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Changes in lipid profile and insulin resistance in obese patients after Scopinaro biliopancreatic diversion

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Abstract

Background

Obesity is associated with many cardiovascular risk factors. The aim of this study is to evaluate the effect of bariatric surgery (BS) in lipid profile and insulin resistance in obese patients.

Material and Methods

We studied changes in lipid parameters glucose, insulin, and insulin resistance (IR) before biliopancreatic diversion and 3, 6, 12, 18, and 24 months after surgery, in 115 obese patients divided in two groups: diabetics (DM) and nondiabetics (non-DM).

Results

In both groups, all parameters significantly decreased at 3 months; however, high-density lipoprotein cholesterol levels (HDL-c) and total cholesterol (TC) to HDL-c ratio decreased up to 6 months. At baseline, in DM, we found a negative correlation between body mass index (BMI) and TC to HDL-c ratio and glucose with HDL-c and homeostasis model assessment (HOMA) with BMI and a direct correlation between glucose with TC to HDL-c ratio and glucose with triglycerides. In non-DM, no correlations were found. Comparing both groups for each parameter, we found significant differences at basal levels for glucose, HOMA, triglycerides (TG), and TG to HDL-c ratio. Changes between basal levels and 1 year after surgery were significantly different in glucose and HOMA.

Conclusion

BS offers excellent results in weight reduction and significantly improves IR, diabetes, and the lipid profile, decreasing global cardiovascular risk.

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References

  1. Lee WJ, Huang MT, Wang W, et al. Effects of obesity surgery on the metabolic syndrome. Arch Surg 2004;139(10):1088–92. October.

    Article  PubMed  Google Scholar 

  2. Geloneze B, Tambascia MA, Pareja JC, et al. The insulin tolerance test in morbidly obese patients undergoing bariatric surgery. Obes Res 2001;9(12):763–9. December.

    Article  CAS  PubMed  Google Scholar 

  3. Busetto L, Sergi G, Enzi G, et al. Short-term effects of weight loss on the cardiovascular risk factors in morbidly obese patients. Obes Res 2004;12(8):1256–63. August.

    Article  PubMed  Google Scholar 

  4. Rossner S, Bjorvell H. Early and late effects of weight loss on lipoprotein metabolism in severe obesity. Atherosclerosis 1987;64(2–3):125–30. April.

    Article  CAS  PubMed  Google Scholar 

  5. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735–52. October 25.

    Article  PubMed  Google Scholar 

  6. Barakat HA, Carpenter JW, McLendon VD, et al. Influence of obesity, impaired glucose tolerance, and NIDDM on LDL structure and composition. Possible link between hyperinsulinemia and atherosclerosis. Diabetes 1990;39(12):1527–33. December.

    Article  CAS  PubMed  Google Scholar 

  7. Dixon JB, O’Brien PE. Lipid profile in the severely obese: changes with weight loss after lap-band surgery. Obes Res 2002;10(9):903–10. September.

    Article  PubMed  Google Scholar 

  8. Pereira JA, Lazarin MA, Pareja JC, et al. Insulin resistance in nondiabetic morbidly obese patients: effect of bariatric surgery. Obes Res 2003;11(12):1495–501. December.

    Article  PubMed  Google Scholar 

  9. Stubbs RS, Wickremesekera SK. Insulin resistance in the severely obese and links with metabolic co-morbidities. Obes Surg 2002;12(3):343–8. June.

    Article  PubMed  Google Scholar 

  10. Vage V, Berstad A, Solhaug JH, et al. Cardiovascular risk factors in obese patients treated with jejunoileal bypass operation: a 25-year follow-up study. Scand J Gastroenterol 2005;40(1):90–5. January.

    Article  PubMed  Google Scholar 

  11. Rribas del AD, Elia GM, Aguilella DV, et al. Effect of vertical banded gastroplasty on hypertension, diabetes and dyslipidemia. Obes Surg 2002;12(3):319–23. June.

    Article  Google Scholar 

  12. Brolin RE, Bradley LJ, Wilson AC, et al. Lipid risk profile and weight stability after gastric restrictive operations for morbid obesity. J Gastrointest Surg 2000;4(5):464–9. September.

    Article  CAS  PubMed  Google Scholar 

  13. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351(26):2683–93. December 23.

    Article  PubMed  Google Scholar 

  14. Lubrano C, Cornoldi A, Pili M, et al. Reduction of risk factors for cardiovascular diseases in morbid-obese patients following biliary-intestinal bypass: 3 years’ follow-up. Int J Obes Relat Metab Disord 2004;28(12):1600–6. December.

    Article  CAS  PubMed  Google Scholar 

  15. Diniz MF, Diniz MT, Sanches SR, et al. Glycemic control in diabetic patients after bariatric surgery. Obes Surg 2004;14(8):1051–5. September.

    Article  PubMed  Google Scholar 

  16. Adami GF, Cordera R, Camerini G, et al. Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity. Int J Obes Relat Metab Disord 2004;28(5):671–3. May.

    Article  CAS  PubMed  Google Scholar 

  17. Gleysteen JJ, Barboriak JJ, Sasse EA. Sustained coronary-risk-factor reduction after gastric bypass for morbid obesity. Am J Clin Nutr 1990;51(5):774–8. May.

    Article  CAS  PubMed  Google Scholar 

  18. McLaughlin T, Abbasi F, Cheal K, et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003;139(10):802–9. November 18.

    Article  PubMed  Google Scholar 

  19. Genuth S, Alberti KG, Bennett P, et al. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26(11):3160–7. November.

    Article  PubMed  Google Scholar 

  20. Scopinaro N. Laparoscopic BPD. Obes Surg 2000;10(6):524. December.

    Article  PubMed  Google Scholar 

  21. Scopinaro N, Marinari GM, Camerini G. Laparoscopic standard biliopancreatic diversion: technique and preliminary results. Obes Surg 2002;12(2):241–4. April.

    Article  PubMed  Google Scholar 

  22. Scopinaro N, Marinari GM, Camerini G. Laparoscopic standard biliopancreatic diversion: technique and preliminary results. Obes Surg 2002;12(3):362–5. June.

    Article  PubMed  Google Scholar 

  23. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18(6):499–502. June.

    CAS  PubMed  Google Scholar 

  24. Wood WG. Luminescence immunoassays: problems and possibilities. J Clin Chem Clin Biochem 1984;22(12):905–18. December.

    CAS  PubMed  Google Scholar 

  25. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28(7):412–9. July.

    Article  CAS  PubMed  Google Scholar 

  26. Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg 2007;17(5):565–8. May.

    Article  PubMed  Google Scholar 

  27. Carr DB, Utzschneider KM, Hull RL, et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 2004;53(8):2087–94. August.

    Article  CAS  PubMed  Google Scholar 

  28. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285(19):2486–97. May 16.

    Article  Google Scholar 

  29. Wolf AM, Beisiegel U, Kortner B, et al. Does gastric restriction surgery reduce the risks of metabolic diseases. Obes Surg 1998;8(1):9–13. February.

    Article  CAS  PubMed  Google Scholar 

  30. Larrad JA, Sanchez CC, de Quadros Borrajo PP, et al. Course of metabolic syndrome following the biliopancreatic diversion of Larrad. Obes Surg 2004;14(9):1176–81. October.

    Article  Google Scholar 

  31. Spivak H, Hewitt MF, Onn A, et al. Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg 2005;189(1):27–32. January.

    Article  PubMed  Google Scholar 

  32. Dhabuwala A, Cannan RJ, Stubbs RS. Improvement in co-morbidities following weight loss from gastric bypass surgery. Obes Surg 2000;10(5):428–35. October.

    Article  CAS  PubMed  Google Scholar 

  33. Silvestre V, Ruano M, Dominguez Y, et al. Morbid obesity and gastric bypass surgery: biochemical profile. Obes Surg 2004;14(9):1227–32. October.

    Article  CAS  PubMed  Google Scholar 

  34. Flancbaum L. Mechanisms of weight loss after surgery for clinically severe obesity. Obes Surg 1999;9(6):516–23. December.

    Article  CAS  PubMed  Google Scholar 

  35. Cowan GS Jr, Buffington CK. Significant changes in blood pressure, glucose, and lipids with gastric bypass surgery. World J Surg 1998;22(9):987–92. September.

    Article  PubMed  Google Scholar 

  36. Brizzi P, Angius MF, Carboni A, et al. Plasma lipids and lipoprotein changes after biliopancreatic diversion for morbid obesity. Dig Surg 2003;20(1):18–23.

    Article  CAS  PubMed  Google Scholar 

  37. Corradini SG, Eramo A, Lubrano C, et al. Comparison of changes in lipid profile after bilio-intestinal bypass and gastric banding in patients with morbid obesity. Obes Surg 2005;15(3):367–77. March.

    Article  PubMed  Google Scholar 

  38. Papapietro K, Diaz E, Csendes A, et al. Effects of gastric bypass on weight, blood glucose, serum lipid levels and arterial blood pressure in obese patients. Rev Med Chil 2005;133(5):511–6. May.

    Article  PubMed  Google Scholar 

  39. Wolf AM, Beisiegel U. The effect of loss of excess weight on the metabolic risk factors after bariatric surgery in morbidly and super-obese patients. Obes Surg 2007;17(7):910–9. July.

    Article  PubMed  Google Scholar 

  40. Garcia-Diaz JD, Lozano O, Ramos JC, et al. Changes in lipid profile after biliopancreatic diversion. Obes Surg 2003;13(5):756–60. October.

    Article  Google Scholar 

  41. Scopinaro N, Marinari GM, Camerini GB, et al. Specific effects of biliopancreatic diversion on the major components of metabolic syndrome: a long-term follow-up study. Diabetes Care 2005;28(10):2406–11. October.

    Article  PubMed  Google Scholar 

  42. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292(14):1724–37. October 13.

    Article  CAS  PubMed  Google Scholar 

  43. Vazquez LA, Pazos F, Berrazueta JR, et al. Effects of changes in body weight and insulin resistance on inflammation and endothelial function in morbid obesity after bariatric surgery. J Clin Endocrinol Metab 2005;90(1):316–22. January.

    Article  CAS  PubMed  Google Scholar 

  44. Wickremesekera K, Miller G, Naotunne TD, Knowles G, Stubbs RS. Loss of insulin resistance after Roux-en-Y gastric bypass surgery: a time course study. Obes Surg 2005;15(4):474–81. April.

    Article  PubMed  Google Scholar 

  45. Rubino F. Bariatric surgery: effects on glucose homeostasis. Curr Opin Clin Nutr Metab Care 2006;9(4):497–507. July.

    Article  CAS  PubMed  Google Scholar 

  46. Brehm A, Pfeiler G, Pacini G, et al. Relationship between serum lipoprotein ratios and insulin resistance in obesity. Clin Chem 2004;50(12):2316–22. December.

    Article  CAS  PubMed  Google Scholar 

  47. Muscelli E, Mingrone G, Camastra S, et al. Differential effect of weight loss on insulin resistance in surgically treated obese patients. Am J Med 2005;118(1):51–7. January.

    Article  CAS  PubMed  Google Scholar 

  48. Capella JF, Capella RF. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg 1996;171(1):74–9. January.

    Article  CAS  PubMed  Google Scholar 

  49. Ballantyne GH, Gumbs A, Modlin IM. Changes in insulin resistance following bariatric surgery and the adipoinsular axis: role of the adipocytokines, leptin, adiponectin and resistin. Obes Surg 2005;15(5):692–9. May.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinical Analysis Service, Son Dureta Hospital, Andrea Doria 55, 07014, Palma de Mallorca, Balearic Islands, Spain

    Magdalena Vila, Olga Ruíz, Mar Belmonte, Maria Riesco, Antonia Barceló & Gerardo Perez

  2. Endocrinology and Nutrition Service, Son Dureta Hospital, Palma de Mallorca, Spain

    Jose Moreiro

  3. Surgery Service, Son Dureta Hospital, Palma de Mallorca, Spain

    Ramon Salinas

Authors
  1. Magdalena Vila
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  2. Olga Ruíz
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  3. Mar Belmonte
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  4. Maria Riesco
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  5. Antonia Barceló
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  6. Gerardo Perez
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  7. Jose Moreiro
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  8. Ramon Salinas
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Correspondence to Mar Belmonte.

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Vila, M., Ruíz, O., Belmonte, M. et al. Changes in lipid profile and insulin resistance in obese patients after Scopinaro biliopancreatic diversion. OBES SURG 19, 299–306 (2009). https://doi.org/10.1007/s11695-008-9790-6

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  • DOI: https://doi.org/10.1007/s11695-008-9790-6

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