Serum leptin levels after bariatric surgery across a range of glucose tolerance from normal to diabetes

A longitudinal, clinical intervention study with bariatric surgery was done to investigate the relationship between leptin levels, BMI, and insulin during weight loss across a range of glucose tolerance from normal to diabetes. 43 morbidly obese patients (BMI: 42-75 kg/m2) undergoing vertical banded...

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Bibliographic Details
Published in:Obesity surgery 2001-12, Vol.11 (6), p.693-698
Main Authors: Geloneze, B, Tambascia, M A, Pareja, J C, Repetto, E M, Magna, L A, Pereira, S G
Format: Article
Language:English
Subjects:
Adult
Blood Glucose - metabolism
Body Mass Index
Diabetes Mellitus - metabolism
Female
Gastric Bypass
Gastrointestinal surgery
Glucose Intolerance - metabolism
Humans
Insulin - metabolism
Leptin - blood
Longitudinal Studies
Male
Middle Aged
Obesity
Obesity, Morbid - blood
Obesity, Morbid - metabolism
Obesity, Morbid - surgery
Regression Analysis
Weight control
Weight Loss - physiology
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Summary:A longitudinal, clinical intervention study with bariatric surgery was done to investigate the relationship between leptin levels, BMI, and insulin during weight loss across a range of glucose tolerance from normal to diabetes. 43 morbidly obese patients (BMI: 42-75 kg/m2) undergoing vertical banded gastroplasty Roux-en-Y gastric bypass (VBG-RGB), were divided into 3 groups: 21 normal (NGT), 12 impaired glucose tolerance (IGT) and 10 type 2 diabetes (DM). Leptin, insulin, glucose, lipids and uric acid were measured at baseline and 2, 4, 6, and 12 months following surgery. BMI fell from 54.1 +/- 9.1 to 34.6 +/- 6.3 kg/m2, similarly in all groups. Leptin decreased from 73.9 +/- 8.7 to 16.9 +/- 10.2 ng/ml and was strongly correlated with BMI during 1-year follow-up (r = 0.78; p < 0.001). Linear univariate analysis for repeated evaluation showed a positive correlation between leptin and glucose, triglycerides, uric acid, and insulin. Multivariate regression analysis indicated that BMI was independently correlated with the decrease in leptin (p < 0.001), accounting for 66% of the variance in leptin levels during weight loss. These results were found in the NGT and IGT groups. In the DM group, a small additional influence in leptin levels was attributed to glucose decrease. A strong link between leptin and BMI was found after surgery. BMI was the main determinant of the decrease of leptin. In these patients submitted to bariatric surgery, ranging from normal glucose tolerance to diabetes, changes in insulin levels and metabolic parameters, except for glucose in the DM group, did not appear to be correlated with changes in leptin levels.
ISSN:0960-8923
1708-0428
DOI:10.1381/09608920160558623