 obez olmayan hastadan oluştu. Her iki grup için preoperative (bazal), postoperatif 1. ay, 3. ay ve 12. ayda vücut kitle indeksi ve MPV değerleri kaydedildi. Bulgular: Bazal MPV değerleri, morbid obez grubu ile kontrol grubu arasında benzerdi (8.8 ± 1.8 vs. 8.6 ± 1.2, p = 0.283). Kontrol grubunda, 12 aylık takip süresince MPV seviyelerinde anlamlı bir değişiklik gözlenmedi. Morbid obez grubunda, cerrahi sonrası 1. ve 3. ayda ortalama MPV seviyeleri benzer olup, bazal seviyelere göre artış gösterdi. 12. ayda ise ortalama MPV seviyeleri azalma eğilimi göstererek, bazal değerlere benzer hale geldi. Sonuçlar: MPV seviyeleri, sleeve gastrektomi sonrası erken postoperatif dönemde artış gösterdi, ancak 12. ayda başlangıç seviyelerine döndü. Bu bulgular, bariatrik cerrahi ile kilo kaybının MPV seviyelerini etkileyebileceğini, ancak bu etkinin zamanla normale döndüğünü göstermektedir.

Anahtar Kelimeler

• bariatrik cerrahi
• sleeve gastrektomi
• ortalama trombosit hacmi
• obezite

The temporal changes in mean platelet volume after bariatric surgery

Öz

Aim: Studies on obese individuals have proposed a correlation between weight loss and variations in mean platelet volume (MPV). Therefore, this study aimed to examine the changes in MPV in morbidly obese patients who underwent weight loss via bariatric surgery. Material and Methods: A total of 328 morbidly obese patients who underwent sleeve gastrectomy (morbidly obese group) and were retrospectively evaluated from January 2010 to November 2014. The control group consisted of 53 non-obese patients who had laparoscopic cholecystectomy. Body mass index values and MPV values at preoperative (baseline), postoperative 1st month, 3rd month, and 12th month for both groups were documented. Results: The baseline MPV values were comparable between morbidly obese group and control group (8.8 ± 1.8 vs. 8.6 ± 1.2, p = 0.283). In control group, there was no significant change in MPV levels during the 12-month follow-up. In morbidly obese group, mean MPV levels at the 1st and 3rd months post-surgery were similar, showing an increase compared to baseline levels. By the 12th month, mean MPV levels tended to decrease, becoming comparable to baseline values. Conclusion: MPV levels increased in the early postoperative period following sleeve gastrectomy, they returned to baseline by the 12th month. These findings suggest that weight loss from bariatric surgery may influence MPV levels, but this effect normalizes over time.

Anahtar Kelimeler

• bariatric surgery
• sleeve gastrectomy
• mean platelet volume
• obesity

Kaynakça

1. Scridon A. Platelets and Their Role in Hemostasis and Thrombosis-From Physiology to Pathophysiology and Therapeutic Implications. Int J Mol Sci. 2022;23(21) DOI: 10.3390/ijms232112772.
2. Gasparyan AY, Ayvazyan L, Mikhailidis DP, and Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58. DOI: 10.2174/138161211795049804.
3. Shah B, Sha D, Xie D, Mohler ER, 3rd, and Berger JS. The relationship between diabetes, metabolic syndrome, and platelet activity as measured by mean platelet volume: the National Health And Nutrition Examination Survey, 1999-2004. Diabetes Care. 2012;35(5):1074-8. DOI: 10.2337/dc11-1724.
4. Gulcan M, Varol E, Etli M, Aksoy F, and Kayan M. Mean platelet volume is increased in patients with deep vein thrombosis. Clin Appl Thromb Hemost. 2012;18(4):427-30. DOI: 10.1177/1076029611427437.
5. Park Y, Schoene N, and Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets. 2002;13(5-6):301-6. DOI: 10.1080/095371002220148332.
6. Handtke S and Thiele T. Large and small platelets-(When) do they differ? J Thromb Haemost. 2020;18(6):1256-67. DOI: 10.1111/jth.14788.
7. Furman-Niedziejko A, Rostoff P, Rychlak R, et al. Relationship between abdominal obesity, platelet blood count and mean platelet volume in patients with metabolic syndrome. Folia Med Cracov. 2014;54(2):55-64.
8. Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010;8(1):148-56. DOI: 10.1111/j.1538-7836.2009.03584.x.

9. Braekkan SK, Mathiesen EB, Njolstad I, Wilsgaard T, Stormer J, and Hansen JB. Mean platelet volume is a risk factor for venous thromboembolism: the Tromso Study, Tromso, Norway. J Thromb Haemost. 2010;8(1):157-62. DOI: 10.1111/j.1538-7836.2009.03498.x.
10. Coban E, Yilmaz A, and Sari R. The effect of weight loss on the mean platelet volume in obese patients. Platelets. 2007;18(3):212-6. DOI: 10.1080/09537100600975362.
11. Coban E, Ozdogan M, Yazicioglu G, and Akcit F. The mean platelet volume in patients with obesity. Int J Clin Pract. 2005;59(8):981-2. DOI: 10.1111/j.1742-1241.2005.00500.x.
12. Ding Q, Wang F, Guo X, and Liang M. The relationship between mean platelet volume and metabolic syndrome in patients with type 2 diabetes mellitus: A retrospective study. Medicine (Baltimore). 2021;100(13):e25303. DOI: 10.1097/MD.0000000000025303.
13. Furuncuoglu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, and Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016;20(7):1300-6.
14. Esen B, Atay AE, Gunoz N, et al. The relation of mean platelet volume with microalbuminuria and glomerular filtration rate in obese individuals without other metabolic risk factors: the role of platelets on renal functions. Clin Nephrol. 2015;83(6):322-9. DOI: 10.5414/CN108534.
15. Park BJ, Shim JY, Lee HR, Jung DH, Lee JH, and Lee YJ. The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences. Platelets. 2012;23(1):45-50. DOI: 10.3109/09537104.2011.589014.
16. Yilmaz MA, Duran C, and Basaran M. The mean platelet volume and neutrophil to lymphocyte ratio in obese and lean patients with polycystic ovary syndrome. J Endocrinol Invest. 2016;39(1):45-53. DOI: 10.1007/s40618-015-0335-2.
17. Raoux L, Moszkowicz D, Vychnevskaia K, et al. Effect of Bariatric Surgery-Induced Weight Loss on Platelet Count and Mean Platelet Volume: a 12-Month Follow-Up Study. Obes Surg. 2017;27(2):387-93. DOI: 10.1007/s11695-016-2292-z.
18. Kutluturk F and Ozsoy Z. Effect of Sleeve Gastrectomy on Platelet Counts and Mean Platelet Volumes. Obes Surg. 2018;28(10):3159-64. DOI: 10.1007/s11695-018-3287-8.
19. Melissas J. IFSO guidelines for safety, quality, and excellence in bariatric surgery. Obes Surg. 2008;18(5):497-500. DOI: 10.1007/s11695-007-9375-9.
20. Aykota MR, Yilmaz S, Atabey M, Ozgen U, and Simsek S. Effect of sleeve gastrectomy on the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio, platelet counts, and mean platelet volumes. Indian Journal of Surgery. 2021;83(1):261-67.
21. Zhou L, Lin S, Zhang F, et al. The Correlation Between RDW, MPV and Weight Indices After Metabolic Surgery in Patients with Obesity and DM/IGR: Follow-Up Observation at 12 Months. Diabetes Ther. 2020;11(10):2269-81. DOI: 10.1007/s13300-020-00897-9.
22. Felemban S and Hamouda AF. A pilot study of diet lifestyle on complete blood picture, elements, and biological profile in females. Trends in Immunotherapy. 2024;8(2):6766.
23. Öztürk G, Ak MA, and Ertop S. The Association Between Weight Loss and Platelet Markers in Morbidly Obese Patients. Dicle Tıp Dergisi. 2021;48(4):754-60.
24. Sen O, Oray S, Calikoglu I, Sekmen U, and Turkcapar AG. Effect of laparoscopic sleeve gastrectomy on platelet count and mean platelet volume. J Minim Access Surg. 2023;19(4):489-92. DOI: 10.4103/jmas.jmas_301_22.
25. Benaiges D, Mas-Lorenzo A, Goday A, et al. Laparoscopic sleeve gastrectomy: More than a restrictive bariatric surgery procedure? World J Gastroenterol. 2015;21(41):11804-14. DOI: 10.3748/wjg.v21.i41.11804.
26. Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy: a restrictive procedure? Obes Surg. 2007;17(1):57-62. DOI: 10.1007/s11695-007-9006-5.
27. Laurenius A, Larsson I, Melanson KJ, et al. Decreased energy density and changes in food selection following Roux-en-Y gastric bypass. Eur J Clin Nutr. 2013;67(2):168-73. DOI: 10.1038/ejcn.2012.208.
28. Toplak H and Wascher TC. Influence of weight reduction on platelet volume: different effects of a hypocaloric diet and a very low calorie diet. Eur J Clin Invest. 1994;24(11):778-80. DOI: 10.1111/j.1365-2362.1994.tb01076.x.
29. Paul M, Hemshekhar M, Kemparaju K, and Girish KS. Aggregation is impaired in starved platelets due to enhanced autophagy and cellular energy depletion. Platelets. 2019;30(4):487-97. DOI: 10.1080/09537104.2018.1475630.
30. Oswiecimska J, Malczyk Z, Szymlak A, et al. Changes in Platelet Count and Size Indices in Adolescent Patients With Anorexia Nervosa. Clin Appl Thromb Hemost. 2017;23(6):562-66. DOI: 10.1177/1076029617705727.
31. Farey JE, Preda TC, Fisher OM, et al. Effect of Laparoscopic Sleeve Gastrectomy on Fasting Gastrointestinal, Pancreatic, and Adipose-Derived Hormones and on Non-Esterified Fatty Acids. Obes Surg. 2017;27(2):399-407. DOI: 10.1007/s11695-016-2302-1.
32. Zhao X, Han Q, Gang X, et al. The Role of Gut Hormones in Diet-Induced Weight Change: A Systematic Review. Horm Metab Res. 2017;49(11):816-25. DOI: 10.1055/s-0043-115646.
33. Morsy MD. Hemostatic effect of acylated ghrelin in control and sleeve gastrectomy-induced rats: mechanisms of action. Arch Physiol Biochem. 2020;126(1):31-40. DOI: 10.1080/13813455.2018.1489849.
34. Tymitz K, Engel A, McDonough S, Hendy MP, and Kerlakian G. Changes in ghrelin levels following bariatric surgery: review of the literature. Obes Surg. 2011;21(1):125-30. DOI: 10.1007/s11695-010-0311-z.
35. Elbatarny HS, Netherton SJ, Ovens JD, Ferguson AV, and Maurice DH. Adiponectin, ghrelin, and leptin differentially influence human platelet and human vascular endothelial cell functions: implication in obesity-associated cardiovascular diseases. Eur J Pharmacol. 2007;558(1-3):7-13. DOI: 10.1016/j.ejphar.2006.11.052.