Laparoscopic Adjustable Gastric Banding for the Treatment of Morbid (Grade 3) Obesity and its Metabolic Complications: A Three-Year Study
| Autor: | Paola Vedani, Antonio E. Pontiroli, Michele Paganelli, E. Cucchi, Monica Marchi, Corrado Orena, Maurizio Giacomelli, Maria Cristina Librenti, Gianfranco Ferla, Franco Folli, Pierluigi Pizzocri |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Gastroplasty Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Biochemistry Impaired glucose tolerance Postoperative Complications Endocrinology Waist–hip ratio Weight loss Internal medicine Weight Loss Blood plasma Diabetes Mellitus medicine Humans Obesity business.industry Insulin Biochemistry (medical) nutritional and metabolic diseases Glucose Tolerance Test medicine.disease Obesity Morbid Treatment Outcome Blood pressure Diabetes Mellitus Type 2 Body Constitution Female Laparoscopy medicine.symptom business Body mass index |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 87:3555-3561 |
| ISSN: | 1945-7197 0021-972X |
| Popis: | Weight loss ameliorates arterial hypertension and glucose metabolism in obese patients, but the dietary approach is unsatisfactory because obesity relapses. Durable reduction of body weight, obtained through major nonreversible surgical procedures, such as jejunal and gastric bypass, allows improvement of glucose metabolism and arterial blood pressure in morbid (grade 3) obesity. Laparoscopic adjustable gastric banding (LAGB) is a minimally invasive and reversible surgical procedure that yields a significant reduction of gastric volume and hunger sensation. In this study, 143 patients with grade 3 obesity [27 men and 116 women; age, 42.9 0.83 yr; body mass index (BMI), 44.9 0.53 kg/m 2 ; normal glucose tolerance (NGT; n 77); impaired glucose tolerance (IGT; n 47); type 2 diabetes mellitus (T2DM; n 19)] underwent LAGB and a 3-yr follow-up for clinical (BMI, waist circumference, waist to hip ratio, and arterial blood pressure) and metabolic variables (glycosylated hemoglobin, fasting insulin and glucose, insulin and glucose response to oral glucose tolerance test, homeostasis model assessment index, total and highdensity lipoprotein cholesterol, triglycerides, uric acid, and transaminases). At baseline and 1 yr after LAGB, patients underwent computerized tomography and ultrasound evaluation of visceral and sc adipose tissue. One-year metabolic results were compared with 120 obese patients (51 men and 69 women; age, 42.9 1.11 yr; BMI, 43.6 0.46 kg/m 2 ; NGT, n 66; IGT, n 8; T2DM, n 46) receiving standard dietary treatment. LAGB induced a significant and persistent weight loss and decrease of blood pressure. Greater metabolic effects were observed in T2DM patients than in NGT and IGT patients, so that at 3 yr glycosylated hemoglobin was no longer different in NGT and T2DM subjects. Clinical and metabolic improvements were proportional to the amount of weight loss. LAGB induced a greater reduction of visceral fat than sc fat. At 1-yr evaluation, weight loss and metabolic improvements were greater in LAGB-treated than diet-treated patients. We conclude that LAGB is an effective treatment of grade 3 obesity in inducing long-lasting reduction of body weight and arterial blood pressure, modifying body fat distribution, and improving glucose and lipid metabolism, especially in T2DM. (J Clin Endocrinol Metab 87: 3555–3561, 2002) |
| Databáze: | OpenAIRE |
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