The reduction of BMI and WHR after gastric bypass confirmed this operation to be effective against MO. The high basal levels of insulin and the high rate of HD and diabetes in patients with central obesity seem to indicate that they suffer a metabolic syndrome with significant hormonal imbalances and sodium retention. Patients with peripheral obesity only showed a peripheral resistance against insulin, probably with a shorter duration of the hormonal action, but they did not show hormonal abnormalities or sodium retention. After gastric bypass these abnormal hormone levels tended to normalize.
After gastric bypass, a marked decrease in insulin occurred, with normalization of blood pressure and the biochemical parameters associated with the metabolic syndrome. We propose a biochemical follow-up protocol for MO patients.
The high baseline levels of insulin and the high prevalence of hypertension, diabetes or both conditions in patients with central obesity confirm that they suffer a metabolic syndrome, Meanwhile, patients with peripheral obesity with lower levels of chemical parameters and of the metabolic indices suffer peripheral resistance against insulin. Clinical application of these mathematical indices can be useful in patients with MO; they are easily performed and lack the high costs and risks associated with the clamp technique.
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