Body weight, insulin resistance, and serum adipokine levels 2 years after 2 types of bariatric surgery.
OBJECTIVE
Bariatric surgery reverses obesity-related comorbidities, including type 2 diabetes mellitus. Several studies have already described differences in anthropometrics and body composition in patients undergoing Roux-en-Y gastric bypass compared with laparoscopic adjustable gastric banding, but the role of adipokines in the outcomes after the different types of surgery is not known. Differences in weight loss and reversal of insulin resistance exist between the 2 groups and correlate with changes in adipokines.


METHODS
Fifteen severely obese women (mean body mass index [BMI]: 46.7 kg/m(2)) underwent 2 types of laparoscopic weight loss surgery (Roux-en-Y gastric bypass=10, adjustable gastric banding=5). Weight, waist and hip circumference, body composition, plasma metabolic markers, and lipids were measured at set intervals during a 24-month period after surgery.


RESULTS
At 24 months, patients who underwent Roux-en-Y were overweight (BMI 29.7 kg/m(2)), whereas patients who underwent gastric banding remained obese (BMI 36.3 kg/m(2)). Patients who underwent Roux-en-Y lost significantly more fat mass than patients who underwent gastric banding (mean difference 16.8 kg, P<.05). Likewise, leptin levels were lower in the patients who underwent Roux-en-Y (P=.003), and levels correlated with weight loss, loss of fat mass, insulin levels, and Homeostasis Model of Assessment 2. Adiponectin correlated with insulin levels and Homeostasis Model of Assessment 2 (r=-0.653, P=.04 and r=-0.674, P=.032, respectively) in the patients who underwent Roux-en-Y at 24 months.


CONCLUSIONS
After 2 years, weight loss and normalization of metabolic parameters were less pronounced in patients who underwent gastric banding compared with patients who underwent Roux-en-Y gastric bypass. Our findings require confirmation in a prospective randomized trial.
Trakhtenbroit
Michael A
MA
Department of Internal Medicine, Division of Cardiology, University of Texas Medical School at Houston, University of Texas Health Science Center at Houston, TX 77030, USA.
Leichman
Joshua G
JG
Algahim
Mohamed F
MF
Miller
Charles C
CC
Moody
Frank G
FG
Lux
Thomas R
TR
Taegtmeyer
Heinrich
H
D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D050110:Bariatric Surgery / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D001835:Body Weight / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D010535:Laparoscopy / Q000379:methods; D020738:Leptin / Q000097:blood; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D011184:Postoperative Period; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
D054392:Adipokines; D052242:Adiponectin; D015415:Biomarkers; D007328:Insulin; D020738:Leptin