Effect of gastric bypass and gastric banding on lipid absorption and their influence on glucose metabolism
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Abstract
Roux-en-Y gastric bypass (RYGB) leads to sustainable weight loss and resolution of hyperlipidemia and type 2 diabetes in obese patients. Its hypolipidemic effect is presumed to be based on fat malabsorption. Comparison of lipid absorption and insulin resistance following RYGB with adjustable gastric banding (AGB) and medical treatment clarifies the importance of the bypassing aspect of RYGB. The presented work is a cross-sectional study of 48 matched obese patients following RYGB, AGB and medical treatment, whose plasma lipids, glucose and insulin were analyzed after a lipid meal. The results of the study demonstrate that postprandial triglycerides, apolipoprotein B48 and nonesterified fatty acids are lower following RYGB compared with AGB and medical treatment. The accelerated disposal of plasma triglycerides and chylomicrons is associated with normalized insulin sensitivity and this can be a key mechanism in the improvement of lipid metabolism after RYGB, which supports its indications in obese hyperlipidemic and diabetic patients.