Body Weight, Insulin Resistance, and Serum Adipokine Levels 2 Years after 2 Types of Bariatric Surgery

Michael A. Trakhtenbroit, Joshua G. Leichman, Mohamed F. Algahim, Charles C. Miller, Frank G. Moody, Thomas R. Lux, Heinrich Taegtmeyer

Research output: Contribution to journalArticlepeer-review

71 Scopus citations

Abstract

Objective: Bariatric surgery reverses obesity-related comorbidities, including type 2 diabetes mellitus. Several studies have already described differences in anthropometrics and body composition in patients undergoing Roux-en-Y gastric bypass compared with laparoscopic adjustable gastric banding, but the role of adipokines in the outcomes after the different types of surgery is not known. Differences in weight loss and reversal of insulin resistance exist between the 2 groups and correlate with changes in adipokines. Methods: Fifteen severely obese women (mean body mass index [BMI]: 46.7 kg/m 2) underwent 2 types of laparoscopic weight loss surgery (Roux-en-Y gastric bypass = 10, adjustable gastric banding = 5). Weight, waist and hip circumference, body composition, plasma metabolic markers, and lipids were measured at set intervals during a 24-month period after surgery. Results: At 24 months, patients who underwent Roux-en-Y were overweight (BMI 29.7 kg/m 2), whereas patients who underwent gastric banding remained obese (BMI 36.3 kg/m 2). Patients who underwent Roux-en-Y lost significantly more fat mass than patients who underwent gastric banding (mean difference 16.8 kg, P < .05). Likewise, leptin levels were lower in the patients who underwent Roux-en-Y (P = .003), and levels correlated with weight loss, loss of fat mass, insulin levels, and Homeostasis Model of Assessment 2. Adiponectin correlated with insulin levels and Homeostasis Model of Assessment 2 (r = -0.653, P = .04 and r = -0.674, P = .032, respectively) in the patients who underwent Roux-en-Y at 24 months. Conclusion: After 2 years, weight loss and normalization of metabolic parameters were less pronounced in patients who underwent gastric banding compared with patients who underwent Roux-en-Y gastric bypass. Our findings require confirmation in a prospective randomized trial.

Original languageEnglish (US)
Pages (from-to)435-442
Number of pages8
JournalAmerican Journal of Medicine
Volume122
Issue number5
DOIs
StatePublished - May 2009
Externally publishedYes

Keywords

  • Adiponectin
  • Bariatric surgery
  • Insulin
  • Leptin
  • Obesity
  • Weight loss

ASJC Scopus subject areas

  • General Medicine

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