Laboratory for Health and Exercise Science, Department of Human Nutrition, Foods and Exercise, Virginia Polytechnic Institute and State University, 231-A War Memorial Hall 0351, Blacksburg, VA 24061, USA.
Obes Surg. 2010 May;20(5):559-68. doi: 10.1007/s11695-010-0089-z. Epub 2010 Feb 23.
Bariatric surgery is a common procedure often used to ameliorate comorbidities associated with obesity, including type 2 diabetes. Substantial weight loss leads to alterations in inflammation and insulin sensitivity as well as numerous metabolic and physiologic pathways. Several inflammatory markers have been evaluated, yet adiponectin, an anti-inflammatory adipokine, has not been fully investigated. Adiponectin may play a key role as a mediator between obesity and inflammation, as lower blood levels are more commonly associated with obesity and type 2 diabetes and because adiponectin lessens insulin resistance. This review evaluates outcome variables from patients who underwent Roux-en-Y gastric bypass (RYGB) or restrictive bariatric surgery to compare and contrast any differential surgical impacts on weight loss, adiponectin, and insulin.
A systematic literature review was conducted using a PubMed search. Published studies from 1999 to 2009 that measured blood levels of adiponectin and insulin in bariatric surgery patients prior to and at least 6 months after surgery were included.
Eighteen studies met inclusion criteria for evaluation. RYGB surgery compared to restrictive surgery led to significantly greater weight loss and improvements in adiponectin and insulin sensitivity. Despite significant weight loss, many patients did not achieve "healthy" body mass index or normalization of inflammatory markers.
While RYGB surgery appears to more favorably influence body weight and inflammatory markers, data are insufficient to fully understand the impact of bariatric surgery on changes in adiponectin and insulin and related health implications. Long-term research is needed to more thoroughly evaluate inflammatory outcomes following these two bariatric surgery procedures.
减重手术是一种常见的手术，常用于改善肥胖相关的合并症，包括 2 型糖尿病。大量的体重减轻会导致炎症和胰岛素敏感性的改变，以及许多代谢和生理途径的改变。已经评估了几种炎症标志物，但脂联素，一种抗炎脂肪因子，尚未得到充分研究。脂联素可能在肥胖和炎症之间作为一种中介物发挥关键作用，因为较低的血液水平更常见于肥胖和 2 型糖尿病，并且脂联素可以减轻胰岛素抵抗。本综述评估了接受 Roux-en-Y 胃旁路术（RYGB）或限制型减重手术的患者的结果变量，以比较和对比任何对体重减轻、脂联素和胰岛素的不同手术影响。
使用 PubMed 搜索进行了系统的文献综述。纳入了 1999 年至 2009 年发表的研究，这些研究在减重手术前和手术后至少 6 个月测量了脂联素和胰岛素在减重手术患者中的血液水平。
有 18 项研究符合评估标准。与限制型手术相比，RYGB 手术导致体重明显减轻，脂联素和胰岛素敏感性改善。尽管体重明显减轻，但许多患者并未达到“健康”体重指数或炎症标志物正常化。
虽然 RYGB 手术似乎更有利于影响体重和炎症标志物，但数据不足以充分了解减重手术对脂联素和胰岛素变化的影响以及相关的健康影响。需要进行长期研究，以更全面地评估这两种减重手术程序后的炎症结果。
