Impact of Roux-en-Y gastric bypass on metabolic syndrome and insulin resistance parameters

Diabetes Technol Ther. 2014 Apr;16(4):262-5. doi: 10.1089/dia.2013.0249. Epub 2013 Dec 3.

Abstract

Background: Metabolic syndrome (MetS) is a complex association of clustering metabolic factors that increase risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. Surgical treatment has become an important tool to achieve its control. The aim of this study was to evaluate the impact of Roux-en-Y gastric bypass (RYGB) on MetS and its individual components, clinical characteristics, and biochemical features.

Subjects and methods: The study is a retrospective cohort of 96 subjects with MetS who underwent RYGB and were evaluated at baseline and after surgery. Clinical and biochemical features were analyzed.

Results: After surgery, significant rates of resolution for MetS (88.5%), T2DM (90.6%), hypertension (85.6%), and dyslipidemias (54.2%) were found. Significant decreases in levels of fasting glucose, fasting insulin, hemoglobin A1c, low-density lipoprotein, and triglycerides and an increase in high-density lipoprotein level were also shown. The decrease in insulin resistance evaluated by homeostasis model assessment (HOMA-IR) was consistent. MetS resolution was associated with postoperative glycemic control, decreases in levels of fasting glucose, hemoglobin A1c, HOMA-IR, and triglycerides and in antihypertensive usage, and percentage weight loss.

Conclusions: This study found high rates of resolution for MetS, T2DM, hypertension, and dyslipidemias after RYGB in obese patients. This finding was consistent with current literature. Hence RYGB should be largely indicated for this group of subjects as it is a safe and powerful tool to achieve MetS control.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Body Mass Index
  • Cardiovascular Diseases / prevention & control
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Fasting
  • Female
  • Follow-Up Studies
  • Gastric Bypass*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Insulin Resistance*
  • Length of Stay
  • Male
  • Metabolic Syndrome / metabolism*
  • Metabolic Syndrome / prevention & control
  • Middle Aged
  • Obesity, Morbid / metabolism*
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery*
  • Remission Induction
  • Retrospective Studies
  • Treatment Outcome
  • Triglycerides
  • Weight Loss

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Triglycerides
  • hemoglobin A1c protein, human