Obesity Surgery

, Volume 20, Issue 5, pp 559–568

A Review of Weight Loss Following Roux-en-Y Gastric Bypass vs Restrictive Bariatric Surgery: Impact on Adiponectin and Insulin

  • Katrina L. Butner
  • Sharon M. Nickols-Richardson
  • Susan F. Clark
  • Warren K. Ramp
  • William G. Herbert
Review

DOI: 10.1007/s11695-010-0089-z

Cite this article as:
Butner, K.L., Nickols-Richardson, S.M., Clark, S.F. et al. OBES SURG (2010) 20: 559. doi:10.1007/s11695-010-0089-z

Abstract

Background

Bariatric surgery is a common procedure often used to ameliorate comorbidities associated with obesity, including type 2 diabetes. Substantial weight loss leads to alterations in inflammation and insulin sensitivity as well as numerous metabolic and physiologic pathways. Several inflammatory markers have been evaluated, yet adiponectin, an anti-inflammatory adipokine, has not been fully investigated. Adiponectin may play a key role as a mediator between obesity and inflammation, as lower blood levels are more commonly associated with obesity and type 2 diabetes and because adiponectin lessens insulin resistance. This review evaluates outcome variables from patients who underwent Roux-en-Y gastric bypass (RYGB) or restrictive bariatric surgery to compare and contrast any differential surgical impacts on weight loss, adiponectin, and insulin.

Methods

A systematic literature review was conducted using a PubMed search. Published studies from 1999 to 2009 that measured blood levels of adiponectin and insulin in bariatric surgery patients prior to and at least 6 months after surgery were included.

Results

Eighteen studies met inclusion criteria for evaluation. RYGB surgery compared to restrictive surgery led to significantly greater weight loss and improvements in adiponectin and insulin sensitivity. Despite significant weight loss, many patients did not achieve “healthy” body mass index or normalization of inflammatory markers.

Conclusions

While RYGB surgery appears to more favorably influence body weight and inflammatory markers, data are insufficient to fully understand the impact of bariatric surgery on changes in adiponectin and insulin and related health implications. Long-term research is needed to more thoroughly evaluate inflammatory outcomes following these two bariatric surgery procedures.

Keywords

Bariatric surgery Adiponectin Insulin 

Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Katrina L. Butner
    • 1
  • Sharon M. Nickols-Richardson
    • 2
  • Susan F. Clark
    • 3
  • Warren K. Ramp
    • 4
  • William G. Herbert
    • 1
  1. 1.Laboratory for Health and Exercise Science and Bone, Osteoporosis, Nutrition, and Exercise Laboratory, Department of Human Nutrition, Foods and ExerciseVirginia Polytechnic Institute and State UniversityBlacksburgUSA
  2. 2.Bone Metabolism, Osteoporosis, and Nutrition Evaluation Laboratory, Department of Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkUSA
  3. 3.Department of Human Nutrition, Foods and ExerciseVirginia Polytechnic Institute and State UniversityBlacksburgUSA
  4. 4.Health Research Group, LLCRockbridge BathsUSA