Efeito do bypass gastrojejunal sobre a resistência à Insulina e Peptídeo C

Abstract

Introduction: Bariatric surgery is now accepted as the most effective treatment for morbid obesity. Its success is measured especially in relation to the amount of weight lost, the weight maintenance after this initial loss and improvement of comorbidities prior to the operation, as insulin resistance and DM2. Measurement of C-peptide, although not common in candidates for bariatric surgery patients, describes more accurately the insulin. This study aims to analyze the effect of bariatric surgery on insulin resistance and levels of C-peptide. Method: A descriptive, longitudinal study was conducted through analysis of obese patients who underwent vertical gastroplasty surgery with gastric bypass Roux-Y, conducted by same team of surgeon, anesthesiologist, psychologist and nutritionist. Measured and the data used in the pre postoperatively for all patients in the study were: fasting blood glucose, postprandial blood glucose, insulin, C-peptide, HOMAII-IR and BMI. The postoperative follow-up was 7.2 months. Results: There was a statistically significant decrease postoperatively, the mean value of all data analyzed. The mean value (standard deviation) preoperative and postoperative average and statistical calculation by the T method for paired student groups were: Fasting glucose 93.8 (16.0) 85.1 (10.1), 0.008; Postprandial glucose 108.8 (19.7) 84.4 (14.1), 0.001; Insulin 18.1 (12.0) 5.1 (2.2) <0.001; C-peptide 3.5 (1.3) 1.9 (0.6) <0.001; HOMA-IR II 2.6 (1.4) 0.8 (0.2) <0.001; BMI 40.5 (5.71) 29.3 (5.15) <0.001. Conclusion: Patients showed improvement in glycemic control after surgery, with decreased insulin resistance and levels of peptide C.