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Obese patients with non-hyperinsulinemia have better postoperative weight loss compared to patients with hyperinsulinemia, who exhibit negative weight change outcomes.

Insulin resistance is closely associated with obesity. While some obese patients with insulin resistance exhibit hyperinsulinemia, others demonstrate non-hyperinsulinemia. This retrospective analysis assessed the influence of hyperinsulinemia on the short-term efficacy of laparoscopic sleeve gastrectomy (LSG) in obese patients with insulin resistance. It was concluded that patients with hyperinsulinemia demonstrated a negative outcome on weight changes, whereas patients with non-hyperinsulinemia demonstrated better postoperative weight loss. These findings are published in the journal Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.

Characteristics of the Study and Participants

This retrospective analysis included 92 patients subjected to LSG, of whom 33 had non-hyperinsulinemia, and 59 had hyperinsulinemia. The mean body mass index (BMI) of non-hyperinsulinemia and hyperinsulinemia patients was 35.14 kg/m2 and 36.60 kg/m2, respectively.

Significant Differences in Weight Loss Percentage After Laparoscopic Sleeve Gastrectomy

Six months after LSG, there was a significant difference (p < 0.001) in the estimated median weight loss percentage (%EWL) among patients in the hyperinsulinemia and non-hyperinsulinemia groups. There were significant differences between groups for mean total weight loss percentage (%TWL). Compared to the hyperinsulinemia group, the non-hyperinsulinemia group demonstrated higher %TWL and %EWL 6 months after LSG, with %EWL being negatively associated with fasting insulin (FINS) at follow-up time, postoperatively. Both groups demonstrated statistically significant differences in the mean %TWL and %EWL at 1, 3, and 6 months postoperatively.

Improvement in Quality of Life Scores After Surgery

The quality of life (QoL) scores increased in both groups at 6 months postoperatively without any statistically significant differences across the two groups; however, the pre- and postoperative QoL score differences were statistically significant. There were no significant differences across the hyperinsulinemia and non-hyperinsulinemia groups for hypertension and dyslipidemia outcomes.

Complications of Laparoscopic Sleeve Gastrectomy

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Two non-hyperinsulinemia patients and four hyperinsulinemia patients experienced postoperative complications during the postoperative follow-up period; however, no deaths occurred during this time. Only one hyperinsulinemia patient suffered from a Clavien–Dindo grade IIIb complication.

Hyperinsulinemia Negatively Affects Postoperative Weight Loss in Obese Patients

Obese patients with non-hyperinsulinemia had better postoperative weight loss than patients with hyperinsulinemia. Patients with hyperinsulinemia exhibited no significant effects related to dyslipidemia, postoperative complications, and hypertension.

Source

Yue, Z., Qian, L., Jin, Y., Xia, Y., Sha, H., Wu, Q., & Hu, K. (2023). Hyperinsulinemia Influences the Short-Term Efficiency of Laparoscopic Sleeve Gastrectomy for Patients with Obesity and Insulin Resistance. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 16, 1745–1753. https://doi.org/10.2147/dmso.s411440