[Obesity, immune resistance and metabolic complications: what morbid obesity can teach the doctor].
Abdominal -- and not peripheral -- obesity induces insulin resistance. Morbid obesity is not always accompanied by either diabetes mellitus or metabolic syndrome. Development of morbid obesity can require appropriate insulin secretion and recruitment of small insulin-sensitive adipocytes, able to store fatty acids. These fatty acids are therefore not stored in ectopic sites (muscle, liver, islets of Langerhans), and neither insulin resistance nor glucolipid toxicity develops and causes insulin deficiency. This explains the relative rarity of diabetes in morbid obesity. Patients with morbid obesity are at greater risk of developing mechanical complications (e.g. cardiac, pulmonary, or locomotor system, or sleep apnea) than metabolic complications or cardiovascular heart disease.
Bihan
Hélène
H
Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, Hôpital Avicenne AP-HP, et Centre de Recherche en Nutrition Humaine Ile-de-France, Université Paris 13, EA 3412, Bobigny Cedex, France.
Choleau
Carine
C
Cohen
Régis
R
Reach
Gérard
G
D017667:Adipocytes / Q000378:metabolism; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002478:Cells, Cultured; D008076:Cholesterol, HDL / Q000097:blood; D002986:Clinical Trials as Topic; D003971:Diastole; D005227:Fatty Acids / Q000378:metabolism; D054439:Ghrelin / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D009767:Obesity, Morbid / Q000097:blood / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D010455:Peptides / Q000097:blood; D013599:Systole; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D005227:Fatty Acids; D054439:Ghrelin; D006442:Glycated Hemoglobin; D007328:Insulin; D010455:Peptides; D014280:Triglycerides; C050632:polypeptide C