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Quel type de tissu adipeux est perdu après chirurgie bariatrique ?

What type of adipose tissue is lost after bariatric surgery?

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Obésité

Résumé

L’obésité est associée à la résistance à l’insuline et aux dyslipidémies et donc à un très grand risque de développer un diabète de type 2. Les études sur la chirurgie bariatrique (c’est-à-dire, toutes les techniques réduisant ou courtcircuitant l’estomac dans le but d’obtenir une perte de poids) ont montré qu’il n’y avait pas de relation quantitative claire entre la perte de poids induite par la chirurgie et l’amélioration de la sensibilité à l’insuline. La nature - plus que la quantité - de tissu adipeux perdu après une perte de poids massive est importante à prendre en compte parce qu’il est montré qu’une diminution du tissu adipeux viscéral, et non sous-cutané, est significativement corrélée à l’amélioration des facteurs de risques métaboliques, incluant la sensibilité à l’insuline et les triglycérides plasmatiques.

Dans ce travail, les études intéressant les modifications de distribution de la masse grasse et les variations de la sensibilité à l’insuline après une perte de poids induite par les techniques de chirurgie bariatrique ont été passées en revue. Il apparaît que tous les dépôts de tissu adipeux sont touchés par la perte de poids.

Après ces chirurgies, l’amélioration de l’inflammation et la diminution du volume des adipocytes sont significativement associées à l’amélioration de la sensibilité à l’insuline.

Donc d’autres facteurs que la perte de masse grasse en tant que telle semblent jouer un rôle dans l’amélioration de l’insulino-sensibilité lors d’une perte de poids.

Abstract

Obesity is associated with insulin resistance and dyslipidemia and also with a very high risk of developing type 2 diabetes. Studies of bariatric surgery (i.e., techniques that reduce or by-pass the stomach in order to achieve massive weight reduction) show that there is no clear quantitative relationship between the weight loss induced by various surgical procedures and the degree of normalization in insulin sensitivity. The type -more than the amount -of adipose tissue, that is lost after marked weight loss, is of importance because decreased visceral adipose tissue, but not subcutaneous fat mass, correlated significantly with improvements in metabolic risk factors, including insulin sensitivity and plasma triglycerides.

Here we reviewed the studies about the changes in regional fat distribution and insulin sensitivity after bariatric surgery. It appears that the weights of all fat depots were decreased after bariatric surgery.

After bariatric surgery, the improvement of adipose tissue inflammation and decrease of fat cell volume are significantly associated with improvements in insulin sensitivity.

Thus, factors other than fat mass per se could play a role for the beneficial effects on insulin sensitivity of weight loss.

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Authors and Affiliations

  1. Inserm UMR1048, Université Paul Sabatier, Toulouse, France

    E. Montastier

  2. Service d’Endocrinologie, Unité de Nutrition, Hôpital Larrey, 24, chemin de Pouvourville,TSA30030, 31059, Toulouse cedex 9, France

    E. Montastier

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Montastier, E. Quel type de tissu adipeux est perdu après chirurgie bariatrique ?. Obes 11, 8–12 (2016). https://doi.org/10.1007/s11690-015-0505-6

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