Multiple effects of bariatric surgery on human biochemical status
https://doi.org/10.14341/omet9754
Abstract
Beneficial effect of bariatric surgery is expressed not only in reducing body weight, but also in improving the functioning of the body as a whole. On the one hand, numerous studies devoted to the investigations of specific mechanisms of the influence of bariatric surgery on the general condition of an organism testify to the enormous interest of scientists in this problem. On the other hand, the range of changes is so vast that it covers almost all physiological and biochemical processes. The most noticeable response to bariatric surgery is from the digestive (including the composition of the microbiota), immune (reducing the level of systemic and local inflammation), cardiovascular (reducing the risks of atherosclerosis and other diseases) systems. Partial or complete compensation of type 2 diabetes mellitus and metabolic syndrome also occurs. Among the variety of data, there is insufficient research on only standard biomarkers: leptin, C-reactive protein, interleukin 6, etc. A detailed study of the profiles of both circulating biomarkers and local ones is necessary. At the same time, it is obligate to continue to accumulate evidence on the positive effect of bariatric surgery, since this type of surgical intervention has come into practice relatively recently. Unfortunately, at the present time in Russia bariatric surgery is not an affordable and popular treatment for morbid obesity (MO). Nevertheless, it is extremely important to change the current situation, since bariatric treatment is an optimal and effective solution to socially significant diseases such as MO or type 2 diabetes mellitus.
About the Authors
Natalya N. SushentsevaRussian Federation
Svetlana V. Apalko
Russian Federation
PhD
Evgeny V. Vasiliev
The Saint Petersburg State Health Care Establishment the City Hospital №40
Russian Federation
MD
Dmitrii V. Gladyshev
The Saint Petersburg State Health Care Establishment the City Hospital №40
Russian Federation
MD, PhD
Stanislava N. Vrublevskaya
Russian Federation
MD, resident
Vladimir V. Salukhov
Russian Federation
MD, PhD
Andrey M. Sarana
The Saint Petersburg State Health Care Establishment the City Hospital №40; Saint-Petersburg State University
Russian Federation
MD, PhD
Sergey G. Scherbak
The Saint Petersburg State Health Care Establishment the City Hospital №40; Saint-Petersburg State University
Russian Federation
MD, PhD, Professor
References
1. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med. 2017;376(7):641-651. DOI:https://doi.org/10.1056/NEJMoa1600869
2. Ершова Е.В., Трошина Е.А., Федорова О.С., и др. Морбидное ожирение возможности консервативной терапии. // Ожирение и метаболизм. — 2010. — Т. 7. — №4. — С. 40-43. [Ershova EV, Troshina EA, Fedorova OS, et al. Morbidnoe ozhirenie - vozmozhnostikonservativnoy terapii. Obesity and metabolism. 2010;7(4):40-43. (In Russ.)] DOI:10.14341/2071-8713-5087
3. Савельева Л.В. Современная концепция лечения ожирения. // Ожирение и метаболизм. — 2011. — Т. 8. — №1. — С. 51-56. [Savel’eva LV. Sovremennaya kontseptsiya lecheniya ozhireniya. Obesity and metabolism. 2011;8(1):51-56. (In Russ.)] DOI:10.14341/2071-8713-5191
4. Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567-1576. DOI:10.1056/NEJMoa1200225
5. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med. 2014;370(21):2002-2013. DOI:10.1056/NEJMoa1401329
6. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724-1737. DOI:10.1001/jama.292.14.1724
7. Arterburn DE, Olsen MK, Smith VA, et al. Association between bariatric surgery and long-term survival. JAMA. 2015;313(1):62-70. DOI:10.1001/jama.2014.16968
8. Яшков Ю.И. Хирургия ожирения: современное состояние и перспективы. // Ожирение и метаболизм. — 2005. — Т. 2. — №2. — С. 11-16. [Yashkov YI. Khirurgiya ozhireniya: sovremennoe sostoyanie i perspektivy. Obesity and metabolism. 2005;2(2):11-16. (In Russ.)] DOI:10.14341/2071-8713-4925
9. Дедов И.И., Мельниченко Г.А., Шестакова М.В., и др. Национальные клинические рекомендации по лечению морбидного ожирения у взрослых. 3-ий пересмотр (лечение морбидного ожирения у взрослых). // Ожирение и метаболизм. — 2018. — Т. 15. — №1. С. 53-70. [Dedov II, Mel’nichenko GA, Shestakova MV, et al. Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults). Obesity and metabolism. 2018;15(1):53-70. (In Russ.)] DOI:10.14341/omet2018153-70
10. Дедов И.И., Шестакова М.В., Майоров А.Ю., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. / Под ред. Дедова И.И., Шестаковой М.В., Майорова А.Ю. — 8-й выпуск. // Сахарный диабет. — 2017. — Т. 20. — №1S. — C. 1-121. [Dedov II, Shestakova MV, Mayorov AY, et al. Dedov II, Shestakova MV, Mayorov AY, editors. Standards of specialized diabetes care. 8th ed. Diabetes mellitus. 2017;20(1S):1-121. (In Russ.)] DOI:10.14341/DM20171S8
11. Бордан Н.С., Яшков Ю.И. Интервенционные методы лечения сахарного диабета 2-го типа и морбидного ожирения. // Поликлиника. — 2017. — № 1-2. — С. 46-52. [Bordan NS, Yashkov YI. Interventional treatment of diabetes mellitus type 2 and obesity. Poliklinika. 2017;(1-2):46-52. (In Russ.)]
12. Яшков Ю.И., Синеокая М.С., Данюшин В.М. Применение внутрижелудочных баллонов с целью предоперационной подготовки больных со сверхожирением. // Ожирение и метаболизм. — 2009. — Т. 6. — №2. — С. 29-33. [Yashkov YI, Sineokaya MS, Danyushin VM. The use of intragastric ballons for preoperational treatment in patients with superobesity. Obesity and metabolism. 2009;6(2):29-33. (In Russ.)] DOI:10.14341/2071-8713-5315
13. Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery. Pediatr Clin North Am. 2009;56(5):1105-1121. DOI:10.1016/j.pcl.2009.07.002
14. Мельниченко Г.А., Мамедова Е.О. Ятрогенные поражения скелета. // Ожирение и метаболизм. — 2016. — Т. 13. — №2. — С. 41-47. [Melnichenko GA, Mamedova EO. Iatrogenic lesions of the skeleton. Obesity and metabolism. 2016;13(2):41-47. (In Russ.)] DOI:10.14341/omet2016241-47
15. Бодунова Н.А., Хатьков И.Е., Сабельникова Е.А., и др. Изменение концентрации витаминов после бариатрических операций. // Медицинский Вестник Северного Кавказа. — 2015. — Т. 10. — №4. — С. 348-352. [Bodunova NA, Khatkov IE, Sabelnikova EA, et al. Vitamins concentration after bariatric surgery. Medical news of North Caucasus. 2015;10(4):348-352. (In Russ.)] DOI:10.14300/mnnc.2015.10085
16. Aasheim ET, Bjorkman S, Sovik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15-22. DOI:10.3945/ajcn.2009.27583
17. Brzozowska MM, Sainsbury A, Eisman JA, et al. Bariatric surgery, bone loss, obesity and possible mechanisms. Obes Rev. 2013;14(1):52-67. DOI:10.1111/j.1467-789X.2012.01050.x
18. Nomura RM, Dias MC, Igai AM, et al. Anemia during pregnancy after silastic ring Roux-en-Y gastric bypass: influence of time to conception. Obes Surg. 2011;21(4):479-484. DOI:10.1007/s11695-011-0376-3
19. Окороков П.Л., Васюкова О.В., Дедов И.И. Бариатрическая хирургия в лечении морбидного ожирения у подростков (обзор литературы). // Проблемы эндокринологии. — 2016. — Т. 62. — №3. — С. 25-32. [Okorokov PL, Vasyukova OV, Dedov II. Bariatric surgery in the treatment of morbid obesity in adolescents (literature review). Problems of endocrinology. 2016;62(3):25-32. (In Russ.)] DOI:10.14341/probl201662325-32
20. Дедов И.И., Яшков Ю.И., Ершова Е.В. Инкретины и их влияние на течение сахарного диабета 2 типа у пациентов с морбидным ожирением после бариатрических операций. // Ожирение и метаболизм. — 2012. — Т. 9. — №2. — С. 3-10. [Dedov II, Yashkov YI, Ershova EV. Incretins and their influence on the course of type 2 diabetes in patients with morbid obesity after bariatric operations. Obesity and metabolism. 2012;9(2):3-10. (In Russ.)] DOI:10.14341/omet201223-10
21. Craig CM, Liu LF, Deacon CF, et al. Critical role for GLP-1 in symptomatic post-bariatric hypoglycaemia. Diabetologia. 2017;60(3):531-540. DOI:10.1007/s00125-016-4179-x
22. Steinert RE, Feinle-Bisset C, Asarian L, et al. Ghrelin, CCK, GLP-1, and PYY(3-36): Secretory Controls and Physiological Roles in Eating and Glycemia in Health, Obesity, and After RYGB. Physiol Rev. 2017;97(1):411-463. DOI:10.1152/physrev.00031.2014
23. Ranganath LR, Beety JM, Morgan LM, et al. Attenuated GLP-1 secretion in obesity: cause or consequence? Gut. 1996;38(6):916-919. DOI:10.1136/gut.38.6.916
24. Boettcher BR. Gastric bypass surgery mimetic approaches. Drug Discov Today. 2017;22(8):1242-1249. DOI:10.1016/j.drudis.2017.04.009
25. Ершова Е.В., Трошина Е.А., Яшков Ю.И. Динамика показателей липидного обмена и их взаимосвязь с секрецией глюкагоноподобного пептида-1 и глюкозозависимого инсулинотропного полипептида у пациентов с ожирением и сахарным диабетом 2 типа после билиопанкреатического шунтирования в модификации Hess. // Ожирение и метаболизм. — 2016. — Т. 13. — №3. — С. 38-44. [Ershova EV, Troshina EA, Yashkov YI. Lipid metabolism and production of incretins in patients with obesity and type 2 diabetes mellitus after biliopancreatic diversion in Hess-Marceau modification at the early stages of follow-up. Obesity and metabolism. 2016;13(3):38-44. (In Russ.)] DOI:10.14341/omet2016338-44
26. Costa Justus JF, Ligocki Campos AC, Figueroa AL, et al. Early Effect of Bariatric Surgery on the Circadian Rhythms of Adipokines in Morbidly Obese Women. Metab Syndr Relat Disord. 2016;14(1):16-22. DOI:10.1089/met.2015.0051
27. Смирнова Е.Н., Шулькина С.Г. Содержание лептина, растворимых рецепторов лептина и индекса свободного лептина у больных с метаболическим синдромом. // Ожирение и метаболизм. — 2017. — Т. 14. — №1. — С. 30-34. [Smirnova EN, Shulkina SG. Leptin, soluble leptin receptor, and free leptin index in patients with metabolic syndrome. Obesity and metabolism. 2017;14(1):30-34. (In Russ.)] DOI:10.14341/omet2017130-34
28. Trevaskis JL, Lei C, Koda JE, et al. Interaction of leptin and amylin in the long-term maintenance of weight loss in diet-induced obese rats. Obesity (Silver Spring). 2010;18(1):21-26. DOI:10.1038/oby.2009.187
29. Roth JD, Roland BL, Cole RL, et al. Leptin responsiveness restored by amylin agonism in diet-induced obesity: evidence from nonclinical and clinical studies. Proc Natl Acad Sci U S A. 2008;105(20):7257-7262. DOI:10.1073/pnas.0706473105
30. Illan-Gomez F, Gonzalvez-Ortega M, Orea-Soler I, et al. Obesity and inflammation: change in adiponectin, C-reactive protein, tumour necrosis factor-alpha and interleukin-6 after bariatric surgery. Obes Surg. 2012;22(6):950-955. DOI:10.1007/s11695-012-0643-y
31. Hagman DK, Larson I, Kuzma JN, et al. The short-term and long-term effects of bariatric/metabolic surgery on subcutaneous adipose tissue inflammation in humans. Metabolism. 2017;70:12-22. DOI:10.1016/j.metabol.2017.01.030
32. Edwards C, Hindle AK, Fu S, Brody F. Downregulation of leptin and resistin expression in blood following bariatric surgery. Surg Endosc. 2011;25(6):1962-1968. DOI:10.1007/s00464-010-1494-z
33. Kirchner H, Nylen C, Laber S, et al. Altered promoter methylation of PDK4, IL1 B, IL6, and TNF after Roux-en Y gastric bypass. Surg Obes Relat Dis. 2014;10(4):671-678. DOI:10.1016/j.soard.2013.12.019
34. Garrido-Sanchez L, Tome M, Santiago-Fernandez C, et al. Adipose tissue biomarkers involved in early resolution of type 2 diabetes after bariatric surgery. Surg Obes Relat Dis. 2017;13(1):70-77. DOI:10.1016/j.soard.2016.03.010
35. Lylloff L, Bathum L, Madsbad S, et al. S100A8/A9 (Calprotectin), Interleukin-6, and C-Reactive Protein in Obesity and Diabetes before and after Roux-en-Y Gastric Bypass Surgery. Obes Facts. 2017;10(4):386-395. DOI:10.1159/000478097
36. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229-241. DOI:10.1056/NEJMoa0708681
37. Bluher M, Rudich A, Kloting N, et al. Two patterns of adipokine and other biomarker dynamics in a long-term weight loss intervention. Diabetes Care. 2012;35(2):342-349. DOI:10.2337/dc11-1267
38. Engl J, Ciardi C, Tatarczyk T, et al. A-FABP--a biomarker associated with the metabolic syndrome and/or an indicator of weight change? Obesity (Silver Spring). 2008;16(8):1838-1842. DOI:10.1038/oby.2008.273
39. Schernthaner GH, Kopp HP, Krzyzanowska K, et al. Soluble CD40L in patients with morbid obesity: significant reduction after bariatric surgery. Eur J Clin Invest. 2006;36(6):395-401. DOI:10.1111/j.1365-2362.2006.01649.x
40. Vila G, Riedl M, Anderwald C, et al. The relationship between insulin resistance and the cardiovascular biomarker growth differentiation factor-15 in obese patients. Clin Chem. 2011;57(2):309-316. DOI:10.1373/clinchem.2010.153726
41. Cinkajzlova A, Lacinova Z, Klouckova J, et al. Angiopoietin-like protein 6 in patients with obesity, type 2 diabetes mellitus, and anorexia nervosa: The influence of very low-calorie diet, bariatric surgery, and partial realimentation. Endocr Res. 2017;42(1):22-30. DOI:10.3109/07435800.2016.1169544
42. Ejarque M, Borlaug M, Vilarrasa N, et al. Angiopoietin-like protein 8/betatrophin as a new determinant of type 2 diabetes remission after bariatric surgery. Transl Res. 2017;184:35-44 e34. DOI:10.1016/j.trsl.2017.03.001
43. Friedrich N, Budde K, Wolf T, et al. Short-term changes of the urine metabolome after bariatric surgery. OMICS. 2012;16(11):612-620. DOI:10.1089/omi.2012.0066
44. Roberts LD, Koulman A, Griffin JL. Towards metabolic biomarkers of insulin resistance and type 2 diabetes: progress from the metabolome. Lancet Diabetes Endocrinol. 2014;2(1):65-75. DOI:10.1016/S2213-8587(13)70143-8
45. Курмангулов А.А., Дороднева Е.Ф., Исакова Д.Н. Функциональная активность микробиоты кишечника при метаболическом синдроме. // Ожирение и метаболизм. —2016. — Т. 13. — №1. — С. 16-19. [Kurmangulov AA, Dorodneva EF, Isakova DN. Functional activity of intestinal microbiota with metabolic syndrome. Obesity and metabolism. 2016;13(1):16-19. (In Russ.)] DOI:10.14341/omet2016116-19
46. Zhang H, DiBaise JK, Zuccolo A, et al. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009;106(7):2365-2370. DOI:10.1073/pnas.0812600106
47. Liou AP, Paziuk M, Luevano JM, Jr., et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci Transl Med. 2013;5(178):178ra141. DOI:10.1126/scitranslmed.3005687
48. Anhe FF, Varin TV, Schertzer JD, Marette A. The Gut Microbiota as a Mediator of Metabolic Benefits after Bariatric Surgery. Can J Diabetes. 2017;41(4):439-447. DOI:10.1016/j.jcjd.2017.02.002
49. Derogar M, Hull MA, Kant P, et al. Increased risk of colorectal cancer after obesity surgery. Ann Surg. 2013;258(6):983-988. DOI:10.1097/SLA.0b013e318288463a
50. Bardou M, Barkun AN, Martel M. Republished: obesity and colorectal cancer. Postgrad Med J. 2013;89(1055):519-533. DOI:10.1136/postgradmedj-2013-304701rep
51. Byers T, Sedjo RL. Does intentional weight loss reduce cancer risk? Diabetes Obes Metab. 2011;13(12):1063-1072. DOI:10.1111/j.1463-1326.2011.01464.x
52. Farey JE, Fisher OM, Levert-Mignon AJ, et al. Decreased Levels of Circulating Cancer-Associated Protein Biomarkers Following Bariatric Surgery. Obes Surg. 2017;27(3):578-585. DOI:10.1007/s11695-016-2321-y
53. Netto BD, Bettini SC, Clemente AP, et al. Roux-en-Y gastric bypass decreases pro-inflammatory and thrombotic biomarkers in individuals with extreme obesity. Obes Surg. 2015;25(6):1010-1018. DOI:10.1007/s11695-014-1484-7
Supplementary files
Review
For citations:
Sushentseva N.N., Apalko S.V., Vasiliev E.V., Gladyshev D.V., Vrublevskaya S.N., Salukhov V.V., Sarana A.M., Scherbak S.G. Multiple effects of bariatric surgery on human biochemical status. Obesity and metabolism. 2019;16(3):3-10. (In Russ.) https://doi.org/10.14341/omet9754

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).