Division of Gastroenterology, Hepatology, and Nutrition, MLC 2010, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, OH 45229, USA.
Rev Endocr Metab Disord. 2011 Sep;12(3):211-7. doi: 10.1007/s11154-011-9172-6.
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortality. Further, the resolution of T2DM has long been understood to precede weight loss, and this finding provides important clues about the physiologic underpinnings of the observation. In order to design more effective, safe, and widely available therapeutics for obesity, important and highly relevant questions need to be addressed regarding mechanisms behind the weight-loss-independent benefits of bariatric surgical procedures. This review will provide an overview of the molecular changes occurring across all biological systems after bariatric surgery including the changes in hepatic, adipocyte and gut derived signals after surgery. We will also discuss existing literature regarding the weight-loss-independent metabolic benefits including improvement in insulin sensitivity and central nervous system integration of these signals.
减重手术已成为治疗成人和青少年肥胖及其合并症（如葡萄糖耐量受损、2 型糖尿病[T2DM]、代谢综合征、脂肪性肝炎、血脂异常和心血管疾病）的重要治疗选择。这些肥胖合并症对个体和整个社会的整体生活质量都有重大影响。Roux-en-Y 胃旁路术（RYGB）和相对较新的胃带术（GB）和垂直袖状胃切除术（VSG）已被证明能有效快速减轻体重并逆转肥胖合并症。不幸的是，减重手术并非没有风险，包括微量营养素缺乏、无法维持减重效果和死亡率。此外，T2DM 的缓解早已被认为先于体重减轻，这一发现为观察到的生理基础提供了重要线索。为了设计更有效、安全和广泛可用的肥胖治疗方法，需要解决与减重手术独立获益相关的重要且高度相关的问题，这些问题涉及减重手术背后的机制。本综述将概述减重手术后所有生物系统发生的分子变化，包括手术后肝脏、脂肪细胞和肠道来源的信号的变化。我们还将讨论关于减重手术独立的代谢获益的现有文献，包括改善胰岛素敏感性和这些信号在中枢神经系统中的整合。
