Abstract
Obesity is one of the most serious worldwide epidemics of the twenty-first century according to the World Health Organization. Frequently associated with a number of comorbidities, obesity threatens and compromises individual health and quality of life. Bariatric surgery (BS) has been demonstrated to be an effective treatment to achieve not only sustained weight loss but also significant metabolic improvement that goes beyond mere weight loss. The beneficial effects of BS on metabolic traits are so widely recognized that some authors have proposed BS as metabolic surgery that could be prescribed even for moderate obesity. However, most of the BS procedures imply malabsorption and/or gastric acid reduction which lead to nutrient deficiency and, consequently, further complications could be developed in the long term. In fact, BS not only affects metabolic homeostasis but also has pronounced effects on endocrine systems other than those exclusively involved in metabolic function. The somatotropic, corticotropic, and gonadal axes as well as bone health have also been shown to be affected by the various BS procedures. Accordingly, further consequences and complications of BS in the long term in systems other than metabolic system need to be addressed in large cohorts, taking into account each bariatric procedure before making generalized recommendations for BS. In this review, current data regarding these issues are summarized, paying special attention to the somatotropic, corticotropic, gonadal axes, and bone post-operative health.
Highlights
Obesity is a chronic, progressive, and multifactorial disease involving genetic, metabolic, psychological, and endocrinology-related factors, among others
Slower IGF-1 secretion in response to Bariatric surgery (BS) possibly attributed to underlying catabolic status, as Growth Hormone (GH) response to GH-releasing hormone (GHRH) severely increased
Rosenblatt et al reported that patients who underwent Roux-en-Y gastric bypass (RYGB) from 6 to 16 years ago had high sexual hormone binding globulin (SHBG), total and free testosterone levels compared to non-surgical obese controls and these levels were comparable to those found in lean subjects
Summary
Progressive, and multifactorial disease involving genetic, metabolic, psychological, and endocrinology-related factors, among others. Savastano et al and Di Somma et al reported significant correlations between body composition and GH response to stimulus (GHRH + arginine) before and after surgery in subjects who underwent LAGB, and found higher success with surgical treatment (weight loss and improved body composition profile) in those subjects without somatotropic axis alterations as well as in patients who recovered GH response to stimulus after surgery [114, 115].
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have