Review on Remission of Metabolic Syndrome after Gastric Bypass_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DAI Lujie ¹ , WANG Yu ² , WANG Lie ² , HUANG Sheng ²

1.The First Clinical Medicine, Anhui Medical University, Hefei 230032, Anhui Province, China;;
2.Department of General Surgery, Fuzhou General Hospital of Nanjing Military Area Command, Fuzhou 350025, Fujian Province, China;

Corresponding author：

Keywords：

Metabolic syndrome; Gastric bypass; Insulin resistance; Diabetes mellitus

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ObjectiveTo explore the effect of gastric bypass (GBP) on metabolic syndrome (MS) and the related mechanisms. MethodsThe literatures addressed the effect of GBP on glucose metabolism and blood pressure were retrospectively analyzed. ResultsIt showed that GBP achieved durable level of blood glucose, remission of dylipidemia and hypertension, however, which occurred before significant weight loss. The changes of many factors such as food intake, gastrointestinal hormones, adipocytokines, fat distribution might be involved in GBP to improve MS. ConclusionGBP seems to achieve the control of MS as a primary and independent effect, rather than secondary to the treatment of overweight.

Citation： DAI Lujie ,WANG Yu,WANG Lie,HUANG Sheng. Review on Remission of Metabolic Syndrome after Gastric Bypass. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 216-219. doi: Copy

1.	Iannelli A, Anty R, Piche T, et al. Impact of laparoscopic RouxenY gastric bypass on metabolic syndrome, inflammation, and insulin resistance in super versus morbidly obese women [J]. Obes Surg, 2009, 19(5): 577582.
2.	Alberti KG, Zimmet P, Shaw J, et al. The metabolic syndrome-a new worldwide definition [J]. Lancet, 2005, 366(9491): 10591062.
3.	Sjstrm L, Narbro K, Sjstrm CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects [J]. N Engl J Med, 2007, 357(8): 741752.
4.	Morino M, Toppino M, Forestieri P, et al. Mortality after bariatric surgery: analysis of 13 871 morbidly obese patients from a national registry [J]. Ann Surg, 2007, 246(6): 10021009.
5.	Yarbrough DE, Leath RR, Leeth TD, et al. Longterm improvement of gastrointestinal complaints following weight loss in patients undergoing laparoscopic RouxenY gastric bypass (LRYGBP) [J]. ASMBS, 2006, 2(3): 296297.
6.	Bose M, Oliván B, Teixeira J, et al. Do incretins play a role in the remission of type 2 diabetes after gastric bypass surgery: What are the evidence? [J]. Obes Surg, 2009, 19(2): 217229.
7.	Puzziferri N, AustrheimSmith IT, Wolfe BM, et al. Threeyear followup of a prospective randomized trial comparing laparoscopic versus open gastric bypass [J]. Ann Surg, 2006, 243(2): 181188.
8.	Pories WJ, MacDonald KG Jr, Morgan EJ, et al. Surgical treatment of obesity and its effect on diabetes: 10y followup [J]. Am J Clin Nutr, 1992, 55(2 Suppl): 582S585S.
9.	Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial [J]. JAMA, 2008, 299(3): 316323.
10.	Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and metaanalysis [J]. Am J Med, 2009, 122(3): 248256.
11.	Rossi M, R Barretto Ferreira da Silva R, Chaves Alcntara G Jr, et al. Remission of metabolic syndrome: a study of 140 patients six months after RouxenY gastric bypass [J]. Obes Surg, 2008, 18(5): 601606.
12.	Alexandrides TK, Skroubis G, Kalfarentzos F. Resolution of diabetes mellitus and metabolic syndrome following RouxenY gastric bypass and a variant of biliopancreatic diversion in patients with morbid obesity [J]. Obes Surg, 2007, 17(2): 176184.
13.	Zlabek JA, Grimm MS, Larson CJ, et al. The effect of laparosscopic gastric bypss surgery on dyslipidemia in severely obese patients [J]. Surg Obes Relat Dis, 2005, 1(6): 537542.
14.	Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and metaanalysis [J]. JAMA, 2004, 292(14): 17241737.
15.	Ali MR, Fuller WD, Rasmussen J. Detailed description of early response of metabolic syndrome after laparoscopic RouxenY gastric bypass [J]. Surg Obes Relat Dis, 2009, 5(3): 346351.
16.	邓治洲, 王烈, 林忆阳, 等. 胃转流术对非肥胖型2型糖尿病的疗效观察及其对胰高血糖样肽1的影响 [J]. 中国普外基础与临床杂志, 2009, 244(9): 466469.
17.	Scopinaro N, Papadia F, Marinari G, et al. Longterm control of type 2 diabetes mellitus and the other major components of the metabolic syndrome after biliopancreatic diversion in patients with BMI <35 kg/m2 [J]. Obes Surg, 2007, 17(2): 185192.
18.	Couzin J. Bypassing medicine to treat diabetes [J]. Science, 2008, 320(5875): 438440.
19.	DePaula AL, MacedoAL, Schraibman V, et al. Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 2034 [J]. Surg Endosc, 2008, 23(8): 17241732.
20.	Ballantyne GH, Farkas D, Laker S, et al. Shortterm changes in insulin resistance following weight loss surgery for morbid obesity: laparoscopic adjustable gastric banding versus laparoscopic RouxenY gastric bypass [J]. Obes Surg, 2006, 16(9): 11891197.
21.	Haider DG, Schindler K, Schaller G, et al. Increased plasma visfatin concentrations in morbidly obese subjects are reduced after gastric banding [J]. J Clin Endocrinol Metab, 2006, 91(4): 15781581.
22.	Koh KK, Quon MJ, Lee SJ, et al. Efonidipine simultaneously improves blood pressure, endothelial function, and metabolic parameters in nondiabetic patients with hypertension [J]. Diabetes Care, 2007, 30(6): 16051607.
23.	Pischon T, Girman CJ, Hotamisligil GS, et al. Plasma adiponectin levels and risk of myocardial infarction in men [J]. JAMA, 2004, 291(14): 17301737.
24.	Choi KM, Lee J, Lee KW, et al. Serum adiponectin concentrations predict the developments of type 2 diabetes and the metabolic syndrome in elderly Koreans [J]. Clin Endocrinol (Oxf), 2004, 61(1): 7580.
25.	Choi EY, Park EH, Cheong YS, et al. Association of Creactive protein with the metabolic risk factors among young and middleaged Korean [J]. Metabolism, 2006, 55(3): 415421.
26.	GómezAmbrosi J, Pastor C, Salvador J, et al. Influence of waist circumference on the metabolic risk associated with impaired fasting glucose: effect of weight loss after gastric bypass [J]. Obes Surg, 2007, 17(5): 585591.
27.	Kotronen A, SepplLindroos A, Bergholm R, et al. Tissue specificity of insulin resistance in humans: fat in the liver rather than muscle is associated with features of the metabolic syndrome [J]. Diabetologia, 2008, 5(1): 130138.
28.	Stearns AT, Balakrishnan A, Tavakkolizadeh A. Impact of RouxenY gastric bypass surgery on rat intestinal glucose transport [J]. Am J Physiol Gastrointest Liver Physiol, 2009, 297（5）: G950G957.
29.	Rao MN, Mulligan K, Tai V, et al. Effects of insulinlike growth factor (IGF)I/IGFbinding protein3 treatment on glucose metabolism and fat distribution in human immunodeficiency virusinfected patients with abdominal obesity and insulin resistance [J]. J Clin Endocrinol Metab, 2010, 95(9): 43614366.
30.	Wang X, Zhang S, Chen Y, et al. APM1 gene variants11377C/G and 4545G/C are associated respectively with obesity and with nonobesity in Chinese type 2 diabetes [J]. Diabetes Res Clin Pract, 2009, 84(3): 205210.
31.	Kashyap SR, Defronzo RA. The insulin resistance syndrome: physiological considerations [J]. Diab Vasc Dis Res, 2007, 4(1): 1319.
32.	Swarbrick MM, Stanhope KL, AustrheimSmith IT, et al. Longitudinal changes in pancreatic and adipocyte hormone following RouxenY gastric bypass surgery [J]. Diabetolog, 2008, 51(10): 19011911.
33.	周龙翔, 汪昱, 杨喆, 等. 胃癌术后不同残胃患者胃肠激素及机体组成变化 [J]. 中国普外基础与临床杂志, 2009, 16(4): 290295.

1. Iannelli A, Anty R, Piche T, et al. Impact of laparoscopic RouxenY gastric bypass on metabolic syndrome, inflammation, and insulin resistance in super versus morbidly obese women [J]. Obes Surg, 2009, 19(5): 577582.
2. Alberti KG, Zimmet P, Shaw J, et al. The metabolic syndrome-a new worldwide definition [J]. Lancet, 2005, 366(9491): 10591062.
3. Sjstrm L, Narbro K, Sjstrm CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects [J]. N Engl J Med, 2007, 357(8): 741752.
4. Morino M, Toppino M, Forestieri P, et al. Mortality after bariatric surgery: analysis of 13 871 morbidly obese patients from a national registry [J]. Ann Surg, 2007, 246(6): 10021009.
5. Yarbrough DE, Leath RR, Leeth TD, et al. Longterm improvement of gastrointestinal complaints following weight loss in patients undergoing laparoscopic RouxenY gastric bypass (LRYGBP) [J]. ASMBS, 2006, 2(3): 296297.
6. Bose M, Oliván B, Teixeira J, et al. Do incretins play a role in the remission of type 2 diabetes after gastric bypass surgery: What are the evidence? [J]. Obes Surg, 2009, 19(2): 217229.
7. Puzziferri N, AustrheimSmith IT, Wolfe BM, et al. Threeyear followup of a prospective randomized trial comparing laparoscopic versus open gastric bypass [J]. Ann Surg, 2006, 243(2): 181188.
8. Pories WJ, MacDonald KG Jr, Morgan EJ, et al. Surgical treatment of obesity and its effect on diabetes: 10y followup [J]. Am J Clin Nutr, 1992, 55(2 Suppl): 582S585S.
9. Dixon JB, O’Brien PE, Playfair J, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial [J]. JAMA, 2008, 299(3): 316323.
10. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and metaanalysis [J]. Am J Med, 2009, 122(3): 248256.
11. Rossi M, R Barretto Ferreira da Silva R, Chaves Alcntara G Jr, et al. Remission of metabolic syndrome: a study of 140 patients six months after RouxenY gastric bypass [J]. Obes Surg, 2008, 18(5): 601606.
12. Alexandrides TK, Skroubis G, Kalfarentzos F. Resolution of diabetes mellitus and metabolic syndrome following RouxenY gastric bypass and a variant of biliopancreatic diversion in patients with morbid obesity [J]. Obes Surg, 2007, 17(2): 176184.
13. Zlabek JA, Grimm MS, Larson CJ, et al. The effect of laparosscopic gastric bypss surgery on dyslipidemia in severely obese patients [J]. Surg Obes Relat Dis, 2005, 1(6): 537542.
14. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and metaanalysis [J]. JAMA, 2004, 292(14): 17241737.
15. Ali MR, Fuller WD, Rasmussen J. Detailed description of early response of metabolic syndrome after laparoscopic RouxenY gastric bypass [J]. Surg Obes Relat Dis, 2009, 5(3): 346351.
16. 邓治洲, 王烈, 林忆阳, 等. 胃转流术对非肥胖型2型糖尿病的疗效观察及其对胰高血糖样肽1的影响 [J]. 中国普外基础与临床杂志, 2009, 244(9): 466469.
17. Scopinaro N, Papadia F, Marinari G, et al. Longterm control of type 2 diabetes mellitus and the other major components of the metabolic syndrome after biliopancreatic diversion in patients with BMI <35 kg/m2 [J]. Obes Surg, 2007, 17(2): 185192.
18. Couzin J. Bypassing medicine to treat diabetes [J]. Science, 2008, 320(5875): 438440.
19. DePaula AL, MacedoAL, Schraibman V, et al. Hormonal evaluation following laparoscopic treatment of type 2 diabetes mellitus patients with BMI 2034 [J]. Surg Endosc, 2008, 23(8): 17241732.
20. Ballantyne GH, Farkas D, Laker S, et al. Shortterm changes in insulin resistance following weight loss surgery for morbid obesity: laparoscopic adjustable gastric banding versus laparoscopic RouxenY gastric bypass [J]. Obes Surg, 2006, 16(9): 11891197.
21. Haider DG, Schindler K, Schaller G, et al. Increased plasma visfatin concentrations in morbidly obese subjects are reduced after gastric banding [J]. J Clin Endocrinol Metab, 2006, 91(4): 15781581.
22. Koh KK, Quon MJ, Lee SJ, et al. Efonidipine simultaneously improves blood pressure, endothelial function, and metabolic parameters in nondiabetic patients with hypertension [J]. Diabetes Care, 2007, 30(6): 16051607.
23. Pischon T, Girman CJ, Hotamisligil GS, et al. Plasma adiponectin levels and risk of myocardial infarction in men [J]. JAMA, 2004, 291(14): 17301737.
24. Choi KM, Lee J, Lee KW, et al. Serum adiponectin concentrations predict the developments of type 2 diabetes and the metabolic syndrome in elderly Koreans [J]. Clin Endocrinol (Oxf), 2004, 61(1): 7580.
25. Choi EY, Park EH, Cheong YS, et al. Association of Creactive protein with the metabolic risk factors among young and middleaged Korean [J]. Metabolism, 2006, 55(3): 415421.
26. GómezAmbrosi J, Pastor C, Salvador J, et al. Influence of waist circumference on the metabolic risk associated with impaired fasting glucose: effect of weight loss after gastric bypass [J]. Obes Surg, 2007, 17(5): 585591.
27. Kotronen A, SepplLindroos A, Bergholm R, et al. Tissue specificity of insulin resistance in humans: fat in the liver rather than muscle is associated with features of the metabolic syndrome [J]. Diabetologia, 2008, 5(1): 130138.
28. Stearns AT, Balakrishnan A, Tavakkolizadeh A. Impact of RouxenY gastric bypass surgery on rat intestinal glucose transport [J]. Am J Physiol Gastrointest Liver Physiol, 2009, 297（5）: G950G957.
29. Rao MN, Mulligan K, Tai V, et al. Effects of insulinlike growth factor (IGF)I/IGFbinding protein3 treatment on glucose metabolism and fat distribution in human immunodeficiency virusinfected patients with abdominal obesity and insulin resistance [J]. J Clin Endocrinol Metab, 2010, 95(9): 43614366.
30. Wang X, Zhang S, Chen Y, et al. APM1 gene variants11377C/G and 4545G/C are associated respectively with obesity and with nonobesity in Chinese type 2 diabetes [J]. Diabetes Res Clin Pract, 2009, 84(3): 205210.
31. Kashyap SR, Defronzo RA. The insulin resistance syndrome: physiological considerations [J]. Diab Vasc Dis Res, 2007, 4(1): 1319.
32. Swarbrick MM, Stanhope KL, AustrheimSmith IT, et al. Longitudinal changes in pancreatic and adipocyte hormone following RouxenY gastric bypass surgery [J]. Diabetolog, 2008, 51(10): 19011911.
33. 周龙翔, 汪昱, 杨喆, 等. 胃癌术后不同残胃患者胃肠激素及机体组成变化 [J]. 中国普外基础与临床杂志, 2009, 16(4): 290295.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Review on Remission of Metabolic Syndrome after Gastric Bypass

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