TY - JOUR
T1 - Body Weight, Insulin Resistance, and Serum Adipokine Levels 2 Years after 2 Types of Bariatric Surgery
AU - Trakhtenbroit, Michael A.
AU - Leichman, Joshua G.
AU - Algahim, Mohamed F.
AU - Miller, Charles C.
AU - Moody, Frank G.
AU - Lux, Thomas R.
AU - Taegtmeyer, Heinrich
N1 - Funding Information:
Funding: The National Heart, Lung, and Blood Institute of the US Public Health Service (R01 HL73162) and National Institute of Diabetes and Digestive and Kidney Diseases (2 T35 DK007676-16).
PY - 2009/5
Y1 - 2009/5
N2 - 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.
AB - 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.
KW - Adiponectin
KW - Bariatric surgery
KW - Insulin
KW - Leptin
KW - Obesity
KW - Weight loss
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U2 - 10.1016/j.amjmed.2008.10.035
DO - 10.1016/j.amjmed.2008.10.035
M3 - Article
C2 - 19375553
AN - SCOPUS:64349097097
SN - 0002-9343
VL - 122
SP - 435
EP - 442
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 5
ER -