Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity

• Published in: International Journal of Obesity Vol. 28; no. 5; pp. 671 - 673
• Main Authors: ADAMI, G. F, CORDERA, R, CAMERINI, G, MARINARI, G. M, SCOPINARO, N
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing 01-05-2004; Nature Publishing Group
• Subjects: Adolescent; Adult; Biliopancreatic Diversion; Biological and medical sciences; Blood Glucose - metabolism; Body Mass Index; Care and treatment; Causes of; Complications and side effects; Diabetes; Female; Follow-Up Studies; Gastrointestinal surgery; Glucose; Humans; Insulin - blood; Insulin Resistance; Leptin - blood; Male; Medical sciences; Metabolic diseases; Metabolism; Middle Aged; Obesity; Obesity - blood; Obesity - physiopathology; Obesity - surgery; Postoperative Period; Surgery; Weight control; Weight Loss; Italy; Human; Obesity; Pancreatic hormone; obesity surgery; Nutrition disorder; Insulin; Long term; leptin; insulin sensitivity; Sensitivity; Bypass; Surgery; Biliodigestive; HOMA; Nutritional status
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802618

Assess insulin sensitivity and metabolic status of obese patients with stable weight loss at long term following biliopancreatic diversion (BPD).
The study was carried out in 36 nondiabetic severely obese patients undergoing BPD. Serum concentration of glucose, insulin and leptin were determined prior to and at 2 y following the operation. Insulin sensitivity was calculated according to the homeostatic model assessment (HOMA IR).
At 2 y following BPD, weight loss in all subjects corresponded to a marked drop in serum leptin concentration and improvement of insulin sensitivity within physiological range. Following the operation, HOMA IR values were positively correlated with serum leptin concentration independently of body mass index values.
The stable weight loss following BPD at long term is accompanied by a complete reversal of the preoperative insulin resistance. Serum leptin concentration and HOMA IR data were positively related only postoperatively, suggesting that the action of factors that could influence the relation between leptin and insulin action in the obese status can be reverted.