Introduction: A-FABP (Adipocyte fatty acid-binding protein) has been shown to affect lipid metabolism, insulin sensitivity, and lipolysis furthermore, studies also found that A-FABP is a key mediator for obesity-related cardiovascular disease and is usually associated with metabolic syndrome. Although A-FABP is thought to be a cytoplasmic protein, it is also detectable in the human bloodstream. Recent evidence showed that circulating A-FABP level to be an independent predictor of the development of metabolic syndrome and diabetes.
Objective: The association of A-FABP with obesity and the decrease of its level after laparoscopic omega loop gastric bypass as indicator of improvement of metabolic syndrome.
Patients and methods: Sixty-five morbid-obese patients had laparoscopic omega loop gastric bypass at Ain Shams University Hospitals and cure hospital from February 2018 to June 2019 with a mean age of 42.5±9.6 years were included in the study with comparative to non-obese control group. The A-FABP was measured before Laparoscopic omega loop gastric bypass and after 1 year of follow-up.
Results: FABP1 levels in the obese 10.5 (8.25-14.25) P < 0.01, as compared to the control group 1.5 (0.675-2.625) analysis revealed that the FABP1 levels were positively correlated with BMI (P < 0.01). After weight loss, A-FABP plasmatic levels decreased significantly [3.4 (0.2-6)] ) P < 0.01.
With correlation to improvement of the laboratory investigations of the metabolic syndrome fasting, 2 hours postprandial
blood glucose level (2hPP) and glycated hemoglobin (HbA1) cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)} fasting serum insulin level. Highly sensitive C-reactive protein (hsCRP). Were also analyzed and they showed a significant difference between the obese patients and 1 year after surgery. 
Conclusion: Serum A -FABP1 levels are markedly associated with obesity and correlated with an increase in BMI, and it markedly decreased with weight loss after omega loop gastric bypass.