A Review of Weight Loss Following Roux-en-Y Gastric Bypass vs Restrictive Bariatric Surgery: Impact on Adiponectin and Insulin
Abstract
Background Bariatric surgery is a common procedure often used to ameliorate comorbidities associated with obesity, including type 2 diabetes. Substantial weight loss leads to alterations in inflammation and insulin sensitivity as well as numerous metabolic and physiologic pathways. Several inflammatory markers have been evaluated, yet adiponectin, an anti-inflammatory adipokine, has not been fully investigated. Adiponectin may play a key role as a mediator between obesity and inflammation, as lower blood levels are more commonly associated with obesity and type 2 diabetes and because adiponectin lessens insulin resistance. This review evaluates outcome variables from patients who underwent Roux-en-Y gastric bypass (RYGB) or restrictive bariatric surgery to compare and contrast any differential surgical impacts on weight loss, adiponectin, and insulin.Methods A systematic literature review was conducted using a PubMed search. Published studies from 1999 to 2009 that measured blood levels of adiponectin and insulin in bariatric surgery patients prior to and at least 6 months after surgery were included.Results Eighteen studies met inclusion criteria for evaluation. RYGB surgery compared to restrictive surgery led to significantly greater weight loss and improvements in adiponectin and insulin sensitivity. Despite significant weight loss, many patients did not achieve "healthy" body mass index or normalization of inflammatory markers.Conclusions While RYGB surgery appears to more favorably influence body weight and inflammatory markers, data are insufficient to fully understand the impact of bariatric surgery on changes in adiponectin and insulin and related health implications. Long-term research is needed to more thoroughly evaluate inflammatory outcomes following these two bariatric surgery procedures.
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The association between weight regain and reduced attention likely involves the return of comorbid medical conditions or independent effects of adiposity.
“The mechanisms for this association likely involve the return of comorbid medical conditions that adversely impact cognitive function (e.g., hypertension, diabetes, sleep apnea) or even from the independent effects of adiposity.28–31”
From Cognitive Function After Bariatric Surgery: Evidence for Improvement 3 Years After Surgery (2014) · cites this paper as [31]
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- Authors
- Butner, K. L., Nickols-Richardson, S. M., Clark, S. F., Ramp, W. K., & Herbert, W. G.
- Affiliations
- Virginia Tech (US)
- Corresponding author
- Butner, Katrina L.
- ORCID
- Herbert, William G.
- Venue
- Obesity Surgery
- Published
- 2010-02-23
- Volume
- 20
- Issue
- 5
- Pages
- 559-568
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2013221492
- Cited by
- 63
- References
- 69
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 2 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 6 · 2014: 5 · 2013: 7 · 2012: 10
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- Roux-en-Y gastric bypass, restrictive bariatric surgery
- MeSH terms
- Humans, Insulin, Obesity, Morbid, Gastric Bypass, Gastroplasty, Weight Loss, Adiponectin
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