Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity.
OBJECTIVE
Assess insulin sensitivity and metabolic status of obese patients with stable weight loss at long term following biliopancreatic diversion (BPD).


METHODS
The study was carried out in 36 nondiabetic severely obese patients undergoing BPD. Serum concentration of glucose, insulin and leptin were determined prior to and at 2 y following the operation. Insulin sensitivity was calculated according to the homeostatic model assessment (HOMA IR).


RESULTS
At 2 y following BPD, weight loss in all subjects corresponded to a marked drop in serum leptin concentration and improvement of insulin sensitivity within physiological range. Following the operation, HOMA IR values were positively correlated with serum leptin concentration independently of body mass index values.


CONCLUSIONS
The stable weight loss following BPD at long term is accompanied by a complete reversal of the preoperative insulin resistance. Serum leptin concentration and HOMA IR data were positively related only postoperatively, suggesting that the action of factors that could influence the relation between leptin and insulin action in the obese status can be reverted.
Adami
G F
GF
Department of Surgery, University of Genoa School of Medicine, Genoa, Italy. adami@unige.it
Cordera
R
R
Camerini
G
G
Marinari
G M
GM
Scopinaro
N
N
D000293:Adolescent; D000328:Adult; D015904:Biliopancreatic Diversion; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D015431:Weight Loss
D001786:Blood Glucose; D007328:Insulin; D020738:Leptin