OBJECTIVE To evaluate changes in insulin sensitivity, hormone secretion, and hepatic steatosis immediately after caloric restriction, vertical sleeve gastrectomy (VSG), and Roux-en-Y gastric bypass (RYGB). RESEARCH DESIGN AND METHODS Obese subjects were assessed for 1) insulin sensitivity with hyperinsulinemic-euglycemic clamp with glucose tracer infusion, 2) adipokine concentrations with serum and subcutaneous adipose interstitial fluid sampling, and 3) hepatic fat content with MRI before and 7–10 days after VSG, RYGB, or supervised caloric restriction. RESULTS Each group exhibited an ∼5% total body weight loss, accompanied by similar improvements in hepatic glucose production and hepatic, skeletal muscle, and adipose tissue insulin sensitivity. Leptin concentrations in plasma and adipose interstitial fluid were equally decreased, and reductions in hepatic fat were similar. CONCLUSIONS The improvements in insulin sensitivity and adipokine secretion observed early after bariatric surgery are replicated by equivalent caloric restriction and weight loss.

中文翻译：

---

热量限制和体重减轻是减肥手术后早期组织特异性代谢变化的主要因素

目的 评估热量限制、垂直袖状胃切除术 (VSG) 和 Roux-en-Y 胃旁路术 (RYGB) 后胰岛素敏感性、激素分泌和肝脂肪变性的变化。研究设在 VSG、RYGB 或监督热量限制之后。结果 每组都表现出约 5% 的总体体重减轻，同时肝脏葡萄糖生成和肝脏、骨骼肌和脂肪组织的胰岛素敏感性也有类似的改善。血浆和脂肪间质液中的瘦素浓度同样降低，和肝脏脂肪的减少是相似的。结论 减肥手术后早期观察到的胰岛素敏感性和脂肪因子分泌的改善可以通过等效的热量限制和体重减轻来复制。