Resolution of Metabolic Syndrome and Morbid Obesity Surgery
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Resolution of Metabolic Syndrome and Morbid Obesity Surgery
- 1. Resolution of Metabolic Syndrome & Morbid Obesity Surgery George S.Ferzli, M.D., Benjamin Chandler, Giancarlo Cires, M.D. , Rosemarie E.Hardin, M.D Metabolic Surgery Symposium New Mexico, 2007
- 3. History 1947: Dr.Jean Vague; made observation that upper body obesity predisposed to diabetes, Atherosclerosis, gout and calculi 1967: Avogaro & Crepaldi; described 6 moderately obese patients with diabetes hypercholesterolemia and marked triglyceridemia, all of which improved with a Hypocaloric, low carbohydrate diet In 1977: Haller used the term “ metabolic syndrome ”: obesity, diabetes mellitus, hyperlipoproteinemia, hyperuricemia and steatosis hepatitis when describing the additive effects of risk factors on atherosclerosis In 1977: Gerald B. Phillips; developed the concept that Risk factors for myocardial infarction concur to form a “constellation of abnormalities” : glucose intolerance, hyperinsulinemia, hyperlipidemia and hypertension is associated with heart disease and obesity MUST BE LINKING FACTOR 1988: Gerald M. Reaven proposed insulin resistance as the linking factor and named the constellation of abnormalities Syndrome X X
- 4. Prevalence
- 11. Pathophysiology
- 16. Hormonal Changes after Bariatric Surgery
- 17. Metabolic Effects of Bariatric Surgery
- 18. Clinical Evidence: Bariatric Surgery & Impact on Metabolic Syndrome
- 19. EFFECT?
- 22. Roux-en-Y Gastric Bypass Prospective Study : enrolled 36 obese patients prior to undergoing Roux-en-Y gastric bypass compared to age and sex matched controls Fasting glucose, HDL cholesterol, triglyceride level, BP, waist circumference & inflammatory markers were measured pre-op, 6wks post op & 52 weeks post op
- 26. Biliopancreatic Diversion (BPD) Scopinaro N, Marinari GM, Camerini GB et al. Specific Effects of Biliopancreatic Diversion on the Major Components of Metabolic Syndrome. Diabetes Care . 2005. 28:2406-2411
- 29. Questions????
Notas del editor
- So why is it important to us??? Take a look at the prevalence of metabolic syndrome in the United States population; great market for surgeons for treatment of metabolic syndrome with bypass procedures
- Reported as high as 67% in the 60-69 year old population
- The pathophysiology of metabolic syndrome is very complex and not fully elucidated; however, you can easily see that there is significant interplay between hormonal signals and metabolic mediators resulting in the classic constellation of symptoms
- Increased fatty acids also mediate vasoconstricton independently
- Dr.Ferzli, please add a few words about your expereince in the Dominican Rebuplic and early results!