Does Abdominoplasty Intensify the Metabolic Effect of Bariatric Surgery?
ORIGINAL ARTICLES IMAJ • VOL 22 • JUNE 2020 Does Abdominoplasty Intensify the Metabolic Effect of Bariatric Surgery? Lior Leibou MD1,4, Tomer Perlok MD1,4, Rivi Haiat Factor MD1,4, Eyal Leibovitz MD2, Jacob Frand MD1,4, Stav Leibou4, Dror Sadan MD1 and Mordechai Shimonov MD3,4 Departments of 1Plastic Surgery Unit, 2Internal Medicine, and 3Surgery A, Wolfson Medical Center, Holon, Israel 4Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel ABSTRACT Background: The effect of weight reduction following bar- skeletal muscle, liver, kidney, and heart. Fat deposition can iatric surgery is already well known. be associated with several metabolic abnormalities including Objectives: To investigate the effects of abdominoplasty on altered adipokine profile, insulin resistance, and endothelial metabolic markers indicative of weight loss. dysfunction [5-7]. Leptin, the satiety hormone, is secreted by Methods: The authors prospectively enrolled consecutive adipocytes along with TNF-α, IL-6, resistin, and adiponectin, obese patients after laparoscopic sleeve gastrectomy. They and provides negative feedback at the hypothalamic-pituitary were candidates for post-bariatric surgery abdominoplasty. axis to modulate appetite and energy expenditure. Some litera- The authors measured metabolic markers one day prior to ture seems to suggest a link between inflammation and insulin surgery, 24 hours after, and 3 months following surgery. They resistance as well as obesity which all play a critical role in the recorded medical and demographic parameters. pathogenesis of human disease [8-10]. Leptin levels increase Results: Sixteen patients were recruited for participation in the as fat mass increases and vice versa. Other metabolic chang- study. Mean age was 47 years and 88% of the patients were fe- es reported include a decrease in subcutaneous fat which is male.
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