Insulin resistance and bariatric surgery

  • Rao R
  • Yanagisawa R
  • Kini S
 et al. 
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Abstract

The objective of this article is to systematically review the changes in insulin resistance after various types of bariatric surgical procedures. A Pubmed and EMBASE search for studies measuring insulin resistance before and after bariatric surgery was done and all original research articles from 1980 to present (2011) were included. Only the currently widely performed bariatric procedures were included. A meta-analysis of change in HOMA-IR was conducted, grouping studies with similar duration of follow-up. The percentage decrease in HOMA-IR at 16-18 months was found to be (mean+/-standard error) -33.48+/-5.78, -46.43+/-6.99, -38.79+/-9.64, -58.62+/-7.38, -44.91+/-7.98 and -67.04+/-10.78%, respectively. RYGB (gastric bypass) and BPD (biliopancreatic diversion) produced a significant decrease in insulin resistance at 2 weeks after surgery, while LSG (sleeve gastrectomy) was strongly trending. LSG produced an earlier decrease in insulin resistance when compared to LAGB (gastric banding). RYGB, BPD and LSG produce an early decrease in insulin resistance through yet unknown mechanisms. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

Author-supplied keywords

  • *bariatric surgery
  • *insulin resistance
  • Embase
  • Medline
  • Roux Y anastomosis
  • adiponectin/ec [Endogenous Compound]
  • biliopancreatic bypass
  • body mass
  • caloric restriction
  • diabetes mellitus
  • embase
  • follow up
  • gastric banding
  • gastric inhibitory polypeptide/ec [Endogenous Comp
  • ghrelin/ec [Endogenous Compound]
  • glucagon like peptide 1/ec [Endogenous Compound]
  • homeostasis model of assessment of insulin resista
  • human
  • incretin/ec [Endogenous Compound]
  • insulin receptor substrate/ec [Endogenous Compound
  • insulin sensitivity
  • insulin/ec [Endogenous Compound]
  • insulinoma
  • interleukin 1/ec [Endogenous Compound]
  • intraabdominal fat
  • intravenous glucose tolerance test
  • laparoscopic sleeve gastrectomy
  • laparoscopic surgery
  • leptin/ec [Endogenous Compound]
  • meta analysis
  • oral glucose tolerance test
  • pubmed
  • review
  • sleeve gastrectomy
  • stomach bypass
  • systematic review
  • tumor necrosis factor alpha/ec [Endogenous Compoun

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Authors

  • R S Rao

  • R Yanagisawa

  • S Kini

  • Rao R.S.

  • Yanagisawa R.

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