Evaluation of metabolic syndrome parameters after Roux-y gastric bypass

Introduction: Morbid obesity is characterized by a state of insulin-resistance and is often associated with metabolic syndrome, increasing overall and cardiovascular mortality. Due to the unsatisfactory results in conventional treatment in specific groups of patients, invasive intervention is an alternative. However, it may be indicated, especially in situations where the patient has severe obesity or morbid obesity. Objective: The present study aims to evaluate the changes in metabolic syndrome parameters after bariatric surgery. Methodology: This is an integrative review of the literature performed through searches in the Scielo, LILACS and PUBMED databases using the following Controlled Health Sciences Descriptors (DeCS): Bariatric Surgery, Gastric Bypass, Obesity and Metabolic Syndrome. The inclusion criteria were: articles in English or Portuguese, text in full, publications in the period from 2009 to 2019 in article format that addressed the theme described. Duplicate publications, articles that did not address the theme after reading the respective abstracts and articles that do not meet the objectives of this study were excluded. Results: According to the analysis of the results, a reduction of 86.1% in the prevalence of metabolic syndrome was observed; 65.3% in arterial hypertension and 84.2% in altered fasting glycemia. A normalization of abdominal circumference in 35.4% of patients, an increase in 35.8% in HDL levels and high triglyceride values may be observed. Among the results obtained, the increase in HDL did not obtain great relevance, as well as the decrease in abdominal circumference. Conclusion: The study showed a positive relationship between bariatric surgery and metabolic syndrome parameters. The results presented were favorable when surgery was associated with a healthy lifestyle and factors that contribute to the effective coping of this condition in most of the cases analyzed. However, multiprofessional follow-up, particularly for medical, nutritional and psychological care, is essential to have a positive impact on the quality of life of these patients.

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Bariatric Surgery in Adults: Patient Workup and Preparation

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1130526 ◽

2020 ◽

pp. 8-14

Author(s):

Ravi Kant ◽

Shankar Roy ◽

Pradeep Yadav KL ◽

Monika Pathania

Keyword(s):

Risk Factors ◽

Metabolic Disease ◽

Bariatric Surgery ◽

Metabolic Syndrome ◽

Morbid Obesity ◽

Life Style ◽

Point Of View ◽

Related Complication ◽

Initial Intervention ◽

Work Up

With the advancement and industrialization of our society, the prevalence of metabolic disease is also increasing. Among the risk factors for metabolic syndrome and many other non-communicable diseases, obesity is the single most important one. Although life style and pharmacological therapies are the part of initial intervention, however once the overt obesity related complication appears, bariatric surgery becomes the only curative intervention. Various modalities surgeries have come into place in recent times. However preparing a patient physically and mentally needs a thorough pre- operative preparation. Here in this review, we are exploring the approach to patient with morbid obesity and work up for bariatric surgery from a physician’s point of view.

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Evaluation of Metabolic Syndrome in morbidly Obese Patients Submitted to Laparoscopic Bariatric Surgery: Comparison of the Results between Roux-En-Y Gastric Bypass and Sleeve Gastrectomy

Obesity Surgery ◽

10.1007/s11695-017-2547-3 ◽

2017 ◽

Vol 27 (7) ◽

pp. 1719-1723 ◽

Cited By ~ 8

Author(s):

Rodrigo Koprovski Menguer ◽

Antônio Carlos Weston ◽

Helena Schmid

Keyword(s):

Bariatric Surgery ◽

Metabolic Syndrome ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Morbidly Obese ◽

Laparoscopic Bariatric Surgery ◽

Obese Patients ◽

Comparison Of The Results

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Resolution of metabolic syndrome and related metabolic disorders after bariatric surgery: comparison of sleeve gastrectomy and gastric bypass

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2018.05.016 ◽

2018 ◽

Vol 14 (9) ◽

pp. 1348-1356 ◽

Cited By ~ 8

Author(s):

Xiao Du ◽

Xiang-hui Fu ◽

Bo-qiang Peng ◽

Rong Luo ◽

Jian-kun Hu ◽

...

Keyword(s):

Bariatric Surgery ◽

Metabolic Syndrome ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Metabolic Disorders

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Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study

Neurosurgical FOCUS ◽

10.3171/2010.5.focus10109 ◽

2010 ◽

Vol 29 (2) ◽

pp. E15 ◽

Cited By ~ 23

Author(s):

Jared M. Pisapia ◽

Casey H. Halpern ◽

Noel N. Williams ◽

Thomas A. Wadden ◽

Gordon H. Baltuch ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Sensitivity Analysis ◽

Gastric Bypass ◽

Deep Brain Stimulation ◽

Decision Analysis ◽

Success Rate ◽

Brain Stimulation ◽

Surgical Complications ◽

Deep Brain

Object Roux-en-Y gastric bypass is the gold standard treatment for morbid obesity, although failure rates may be high, particularly in patients with a BMI > 50 kg/m2. With improved understanding of the neuropsychiatric basis of obesity, deep brain stimulation (DBS) offers a less invasive and reversible alternative to available surgical treatments. In this decision analysis, the authors determined the success rate at which DBS would be equivalent to the two most common bariatric surgeries. Methods Medline searches were performed for studies of laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and DBS for movement disorders. Bariatric surgery was considered successful if postoperative excess weight loss exceeded 45% at 1-year follow-up. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment by LAGB, LRYGB, DBS, or no surgical treatment. A sensitivity analysis in which major parameters were systematically varied within their 95% CIs was used. Results Fifteen studies involving 3489 and 3306 cases of LAGB and LRYGB, respectively, and 45 studies involving 2937 cases treated with DBS were included. The operative successes were 0.30 (95% CI 0.247–0.358) for LAGB and 0.968 (95% CI 0.967–0.969) for LRYGB. Sensitivity analysis revealed utility of surgical complications in LRYGB, probability of surgical complications in DBS, and success rate of DBS as having the greatest influence on outcomes. At no values did LAGB result in superior outcomes compared with other treatments. Conclusions Deep brain stimulation must achieve a success rate of 83% to be equivalent to bariatric surgery. This high-threshold success rate is probably due to the reported success rate of LRYGB, despite its higher complication rate (33.4%) compared with DBS (19.4%). The results support further research into the role of DBS for the treatment of obesity.

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Roux-en-Y-Bariatric Surgery Reduces Markers of Metabolic Syndrome in Morbidly Obese Patients

Obesity Surgery ◽

10.1007/s11695-019-04190-y ◽

2019 ◽

Vol 30 (2) ◽

pp. 391-400 ◽

Cited By ~ 5

Author(s):

G. Rega-Kaun ◽

C. Kaun ◽

G. Jaegersberger ◽

M. Prager ◽

M. Hackl ◽

...

Keyword(s):

Bariatric Surgery ◽

Metabolic Syndrome ◽

Gastric Bypass ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Morbidly Obese ◽

Diabetic Patients ◽

Obese Patients ◽

C Peptide ◽

Hepatic Insulin Clearance

Abstract Background Obesity is closely linked to increased markers of metabolic syndrome and development of diabetes. Roux-en-Y bariatric surgery reduces hyperinsulinemia and improves insulin sensitivity and hence benefits morbidly obese patients. Aim To determine changes in markers of metabolic syndrome, pancreatic function, and hepatic insulin sensitivity in patients before and 1 year after undergoing Roux-en-Y gastric bypass surgery. Methods We enrolled 43 consecutive patients in a single center. Markers for metabolic syndrome included proinsulin, insulin, C-peptide, liver enzymes, and serum levels of selected microRNAs hsa-miR-122, hsa-miR-130, hsa-miR-132, and hsa-miR-375. Results After surgery, all patients showed a significant 37% drop of body mass index (p < 0.001). Furthermore, proinsulin (59% reduction, p < 0.001), insulin (76% reduction, p < 0.001), and C-peptide (56% reduction, p < 0.001) were all reduced 1 year after surgery. Using the hepatic insulin clearance score, we determined a significant increase in hepatic insulin clearance after surgery (76% increase, p < 0.001). Especially diabetic patients showed a marked 2.1-fold increase after surgery. Hepatic enzymes ALT (35% reduction, p = 0.002) and γGT (48% reduction, p < 0.001) were significantly reduced in all patients with similar improvement in diabetic and non-diabetic patients. miRNAs hsa-miR-122, hsa-miR-130, and hsa-miR-132 were all significantly reduced whereas hsa-miR-375 was increased after gastric bypass surgery (p < 0.001 for all miRNAs). Conclusion Both liver and pancreatic stress parameters were reduced significantly 1 year after Roux-en-Y gastric bypass surgery suggesting an overall amelioration of the metabolic syndrome in all patients regardless of previous health status.

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