Original articleEffects of postbariatric surgery weight loss on adipokines and metabolic parameters: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy—a prospective randomized trial
Section snippets
Patients
All studies were performed according to the principles of the Declaration of Helsinki and were approved by the local research and ethics committee in Basel, Switzerland. Morbidly obese patients were evaluated for bariatric surgery by an interdisciplinary team and were included in the present study if they fulfilled the criteria for bariatric surgery in Switzerland (body mass index [BMI] >40 kg/m2 with co-morbidity, age <60 yr, 2 yr of unsuccessful conservative treatment, and approval for
Results
After randomization, 12 patients underwent LRYGB and 11 LSG. All procedures were successfully concluded laparoscopically with no conversion to open surgery. The demographic characteristics of the 2 groups of patients are listed in Table 1. Both groups had a similar preoperative body weight and BMI. All patients had undergone a complete evaluation at all points of follow-up.
Discussion
The metabolic control of blood glucose levels largely depends on the efficient action of insulin. These fundamental actions of insulin are defective in obesity, with development of insulin resistance, as illustrated by an increased HOMA index (Table 1, Table 2) in our study population. As previously observed, the LRYGB patients were expected to improve rapidly (hindgut hypothesis). In contrast, the improvement in glucose homeostasis in the LSG patients was expected to occur at a later stage, in
Conclusion
The results of the present study have confirmed an intimate association of specific adipokines with obesity and with the changes observed with weight loss after 2 different bariatric surgical procedures with different anatomic changes to the azgastrointestinal tract. The changes observed are complex. The leptin levels were much greater before surgery and had already decreased 1 week postoperatively, similar to the improved glycemic control after bariatric surgery. The improved glycemic control
Disclosures
R. Peterli receives grant support from, and consults for, Ethicon Endosurgery, USA. The remaining authors have no commercial associations that might be a conflict of interest in relation to this article.
Acknowledgments
We thank the team of the Clinical Research Centre (Luisa Baselgia Jeker and Claudia Bläsi) for expert technical help with these experiments; Silvia Ketterer and Gerdien Gamboni for their work in measuring the hormones; and Ph. Hendrickson for reviewing the manuscript.
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This research was supported by the Swiss National Science Foundation (grants 3200B0-120020 and 320000-118330) and by a grant from Ethicon Endosurgery.