[Does bariatric surgery cure the metabolic syndrome?]

Area of Science:

• Endocrinology
• Bariatric Surgery
• Metabolic Disorders

Background:

• Metabolic syndrome (MS) is a precursor to systemic atherosclerotic disease.
• Morbid obesity causes insulin resistance (IR) and visceral fat accumulation, contributing to MS development.
• Conservative therapies for MS in severe obesity often result in weight regain.

Purpose of the Study:

• To evaluate the efficacy of bariatric surgery in managing metabolic syndrome (MS) and type 2 diabetes (DM2) in patients with severe obesity.
• To compare the outcomes of different bariatric surgery modalities regarding weight loss and metabolic improvement.
• To establish MS as a surgical condition in cases of severe obesity.

Main Methods:

• Review of bariatric surgery outcomes for metabolic syndrome and type 2 diabetes.
• Comparison of restrictive versus disabsorptive bariatric procedures.
• Analysis of vertical gastroplasty with jejunoileal derivation outcomes.

Main Results:

• Bariatric surgery leads to significant and sustained weight loss compared to conservative therapies.
• Type 2 diabetes (DM2) remission rates range from 70-90% following bariatric surgery.
• Disabsorptive procedures show greater weight reduction and insulin sensitivity improvement than restrictive ones, but with higher complication risks.
• Vertical gastroplasty improves insulin sensitivity and beta-cell function, leading to DM2 reversion.

Conclusions:

• Bariatric surgery is a recommended treatment for severe obesity with metabolic syndrome (MS), especially when clinical treatments fail.
• Reversion of MS and its complications, including type 2 diabetes (DM2), is achievable through bariatric surgery.
• Metabolic syndrome (MS) should be considered a surgical condition in severe obesity due to its association with reduced cardiovascular mortality.