Key result
Laparoscopic adjustable gastric banding significantly increased adiponectin levels from 11.19 to 15.58 µg/mL in nondiabetic morbidly obese patients and reduced insulin resistance in diabetic patients at 1 year.
Why the study?
Does laparoscopic adjustable gastric banding improve blood glucose, insulin resistance, and adipokine levels in morbidly obese patients with and without type 2 diabetes mellitus?
Cohort (n=103)
No
Does laparoscopic adjustable gastric banding improve blood glucose, insulin resistance, and adipokine levels in morbidly obese patients with and without type 2 diabetes mellitus?
Absolute Event Rate: 15.58% vs 11.19%
p-value: p=0.003
Laparoscopic adjustable gastric banding significantly improves adipokine profiles and insulin resistance, leading to high rates of type 2 diabetes remission in morbidly obese patients.
May support metabolic benefits of LAGB in morbid obesity; leaves open whether changes improve long-term glycemic control in randomized trials.
OBJECTIVE: The aim of the study was to evaluate blood glucose, insulin resistance indices, and adipokine (leptin and adiponectin) levels in morbidly obese individuals with and without type 2 diabetes mellitus and to compare the changes in these parameters 1 year after laparoscopic adjustable gastric banding surgery. MATERIAL AND METHODS: In total, 103 patients (37 subjects with and 66 subjects without type 2 diabetes mellitus) were studied preoperatively and again 1 year after laparoscopic adjustable gastric banding. RESULTS: One year after laparoscopic adjustable gastric banding, the leptin concentrations decreased significantly in both treatment groups, while the adiponectin levels increased significantly in the nondiabetic patients (11.19 µg/mL [SD 7.20] vs. 15.58 µg/mL [SD 7.8], P=0.003) and tended to increase in the group of the patients with type 2 diabetes mellitus (8.98 µg/mL [SD 6.80] vs. 13.01 µg/mL [SD 12.14], P>0.05). A considerable decrease in the insulin resistance indices was noted in the patients with type 2 diabetes mellitus 1 year after the intervention, and it was followed by a partial or complete remission of type 2 diabetes mellitus in 23 (85.19%) of the 27 investigated diabetic patients. The postoperative insulin resistance indices in the patients with type 2 diabetes mellitus became similar to the values in the nondiabetic subjects. CONCLUSIONS: Weight loss after laparoscopic adjustable gastric banding is associated with a significant increase in adiponectin secretion in nondiabetic morbidly obese patients and with improvement in adiponectin secretion in type 2 diabetes individuals. In subjects with type 2 diabetes, this surgical intervention results in a significant reduction in blood glucose and insulin resistance.
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Urbanavičius et al. (2013) conducted a cohort in Morbid obesity with and without type 2 diabetes mellitus (n=103). Laparoscopic adjustable gastric banding vs. Baseline was evaluated on Adiponectin levels in nondiabetic patients (p=0.003). Laparoscopic adjustable gastric banding significantly increased adiponectin levels from 11.19 to 15.58 µg/mL in nondiabetic morbidly obese patients and reduced insulin resistance in diabetic patients at 1 year.
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