title: Evolution of low-grade systemic inflammation, insulin resistance, anthropometrics, resting energy expenditure and metabolic syndrome after bariatric surgery: a comparative study between gastric bypass and sleeve gastrectomy.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) for morbid obesity is gaining in popularity as it offers several advantages over laparoscopic Roux-en-Y gastric bypass (LRYGBP), but comparative data between these two procedures have rarely been reported.
  
  
  METHODS
  This case control study compared the incidence of low-grade systemic inflammation, insulin resistance, anthropometrics, resting energy expenditure and metabolic syndrome in 30 patients undergoing LRYGBP and 30 patients undergoing LSG, matched for age, sex, body mass index (BMI), and glycosylated hemoglobin (HbA1c).
  
  
  RESULTS
  At 1-year after surgery, the percent of excess weight loss was 67.8 ± 20.9 for LRYGBP and 61.6 ± 19.4 for LSG. Patients undergoing LRYGBP showed significantly lower plasma levels of C-reactive protein (3.3 ± 2.7 mg/dL vs. 5.3 ± 3.9 mg/dL; P < 0.05), waist circumference (97.4 ± 16.0 vs. 105.5 ± 14.7 cm; P < 0.05), total cholesterol (4.6 ± 1.0 vs. 5.7 ± 0.9 mmol/L; P < 0.01) and LDL cholesterol (2.6 ± 0.8 vs. 3.6 ± 0.8 mmol/L; P < 0.01). Insulin resistance (HOMA index 1.6 ± 1.0 after LRYGBP vs. 2.3 ± 2.4 after LSG), resting energy expenditure (1666.7 ± 320.5 after LRYGBP vs. 1600.4 ± 427.3 Kcal after LSG) and remission of metabolic syndrome (92.9% after LRYGBP vs. 80% after LSG) were not different between the two groups.
  
  
  CONCLUSIONS
  In this study, patients undergoing LRYGBP demonstrated significantly improved lipid profiles, decreased systemic low-grade inflammation compared with those undergoing LSG at 1-year follow-up.
authors.affiliation: Inserm U895, Team 8 "Hepatic complications of obesity", pôle digestif, hôpital Archet 2, université de Nice Sophia-Antipolis, 151, route Saint-Antoine-de-Gines, 06202 Nice, France. Electronic address: antonio_iannelli@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Iannelli
authors.forename: R
authors.initials: R
authors.lastname: Anty
authors.forename: A S
authors.initials: AS
authors.lastname: Schneck
authors.forename: A
authors.initials: A
authors.lastname: Tran
authors.forename: X
authors.initials: X
authors.lastname: Hébuterne
authors.forename: J
authors.initials: J
authors.lastname: Gugenheim
mesh_terms: D000328:Adult; D000886:Anthropometry; D015992:Body Mass Index; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D010535:Laparoscopy; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology* / Q000378:metabolism; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery*; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D008055:Lipids
keywords: Energy expenditure; Gastric bypass; Inflammation; Insulin resistance; Metabolic syndrome; Sleeve gastrectomy