Effects of the Magenstrasse and Mill operation for obesity on plasma leptin and insulin resistance.
BACKGROUND
We evaluated the effect of the Magenstrasse and Mill (M & M) operation--a new form of non-banded vertical gastroplasty-on weight loss, plasma leptin levels and insulin resistance.


METHODS
Fasting plasma glucose, leptin and insulin levels were measured in 12 normal controls, 39 morbidly obese patients and 39 patients a median 3 years after the M & M procedure. Insulin resistance was calculated by the homeostasis model insulin resistance index.


RESULTS
Body mass index mean (s.d.) decreased significantly (p < 0.0001), from 48(7) to 33(5) kg/m2, after the M & M procedure. Fasting plasma leptin concentration in the morbidly obese group was 37.9(15.4) ng/ml, significantly (p < 0.0001) higher than the control group (12.2(8.4)) and the M & M group (19.1(12.7)) ng/ml. Fasting plasma insulin concentrations were also significantly (p < 0.0001) higher in the morbidly obese group compared with than in the M & M group or in the control group: 35.5(22.3) mU/l, 15.5(7.1) mU/l and 13.6(3.4) mU/l, respectively. Insulin resistance was 9.6(7.2) in the morbidly obese group and 3.5(1.9) in the M & M group (p < 0.0001).


CONCLUSIONS
This is one of the first studies to show that the decrease in insulin resistance after weight loss achieved by anti-obesity surgery is associated with significantly lower levels of plasma leptin.
Carmichael
A R
AR
Academic Department of Surgery and Centre for Digestive Diseases, Leeds General Infirmary, Leeds, UK. homepac@doctors.org.uk
Johnston
D
D
King
R F
RF
Sue-Ling
H M
HM
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D005215:Fasting; D005260:Female; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D015431:Weight Loss
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin