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Effects of Weight Loss in Metabolically Healthy Obese Subjects after Laparoscopic Adjustable Gastric Banding and Hypocaloric Diet

By Giorgio Sesti, Franco Folli, Lucia Perego, Marta Letizia Hribal and Antonio E. Pontiroli

Abstract

Weight loss in metabolically healthy obese (MHO) subjects may result in deterioration of cardio-metabolic risk profile. We analyzed the effects of weight loss induced by laparoscopic adjustable gastric banding (LAGB) on cardio-metabolic risk factors in MHO and insulin resistant obese (IRO) individuals. This study included 190 morbidly obese non-diabetic subjects. Obese individuals were stratified on the basis of their insulin sensitivity index (ISI), estimated from an OGTT, into MHO (ISI index in the upper quartile) and IRO (ISI in the three lower quartiles). Anthropometric and cardio-metabolic variables were measured at baseline and 6-months after LAGB. Six months after LAGB, anthropometric measures were significantly reduced in both MHO and IRO. Percent changes in body weight, BMI, and waist circumference did not differ between the two groups. Fasting glucose and insulin levels, triglycerides, AST, and ALT were significantly reduced, and HDL cholesterol significantly increased, in both MHO and IRO subjects with no differences in percent changes from baseline. Insulin sensitivity increased in both MHO and IRO group. Insulin secretion was significantly reduced in the IRO group only. However, the disposition index significantly increased in both MHO and IRO individuals with no differences in percent changes from baseline between the two groups. The change in insulin sensitivity correlated with the change in BMI (r = −0.43; P<0.0001). In conclusion, our findings reinforce the recommendation that weight loss in response to LAGB intervention should be considered an appropriate treatment option for morbidly obese individuals regardless of their metabolic status, i.e. MHO vs. IRO subjects

Topics: Research Article
Publisher: Public Library of Science
OAI identifier: oai:pubmedcentral.nih.gov:3050899
Provided by: PubMed Central

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Citations

  1. (2009). Are metabolically normal but obese individuals at lower risk for all-cause mortality?
  2. (2006). Body mass index, metabolic syndrome, and risk of type 2 diabetes or cardiovascular disease.
  3. (2010). Effects of a lifestyle intervention in metabolically benign and malign obesity.
  4. (2010). Effects of weight loss among metabolically healthy obese men and women.
  5. (2009). Elevated one-hour post-load plasma glucose levels identifies subjects with normal glucose tolerance but early carotid atherosclerosis.
  6. (2008). Identification and characterization of metabolically benign obesity in humans.
  7. (2010). IGF-1 levels link estimated glomerular filtration rate to insulin resistance in obesity: A study in obese, but metabolically healthy, subjects and obese, insulin-resistant subjects. Nutr Metab Cardiovasc Dis.In press.
  8. (2005). Impact of common polymorphisms in candidate genes for insulin resistance and obesity on weight loss of morbidly obese subjects after laparoscopic adjustable gastric banding and hypocaloric diet.
  9. (2008). Insulin Secretion in Metabolically Obese, but Normal Weight, and in Metabolically Healthy but Obese Individuals.
  10. (1999). Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp.
  11. (2002). Laparoscopic adjustable gastric banding for the treatment of morbid (grade 3) obesity and its metabolic complications: a three-year study.
  12. (2005). Laparoscopic gastric banding prevents type 2 diabetes and arterial hypertension and induces their remission in morbid obesity: a 4-year case-controlled study.
  13. (2004). Metabolic and body composition factors in subgroups of obesity: what do we know?
  14. (2007). Metabolically healthy but obese women have an intermediate cardiovascular risk profile between healthy non-obese women and obese insulin resistant women.
  15. (2008). Metabolically healthy but obese women: effect of an energy-restricted diet.
  16. (2010). One-hour postload plasma glucose levels are associated with kidney dysfunction.
  17. (2011). Prevalence, metabolic features and prognosis of metabolically healthy obese Italian individuals: the Cremona Study.
  18. (2005). The metabolically healthy but obese individual presents a favorable inflammation profile.
  19. (2008). The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering: prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004).
  20. (2000). Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity.
  21. (2006). Weight loss effect on inflammation and LDL oxidation in metabolically healthy but obese (MHO) individuals: low inflammation and LDL oxidation in MHO women.
  22. (2001). What are the physical characteristics associated with a normal metabolic profile despite a high level of obesity in postmenopausal women?