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Revista Cubana de Endocrinología
On-line version ISSN 1561-2953
Abstract
HERNANDEZ RODRIGUEZ, José; ARNOLD DOMINGUEZ, Yuri and MONCADA ESPINAL, Olga María. Theories and mechanisms supporting the use of metabolic surgery in patients with diabesity. Rev Cubana Endocrinol [online]. 2018, vol.29, n.3, pp. 1-15. ISSN 1561-2953.
ABSTRACT The use of metabolic surgery as a treatment capable of either reverting or improving diabesity has attracted attention due to the transformations induced in patients undergoing such intervention. These transformations have been attributed to the anatomical and physiological changes brought about by the surgery. Enriched knowledge about the theories and mechanisms ensuring weight loss and a better metabolic response may contribute to the design of more effective strategies. The objective is to describe the theories and mechanisms which intend to explain the beneficial changes observed after metabolic surgery in people with diabesity. Scientific information was obtained from the search engine Google Scholar using the key words bariatric surgery, metabolic surgery, obesity, type 2 diabetes mellitus and diabesity. Evaluation was conducted of review and research papers published in Spanish, Portuguese or English in the past 10 years on various databases (PubMed, LILACS, Cochrane, SciELO) and webpages. A total 110 papers were analyzed of which 66 were referenced. Changes induced by metabolic surgery and their results in people with diabesity have been associated to different theories and mechanisms, e.g. the proximal intestine hypothesis and the distal intestine hypothesis. To this are added the changes in the intestinal microbiota and a greater availability of bile acids in the ileum. The different theories complement one another, and it is hard to decide which is the most useful, for it also depends on the surgical technique used (restrictive or malabsorptive restrictive) and its mechanisms of action.
Keywords : bariatric surgery; metabolic surgery; obesity; type 2 diabetes mellitus; diabesity.
