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Obesity Surgery

, Volume 19, Issue 5, pp 577–582 | Cite as

Impact of Laparoscopic Roux-en-Y Gastric Bypass on Metabolic Syndrome, Inflammation, and Insulin Resistance in Super Versus Morbidly Obese Women

  • Antonio IannelliEmail author
  • Rodolphe Anty
  • Thierry Piche
  • Moucef Dahman
  • Philippe Gual
  • Albert Tran
  • Jean Gugenheim
Research Article

Abstract

Background

Although Roux-en-Y gastric bypass (RYGBP) is one of the preferred bariatric procedures in obese individuals, the efficacy of this procedure in the setting of super-obesity [body mass index (BMI) ≥50] is unclear. The aim of this study was to compare the efficacy of laparoscopic (L) RYGBP to reverse metabolic syndrome, inflammation, and insulin resistance in super-obese women compared to morbidly obese women.

Methods

Seventy-three consecutive women were enrolled in this prospective study. Anthropometric, metabolic, and inflammatory biological parameters were assessed in 18 super-obese and 55 morbidly obese women before LRYGBP and 1 year after surgery. Metabolic syndrome was diagnosed according to the International Diabetes Federation definition.

Results

Before surgery, super-obese women had a higher BMI, fat mass, blood insulin, and HOMA1-IR than morbidly obese women. Both groups had similar serum levels of C-reactive protein and orosomucoid. The incidence of metabolic syndrome, type 2 diabetes, and increased liver enzymes was comparable in the two groups. One year after LRYGBP, metabolic syndrome, type 2 diabetes, metabolic and inflammatory biological parameters were improved in the whole study population. A similar degree of improvement was observed in super-obese and morbidly obese women, although BMI and fat mass were persistently higher in super-obese patients.

Conclusions

One year after surgery, LRYGBP was equally effective at reversing metabolic syndrome, inflammation, and insulin resistance in morbidly obese and super-obese women.

Keywords

Super-obesity Morbid obesity Gastric bypass Insulin resistance Metabolic syndrome 

Notes

Acknowledgments

This work was supported by grants from the Institut National de la Santé et de la Recherche Médicale (France) (ANR-05-PCOD-025-02 to PG), University of Nice and Programme Hospitalier de Recherche Clinique (CHU of Nice). This work is part of the project “Hepatic and adipose tissue function in metabolic syndrome” (HEPADIP, see http://www.hepadip.org/), which is supported by the European Commission as an Integrated Project under the 6th Framework Programme (Contract LSHM-CT-2005-018734). PG is recipient of an interface Grant from the CHU, Nice. The authors thank P Staccini for the statistical analysis of the data; Dr Floch and Newmed Publishing Services for the correction of the proofs; A Fafin and E Mariné-Barjoan for their assistance.

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Antonio Iannelli
    • 1
    • 2
    • 4
    Email author
  • Rodolphe Anty
    • 1
    • 2
    • 3
  • Thierry Piche
    • 1
    • 2
  • Moucef Dahman
    • 1
    • 2
  • Philippe Gual
    • 1
    • 2
    • 3
  • Albert Tran
    • 1
    • 2
    • 3
  • Jean Gugenheim
    • 1
    • 2
    • 3
  1. 1.Pôle DigestifHôpital Archet 2NiceFrance
  2. 2.Université de Nice Sophia-AntipolisNiceFrance
  3. 3.INSERM U895, Team 8 “Hepatic Complications of Obesity”Université de Nice Sophia-AntipolisNiceFrance
  4. 4.Service de Chirurgie Digestive et Centre de Transplantation HépatiqueHôpital Archet 2Nice Cedex 3France

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