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Vol 69, No 5 (2018)
Review paper
Submitted: 2018-08-08
Accepted: 2018-08-12
Published online: 2018-09-12
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Endocrine implications of obesity and bariatric surgery

Michał Dyaczyński1, Colin Guy Scanes2, Helena Koziec3, Helena Koziec4, Krystyna Pierzchała-Koziec5
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Pubmed: 30379322
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Endokrynol Pol 2018;69(5):574-597.
Affiliations
  1. Siemianowice Śląskie Municipal Hospital, Department of General Surgery,, 1 Maja 9 Street, Siemianowice Śląskie, Poland
  2. Center in Excellence in Poultry Science, University of Arkansas, Fayetteville,, Fayetteville, Arkansas, United States
  3. Josef Babinski Clinical Hospital in Kraków, Mehoffera 10, Krakow, Poland
  4. Josef Babinski Clinical Hospital in Kraków, Mehoffera 10, Krakow, Poland
  5. Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Krakow, Poland

open access

Vol 69, No 5 (2018)
Review Article
Submitted: 2018-08-08
Accepted: 2018-08-12
Published online: 2018-09-12

Abstract

Introduction: Obesity is a highly prevalent disease in the world associated with the disorders of endocrine system. Recently, it may be concluded that the only effective treatment of obesity remains bariatric surgery. The aim of the review was to compare the concepts of appetite hormonal regulation, reasons of obesity development and bariatric procedures published over the last decade. Material and methods: The reviewed publications had been chosen on the base on: 1. reasons and endocrine consequences of obesity; 2. development of surgery methods from the first bariatric to present and future less aggressive procedures; 3. impact of surgery on the endocrine status of patient. Results: The most serious endocrine disturbances during obesity are dysfunctions of hypothalamic circuits responsible for appetite regulation, insulin resistance, changes in hormones activity and abnormal activity of adipocytes hormones. The currently recommended bariatric surgeries are Roux-en-Y gastric bypass, sleeve gastrectomy and adjustable gastric banding. Bariatric surgical procedures, particularly combination of restrictive and malabsorptive, decrease the body weight and eliminate several but not all components of metabolic syndrome. Conclusions: 1.Hunger and satiety are mediated by an interplay of nervous and endocrine signals. 2. Healthy adipose tissue secretion of adipokines is coordinated in an anti-inflammatory, insulin-sensitizing and cardioprotective pattern. However, with increasing fat mass this secretion pattern is changed into a proinflammatory, insulin resistant, atherogenic and fatal systemic environment . 3. Bariatric surgery is not a solution of the obesity problem for everyone. 4. Long term postsurgical observations of the hormonal profile changes are necessary and should be obligatory.

Abstract

Introduction: Obesity is a highly prevalent disease in the world associated with the disorders of endocrine system. Recently, it may be concluded that the only effective treatment of obesity remains bariatric surgery. The aim of the review was to compare the concepts of appetite hormonal regulation, reasons of obesity development and bariatric procedures published over the last decade. Material and methods: The reviewed publications had been chosen on the base on: 1. reasons and endocrine consequences of obesity; 2. development of surgery methods from the first bariatric to present and future less aggressive procedures; 3. impact of surgery on the endocrine status of patient. Results: The most serious endocrine disturbances during obesity are dysfunctions of hypothalamic circuits responsible for appetite regulation, insulin resistance, changes in hormones activity and abnormal activity of adipocytes hormones. The currently recommended bariatric surgeries are Roux-en-Y gastric bypass, sleeve gastrectomy and adjustable gastric banding. Bariatric surgical procedures, particularly combination of restrictive and malabsorptive, decrease the body weight and eliminate several but not all components of metabolic syndrome. Conclusions: 1.Hunger and satiety are mediated by an interplay of nervous and endocrine signals. 2. Healthy adipose tissue secretion of adipokines is coordinated in an anti-inflammatory, insulin-sensitizing and cardioprotective pattern. However, with increasing fat mass this secretion pattern is changed into a proinflammatory, insulin resistant, atherogenic and fatal systemic environment . 3. Bariatric surgery is not a solution of the obesity problem for everyone. 4. Long term postsurgical observations of the hormonal profile changes are necessary and should be obligatory.
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Keywords

obesity; endocrine dysfunctions; bariatric surgery; gastrointestinal hormones

About this article
Title

Endocrine implications of obesity and bariatric surgery

Journal

Endokrynologia Polska

Issue

Vol 69, No 5 (2018)

Article type

Review paper

Pages

574-597

Published online

2018-09-12

Page views

4642

Article views/downloads

3231

DOI

10.5603/EP.2018.0059

Pubmed

30379322

Bibliographic record

Endokrynol Pol 2018;69(5):574-597.

Keywords

obesity
endocrine dysfunctions
bariatric surgery
gastrointestinal hormones

Authors

Michał Dyaczyński
Colin Guy Scanes
Helena Koziec
Helena Koziec
Krystyna Pierzchała-Koziec

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