Course of Metabolic Syndrome following the Biliopancreatic Diversion of Larrad |
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Authors: | Álvaro Larrad Jiménez Carlos Sánchez Cabezudo Pedro Pablo de Quadros Borrajo I Ramos García B Moreno Esteban R García Robles |
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Institution: | Endocrinology and Metabolism Surgery Unit, Clínica Ruber, Rafael Bergamin 12, 28043 Madrid, Spain. LARRAD@inicia.es |
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Abstract: | Background: The authors assessed the effect of Larrad's biliopancreatic diversion (BPD) on the main components of the metabolic
syndrome. Patients and Methods: Plasma concentrations of glucose, insulin, total cholesterol (TC), HDL and LDL cholesterol,
triglycerides, LDL/HDL and TC/HDL ratios, and blood pressure and body weight were retrospectively evaluated in 40 patients
3-6, 12, 24 and 60 months after undergoing BPD for morbid obesity with metabolic syndrome. Results: 3-6 months after BPD,
glycemia and insulinemia had normalized in 97.5% of the patients and remained stable over the following 5 years. Over this
period of 3-6 months to 5 years following BPD, total and LDL cholesterol levels fell by 45.2% and 53.1%, respectively. From
12 months onwards, triglyceride levels decreased appreciably, dropping by 57.4% at 5 years. HDL cholesterol concentrations
failed to vary significantly or increased to normal levels in patients showing low initial values. At 5 years, high blood
pressure had resolved in 75% of patients and the amount of excess weight lost was 65.5% (±14.6). No patient required reversal
of the BPD due to severe gastrointestinal or metabolic complications. Conclusions: Technically adapted to the patient's weight,
the Larrad BPD effectively stabilizes the main components of the metabolic syndrome. The BPD has low morbidity rate and should
be considered a therapeutic option for patients who do not respond to medical treatment. |
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Keywords: | MORBID OBESITY METABOLIC SYNDROME INSULIN RESISTANCE BILIOPANCREATIC DIVERSION PARTIAL ILEAL BYPASS DYSLIPIDEMIA HYPERTENSION |
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