title: Metabolic effects of bariatric surgery in insulin-sensitive morbidly obese subjects.
abstract: BACKGROUND
  The effects of bariatric surgery (BS) in metabolically healthy morbidly obese (MO) subjects are not well established. Against this background, we characterized the metabolic and inflammatory profiles of MO subjects with insulin sensitivity (IS) in the normal range, and evaluated the changes on these parameters following BS in this population.
  
  
  METHODS
  We conducted a retrospective analysis of prospectively collected data in MO women undergoing BS between 2006 and 2010. Anthropometric, metabolic comorbidities, and inflammatory markers were compared at baseline and 12 months after BS, between 52 women (10.4%) presenting with a HOMA-IR < 2.94 (80th percentile reference population) (IS-MO group) and an age- and BMI-matched group of women (n = 52) with HOMA-IR > 2.94.
  
  
  RESULTS
  The IS-MO women presented a more favorable metabolic and inflammatory profile as compared to the IR-MO group. However, an enlarged waist circumference (WC), a high-sensitivity C-reactive protein (hs-CRP) > 3 mg/dL, and metabolic syndrome (MS) were present in 100%, 90%, and 51.9% of the IS-MO group at baseline. At 12 months after surgery, all the MS components and hs-CRP improved in IS-MO subjects (p < 0.01). The prevalence of the MS in the IS-MO group significantly decreased (11%, p < 0.05) despite WC and hs-CRP being abnormal respectively in 53.3% and 20.0% of women in this group.
  
  
  CONCLUSIONS
  In MO women, an IS in the normal range is associated with a limited protection from metabolic co-morbidities. Nonetheless, BS results in the amelioration of the altered metabolic and inflammatory profiles also in this group of subjects.
authors.affiliation: Obesity Unit, Hospital Clinic Universitari, Barcelona, Spain.
authors.forename: Amanda
authors.initials: A
authors.lastname: Jiménez
authors.forename: Verónica
authors.initials: V
authors.lastname: Perea
authors.forename: Ricard
authors.initials: R
authors.lastname: Corcelles
authors.forename: Violeta
authors.initials: V
authors.lastname: Moizé
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacy
authors.forename: Josep
authors.initials: J
authors.lastname: Vidal
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000097:blood* / Q000601:surgery*; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human