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Mechanisms of Weight Loss After Sleeve Gastrectomy and Adjustable Gastric Banding: Far More Than Just Restriction.
Obesity ( IF 4.2 ) Pub Date : 2019-09-23 , DOI: 10.1002/oby.22623
Yanmin Wang 1 , Xiaomei Guo 1 , Xiao Lu 1 , Samer Mattar 2 , Ghassan Kassab 1
Affiliation  

Obesity has reached global epidemic proportions in recent decades. Bariatric surgery is currently accepted as most effective in alleviating morbid obesity and related disorders. Sleeve gastrectomy (SG) and adjustable gastric banding (AGB) have gained popularity since the beginning of this century because of their efficacy, safety, and simplicity. SG, in particular, has emerged as the most popular bariatric procedure because of its simpler concept and shorter operative time compared with gastric bypass. Caloric restriction, however, cannot account for the sustained weight loss and improved glucose metabolism seen following SG and AGB. Other mechanisms, including changes in gastrointestinal hormone secretion, rearrangement of hypothalamic and vagal control, alteration in energy expenditure, and re‐regulation of bile acid metabolism and the intestinal flora environment, are thought to contribute to the postoperative benefits. This review focuses on clinical and experimental literature addressing the potential mechanisms for SG and AGB procedures in human and animal models. Understanding such mechanisms can provide important insight into how current gastric restrictive procedures work and how future treatments of obesity, both surgical and nonsurgical, can be developed.

中文翻译:

袖胃切除术和可调节胃束带术后体重减轻的机制:不仅限于限制。

近几十年来,肥胖症已达到全球流行的程度。减肥手术目前被认为是减轻病态肥胖和相关疾病最有效的方法。自本世纪初以来,由于其有效性,安全性和简便性,套管胃切除术(SG)和可调节胃束带术(AGB)受到欢迎。特别是SG,由于其概念简单,手术时间短于胃旁路手术,因此已成为最受欢迎的减肥手术。然而,热量限制不能解释SG和AGB后持续的体重减轻和葡萄糖代谢改善。其他机制,包括胃肠激素分泌的变化,下丘脑和迷走神经控制的重新排列,能量消耗的改变,胆汁酸代谢和肠道菌群环境的重新调节被认为有助于术后获益。这篇综述着重于临床和实验文献,探讨了人和动物模型中SG和AGB程序的潜在机制。了解这种机制可以提供重要的见解,以了解当前的胃限制性手术的工作原理以及如何开发手术和非手术肥胖的未来治疗方法。
更新日期:2019-09-23
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