Course of metabolic syndrome following the biliopancreatic diversion of Larrad.
BACKGROUND
The authors assessed the effect of Larrad's biliopancreatic diversion (BPD) on the main components of the metabolic syndrome.


METHODS
Plasma concentrations of glucose, insulin, total cholesterol (TC), HDL and LDL cholesterol, triglycerides, LDL/HDL and TC/HDL ratios, and blood pressure and body weight were retrospectively evaluated in 40 patients 3-6, 12, 24 and 60 months after undergoing BPD for morbid obesity with metabolic syndrome.


RESULTS
3-6 months after BPD, glycemia and insulinemia had normalized in 97.5% of the patients and remained stable over the following 5 years. Over this period of 3-6 months to 5 years following BPD, total and LDL cholesterol levels fell by 45.2% and 53.1%, respectively. From 12 months onwards, triglyceride levels decreased appreciably, dropping by 57.4% at 5 years. HDL cholesterol concentrations failed to vary significantly or increased to normal levels in patients showing low initial values. At 5 years, high blood pressure had resolved in 75% of patients and the amount of excess weight lost was 65.5% (+/-14.6). No patient required reversal of the BPD due to severe gastrointestinal or metabolic complications.


CONCLUSIONS
Technically adapted to the patient's weight, the Larrad BPD effectively stabilizes the main components of the metabolic syndrome. The BPD has low morbidity rate and should be considered a therapeutic option for patients who do not respond to medical treatment.
Larrad Jiménez
Alvaro
A
Endocrinology and Metabolism Surgery Unit, Clínica Ruber, Rafael Bergamin 12, 28043 Madrid, Spain. LARRAD@inicia.es
Sánchez Cabezudo
Carlos
C
de Quadros Borrajo
Pedro Pablo
PP
Ramos García
I
I
Moreno Esteban
B
B
García Robles
R
R
D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods*; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007328:Insulin