title: Metabolic disorders of liver and iron in diabetic and non-diabetic patients BMI < 35 or > 35 before gastric bypass.
abstract: BACKGROUND
  The presence of abnormalities in the metabolic pathways of iron and liver functioning can produce insulin resistance or metabolic syndrome. Therefore, it is important to examine those alterations that may lead to the development of diseases. Nutritional status is another important factor that is intimately linked to diabetes and obesity.
  
  
  METHODS
  We studied 131 patients (78 nondiabetic patients and 53 diabetic), 37 patients BMI ≤35 (3 BMI < 25, 18 BMI 25-29.9, 16 BMI 30-34.9) and 94 patients BMI ≥35 (81 BMI 35-49.9 and 13 BMI ≥50). Subjects underwent to laboratory studies related to liver functioning and iron metabolism. Nutritional status was also determined in our patients.
  
  
  RESULTS
  Iron was altered 14% of patients BMI >35 and diabetics reached 3% to 25%. Vitamin B12 was low 4% of non-diabetics BMI > 35, and high in 6% of diabetics BMI < 35. The 6% of diabetics BMI < 35 had hyperbilirubinemia. Transaminases are elevated in patients BMI >35 but exacerbated on diabetics. GGT is raised 41% to 47% in BMI >35. ALP is elevated in 25% of diabetics. Total protein and serum albumin were altered in diabetics causing mild malnutrition. 90% of patients had normal nutrition and 10% mild malnutrition.
  
  
  CONCLUSIONS
  The metabolisms Hepatic and iron are closely related to the onset of obesity and diabetes. If there is weight gain, cumulative metabolic risks rise. The presence of diabesity and increased duration of diabetes produce altered metabolism. Nutritional status is altered in obesity but is worse with the addition of diabetes.
authors.affiliation: Dept. of Surgery, Medical Faculty. Malaga. Spain. Autonomous University of the State of Mexico. U.M.F. 229, Del. 16. Mexican Social Security Institute. Mexico.. gcaballe@uma.es.
authors.forename: Manuel
authors.initials: M
authors.lastname: Garcíacaballero
authors.affiliation: Dept. of Surgery, Medical Faculty. Malaga. Spain.. alexxanderhola@yahoo.com.mx.
authors.forename: Alexander
authors.initials: A
authors.lastname: Reyes-Ortiz
authors.affiliation: Dept. of Surgery, Medical Faculty. Malaga. Spain.. jmmartinezm@uma.es.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Martínez-Moreno
authors.affiliation: Dept. of Surgery, Medical Faculty. Malaga. Spain.. josetoval@telefonica.net.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Toval-Mata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D019189:Iron Metabolism Disorders / Q000601:surgery*; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008659:Metabolic Diseases / Q000601:surgery*; D008875:Middle Aged; D009752:Nutritional Status; D016896:Treatment Outcome; D055815:Young Adult