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Metabolic Syndrome and Insulin Resistance Are Associated with Chronic Kidney Disease in Nondiabetic Adults with Abdominal Obesity

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International Journal of Clinical Medicine 2011年第4期2卷 367-377页

作者： Luis Vigil albert goday Rafael Gabriel Juan Francisco Ascaso Josep Franch Rafael Ortega 不详

Aims: we investigate whether insulin resistance is associated with an increased prevalence for chronic kidney disease irrespective of the concurrent presence of metabolic syndrome. Methods: 1638 patients with abdominal obesity were selected. Metabolic syndrome and abdominal obesity were defined according to the International Diabetes Federation criteria. Insulin resistance was defined by Homeostasis Model Assessment Index >P75. Chronic kidney disease was defined by the presence of a low estimated glomerular filtration rate (Results: metabolic syndrome was present in 1030 (62.9%) patients and insulin resistance in 787 (48%). Conversely 61% of those with metabolic syndrome were insulin resistant and 79% of those with insulin resistance had metabolic syndrome. Chronic kidney disease was present in 18%. In multivariate analysis, chronic kidney disease was increased in subjects with insulin resistance (odds ratio [OR] = 1.350;CI 95%: 1.021 - 1.785;p = 0.035) and in those with metabolic syndrome (OR = 1.417;CI 95%: 1.045 - 1.922;p = 0.025). Conclusions: Metabolic syndrome and insulin resistance were significant and independently associated with chronic kidney disease in nondiabetic adults with abdominal obesity.

关键词： Insulin Resistance Metabolic Syndrome Abdominal Obesity Microalbuminuria Chronic Kidney Disease

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Laparoscopic sleeve gastrectomy:More than a restrictive bariatric surgery procedure?

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World Journal of Gastroenterology 2015年第41期21卷 11804-11814页

作者： David Benaiges Antonio Más-Lorenzo albert goday José M Ramon Juan J Chillarón Juan Pedro-Botet Juana A Flores-Le Roux Department of Endocrinology and Nutrition Hospital del Mar Department of Medicine Universitat Autònoma de Barcelona Institut Hospital del Mar d’Investigacions Mèdiques (IMIM) CiberOBN Instituto de Salud Carlos III Department of Gastrointestinal Surgery Hospital del Mar

Sleeve gastrectomy(SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a single technique have led to a rise in its use, and it is currently the second most performed technique worldwide. SG achieves clearly better results than other restrictive techniques and is comparable in some aspects to the Roux-en-Y gastric bypass, the current gold standard in bariatric surgery. These benefits have been associated with different pathophysiologic mechanisms unrelated to weight loss such as increased gastric emptying and intestinal transit, and activation of hormonal mechanisms such as increased GLP-1 hormone and decreased ghrelin. The aim of this review was to highlight the salient aspects of SG regarding its historical evolution, pathophysiologic mechanisms, main results, clinical applications and perioperative complications.

关键词： Bariatric surgery Sleeve gastrectomy Severe obesit

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