Potential mechanisms mediating improved glycemic control after bariatric/metabolic surgery

Conservative medical treatment for morbid obesity generally fails to sustain weight loss. On the other hand, surgical operations, so-called bariatric surgery, have evolved due to their long-term effects. The global increase in the overweight population and the introduction of laparoscopic surgery ha...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2016-03, Vol.46 (3), p.268-274
Main Authors: Yamamoto, Hiroshi, Kaida, Sachiko, Yamaguchi, Tsuyoshi, Murata, Satoshi, Tani, Masaji, Tani, Tohru
Format: Article
Language:English
Subjects:
Adipose Tissue - metabolism
Animals
Bariatric Surgery - methods
Bile Acids and Salts - metabolism
Body Weight
Diabetes Mellitus, Type 2 - prevention & control
Gastrointestinal Hormones - metabolism
Gastrointestinal Microbiome
Gastrointestinal Motility
Gluconeogenesis
Glycemic Index
Humans
Inflammation Mediators - metabolism
Intestines - metabolism
Laparoscopy
Medicine
Medicine & Public Health
Obesity, Morbid - metabolism
Obesity, Morbid - microbiology
Obesity, Morbid - physiopathology
Obesity, Morbid - surgery
Review Article
Surgery
Surgical Oncology
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Summary:Conservative medical treatment for morbid obesity generally fails to sustain weight loss. On the other hand, surgical operations, so-called bariatric surgery, have evolved due to their long-term effects. The global increase in the overweight population and the introduction of laparoscopic surgery have resulted in the use of bariatric surgery spreading quickly worldwide in recent years. Recent clinical evidence suggests that bariatric surgery not only reduces body weight, but also improves secondary serious diseases, including type 2 diabetes mellitus, in so-called metabolic surgery. Moreover, several potential mechanisms mediating the improvement in glycemic control after bariatric/metabolic surgery have been proposed based on the animal and human studies. These mechanisms include changes in the levels of gastrointestinal hormones, bacterial flora, bile acids, intestinal gluconeogenesis and gastrointestinal motility as well as adipose tissue and inflammatory mediators after surgery. The mechanisms underlying improved glycemic control are expected to accelerate the promotion of both metabolic and bariatric surgery. This article describes the current status of bariatric surgery worldwide and in Japan, reviews the accumulated data for weight loss and diabetic improvements after surgery and discusses the potential mechanisms mediating improved glycemic control.
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-015-1134-2