Adami G F, Cordera R, Camerini G, Marinari G M, Scopinaro N
Department of Surgery, University of Genoa School of Medicine, Genoa, Italy.
Int J Obes Relat Metab Disord. 2004 May;28(5):671-3. 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.
评估胆胰分流术（BPD）后长期体重稳定减轻的肥胖患者的胰岛素敏感性和代谢状态。
本研究对36例接受BPD的非糖尿病重度肥胖患者进行。在手术前及术后2年测定血清葡萄糖、胰岛素和瘦素浓度。根据稳态模型评估（HOMA-IR）计算胰岛素敏感性。
BPD术后2年，所有受试者体重减轻，血清瘦素浓度显著下降，胰岛素敏感性在生理范围内得到改善。术后，HOMA-IR值与血清瘦素浓度呈正相关，独立于体重指数值。
BPD术后长期体重稳定减轻伴随着术前胰岛素抵抗的完全逆转。血清瘦素浓度和HOMA-IR数据仅在术后呈正相关，表明在肥胖状态下可能影响瘦素与胰岛素作用关系的因素的作用可以逆转。
