Istmin Levels in Laparoscopik Sleeve Gastrectomy

January 2, 2026 updated by: Mehmet Buğra Bozan, Saglik Bilimleri Universitesi

Effect of Laparoscopic Sleeve Gastrectomy on Blood Isthmın Levels: A Prospective Cohort Study

Obesity is a multifactorial disease which has become a public health problem with increasing frequency, especially in recent years. Obesity causes many health problems with its negative effects on organs, systems, and psychosocial status. It is a serious risk factor for many diseases and also causes a significant increase in morbidity and mortality in these diseases.

Although dietary treatments and medical treatment options are frequently used, surgical options are still the most effective treatment. Bariatric and metabolic surgical techniques are frequently applied, especially in patients with advanced obesity and obesity-related comorbidities. The most commonly applied bariatric metabolic surgical techniques, as in our clinic, are laparoscopic sleeve gastrectomy (LSG) and Roux-en-y gastric bypass procedures.

The role of adipokines, secreted from adipose tissue and thought to play a role in the development of obesity, is quite important in the obesity mechanism, as they are effective not only in energy processes but also in metabolic processes. These adipokines secreted by adipose tissue play an active role in many mechanisms in the body, including vasoactivity, oxidative processes, immunity, lipid and glucose metabolism. Adipokines function actively in many target organs such as the pancreas, liver, and brain.

Isthmin, a relatively new adipokine expressed from brown and white adipocytes, also affects many systems like other adipokines. Studies have shown that Isthmin plays an active role in glucose and lipid metabolism, and it has been reported to play a role in many metabolic processes, from insulin resistance to hepatic steatosis.

The aim of this study is to investigate whether isthmin levels change before and after surgery in patients undergoing LSG for severe obesity, given that isthmin is thought to be associated with obesity and insulin resistance, particularly by affecting the appetite center in metabolism.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Obesity is a multifactorial disease caused by genetic, environmental, and psychiatric factors. Having existed for hundreds of years, obesity has become a public health problem with increasing frequency, especially in recent years. According to WHO data, in 2016 there were 1.9 billion overweight and 650 million obese patients worldwide, and in 2022, there were 2.5 billion overweight and 890 million obese patients. This massive increase in obesity incidence in such a short time highlights that obesity is a very serious problem worldwide. According to this data, approximately 43% of the adult population over 18 years of age is overweight. This data reiterates the fact that obesity is a widespread problem with a rapidly increasing trend globally.

Obesity causes many health problems with its negative effects on organs, systems, and psychosocial status. It is a serious risk factor for many diseases and also causes a significant increase in morbidity and mortality in these diseases. Studies estimate that approximately 5 million people die worldwide due to non-communicable diseases such as cardiovascular diseases, diabetes, cancer, neurological disorders, chronic respiratory diseases, and digestive disorders related to obesity.

Today, many treatment methods are available for obesity. Although dietary treatments and medical treatment options are frequently used, surgical options are still the most effective treatment. Bariatric and metabolic surgical techniques are frequently applied, especially in patients with advanced obesity and obesity-related comorbidities. For this purpose, numerous bariatric metabolic surgical techniques have been developed. Currently, the most commonly applied bariatric metabolic surgical techniques, as in our clinic, are laparoscopic sleeve gastrectomy (LSG) and Roux-en-y gastric bypass procedures.

The role of adipokines, secreted from adipose tissue and thought to play a role in the development of obesity, is quite important in the obesity mechanism, as they are effective not only in energy processes but also in metabolic processes. These adipokines secreted by adipose tissue play an active role in many mechanisms in the body, including vasoactivity, oxidative processes, immunity, lipid and glucose metabolism. They exert their effects through paracrine and autocrine pathways. Adipokines function actively in many target organs such as the pancreas, liver, and brain.

Isthmin, a relatively new adipokine expressed from brown and white adipocytes, also affects many systems like other adipokines. Studies have shown that Isthmin plays an active role in glucose and lipid metabolism, and it has been reported to play a role in many metabolic processes, from insulin resistance to hepatic steatosis.

The aim of this study is to investigate whether isthmin levels change before and after surgery in patients undergoing LSG for severe obesity, given that isthmin is thought to be associated with obesity and insulin resistance, particularly by affecting the appetite center in metabolism.

Study Type

Observational

Enrollment (Actual)

40

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Elâzığ, Turkey (Türkiye), 23100
        • Elazig Fethi Sekin City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Probability Sample

Study Population

BMI > 40 kg/m2 without comorbidity who are planned for Laparoscopic Sleeve Gastrectomy

Description

Inclusion Criteria:

  • Being over 18 years of age
  • Being diagnosed with severe obesity
  • Patients who do not wish to participate in the study

Exclusion Criteria:

  • Patients under 18 years of age
  • Overweight patients with a Body Mass Index <40 kg/m2 and no comorbidities
  • Patients with rheumatological diseases (rheumatoid arthritis, SLE, etc.)
  • Patients with chronic kidney and liver failure
  • Patients diagnosed with Diabetes Mellitus
  • Patients with malignancy
  • Patients who do not wish to participate in the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Laparoscopic Sleeve Gastrectomy Patients for Severe Obesity
Diagnostic test: Preoperative Serum Isthmin Levels
Preoperative Serum Isthmin Levels
Diagnostic test: Postoperative Third Month's Serum Isthmin Levels
Postoperative Third Month's Serum Isthmin Levels
Other: Preoperative BMI
Preoperative the height and the weight of the patient will record. After that BMI will be calculated as formula "The Body Weight (kg)/(The Height (meters)x The Height (meters))
Other: Postoperative BMI
Postoperative third month's the height and the weight of the patient will record. After that BMI will be calculated as formula "The Body Weight (kg)/(The Height (meters)x The Height (meters))

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Serum Isthmin Levels' change
Time Frame: Preoperative and postoperative third month
Serum Isthmin Levels' change
Preoperative and postoperative third month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Saglik Bilimleri Universitesi

Investigators

  • Study Director: Mehmet B Bozan, Professor, Turkish Health Sciences University Elazig City Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2025

Primary Completion (Actual)

January 1, 2026

Study Completion (Actual)

January 1, 2026

Study Registration Dates

First Submitted

January 2, 2026

First Submitted That Met QC Criteria

January 2, 2026

First Posted (Actual)

January 13, 2026

Study Record Updates

Last Update Posted (Actual)

January 13, 2026

Last Update Submitted That Met QC Criteria

January 2, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EFSCH1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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