[Carbohydrate metabolism derangements in patients with morbid obesity: weight loss impact].
OBJECTIVE
Examination of carbohydrate metabolism derangements in patients with morbid obesity and the influence of weight reduction through nutritional intervention. Assessment of gender influence on carbohydrate metabolism derangements and on response to diet.


METHODS
59 patients with morbid obesity were studied with anthropometric assessment and with carbohydrate metabolism assessment through an oral glucose overload and measurement of insulin resistance, before and after a dietary intervention alternating diets of very low caloric content with conventional low-calorie diets.


RESULTS
A very significant global weight reduction in both sexes was observed (95% confidence interval [CI], 26.9 to 39.8 kg in males, and 13.5 to 20.3 kg in women). A significant improvement in basal blood glucose was found in both sexes (95% CI: males, 0.44 to 46.5 mg/dl; women, 9.5 to 32.8 mg/dl), and in 120 minute oral glucose tolerance test (OGTT) blood glucose in women (95% CI: 3.5 to 52.9 mg/dl). Both males and women showed significant improvement in basal insulinemia (95% CI: males, 1.6 to 14.2 microU/ml; women, 3.9 to 8.5 microU/ml) and in sex hormone-binding globulins (SHBG) (95% CI: males, -30.1 to -13.3 nmol/l; women, -54 to -19.4 nmol/l). Both males and women showed an improvement of sensitivity to insulin measured with HOMA (HOMAIR) (95% CI: males, 1.46 to 3.59; women, 0.67 to 2.24).


CONCLUSIONS
In patients with morbid obesity carbohydrate metabolism derangements are common. Weight reduction led to a significant reduction of these derangements.
Solá Izquierdo
E
E
Sección de Endocrinología, Hospital Universitario Doctor Peset, Valencia. solaeva@yahoo.es
Morillas Ariño
C
C
Royo Taberner
R
R
García Torres
S
S
Núñez Tortajada
A
A
Hernández Mijares
A
A
D000328:Adult; D000368:Aged; D050260:Carbohydrate Metabolism; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy / Q000378:metabolism*; D015431:Weight Loss / Q000502:physiology*