Normal Lipid Metabolism in Obese Patients, Term Paper Example

When excess body fat develops to the point that it poses a health threat, the condition is commonly recognized as obesity. It can lead to reduced life expectancy through a variety of enhanced morbidity issues. The effect obesity has on the human metabolism is a consequence that is not completely understood. Some of these consequences can include insulin resistance, metabolic syndrome and type 2 diabetes. Another consequence is polycystic ovary syndrome.   complex consequence insulin resistance, type 2 diabetes,, the metabolic syndrome, and polycystic ovary syndrome (PCOS)(Folli, Pontiroli, and Schwesinger 393–414). The concept of insulin resistance and what it means for the body attributes to much of the complications when it comes to understanding obesity. Insulin is a hormone, specifically a potent anabolic/pleiotropic one that deals with fat and protein metabolism and nitric oxide synthesis. Insulin is predominantly  responsible for glucose homeostasis,. cell differentiation and growth (Folli, Pontiroli, and Schwesinger 393–414).  Another significant effect of obesity can be seen in the comorbidities that develop from it.Up to 70% of obese people have comorbidities and they worsen the overall prognosis for treatment.  In addition, a long duration of obesity is important in the development of type 2 diabetes mellitus and complications of arterial hypertension (left ventricular hypertrophy) (Frige, Laneri, Veronelli, Folli, Paganelli, Vedani, Marchi, and et al 198-204).

Then comparing the effects of bariatric surgery (roux en Y vs. gastric sleeve) on lipid metabolism with details (e.g. what hormone levels change, what metabolic pathways change) and how that change leads to weight loss

Gastric Sleeve vs RYGB

Sleeve gastrectomy, or gastric sleeve is the in past years was viewed as an initial procedure to be performed prior to a Roux-en-Y gastric bypass biliopancreatic diversion with duodenal, but only for the severly obese. . This procedure leads to significantly lower levels of of the hormoneserum ghrelin, which a potent orexigenic hormone. Meal-induced ghrelin release was also diminished postoperatively (Dimitriadis, Daskalakis, Kampa, Peppe, Papadakis, and Melissas 1-8).The Roux-en-Y gastric bypass (RYGB) is considered the best bariatric procedures in the United States. The authors are keen to point out that is has restrictive and malabsorptive effects. This operations restructures the digestive track of a patient and limits their appetite in the process by restricting the flow of food with braces, or tightening of the upper pouch of the stomach leading to the intestines. It has a significant effect on the Glucagon-like peptide-1 (GLP-1) which is a potent anti-hyperglycemic gut hormone. An increase in the anorectic hormones like GLP-1 or peptide tyrosine tyrosine PYY which controls the levels of aminos acids in the pancreas, or a decrease in orexgenic hormones like ghrelin, caused by an RYGB operation can be directly credited for the significant weight loss that occurs afterwards. Studies show that after patients go through an RYGB surgery they report having an increased postprandial levels of plasma PYY and GLP-1. The results of increased hormonal levels is combined with early and exaggerated insulin responses, as well as enhanced glycemic control.  These hormonal changes were not seen in subjects after gastric sleeve.  In summary, the significant change in hormonal patterns specifically the increase of GLP-1, or PYY results in sustained weight loss after gastric bypass surgery.  The same cannot be said for the after affects of a gastric sleeve operation.  The core reason these hormones influence weight loss is because they improve adipose tissue insulin sensitivity to levels near that of lean individuals, and they improve the ability to metabolize glucose (Curry, Roberts, Basu, Basu, Schroeder, Joyner, and Miles 746–751).

Then suggesting mechanisms using the above information for future targets for drug therapy for obesity.

In suggesting mechanisms based on the above information there is significant data that suggests loss of fat mass FM is attained through biliary-intestinal bypass methods and the use of Leptin. Leptin is a hormone that controls energy expenditures and appetite it has w significant influence on metabolism when it’s used correctively.  These implications suggest there will be a significant use of Leptin as a steroid to treat obesity in the future (Frige, Laneri, Veronelli, Folli, Paganelli, Vedani, Marchi, and et al 198-204). The mechanisms or surgical techniques that might cure this are able to reduce body weight in a significant way. In laymens terms in targeting drug therapy that can directly influence obesity, researchers found that in reducing FM gastric medication could be directly connected to a significant intended result in the metabolic system, but the same is not true through FFM manipulation. Studies show that Leptin is highly effective in reducing body mass index BMI. with BIBP superior to LAGB in reducing fat mass FM but not fat free mass FFM. The metabolic effects of leptin implementation are  proportional to FM decrease but not to FFM decrease (Frige, Laneri, Veronelli, Folli, Paganelli, Vedani, Marchi, and et al 198-204).

Work Cited:

Ballantyne, Gareth H., Andrew Gumbs, and Irvin M. Modlin. “Obesity Surgery.” Obesity Surgery. 15. (2005): 692-699. Print.

Curry, Timothy B. , Shelly K. Roberts, Rita Basu, Ananda Basu, Darrell Schroeder, Michael J. Joyner, and Jonh M. Miles. “American Journal of Physiology – Endocrinology and Metabolism.” American Journal of Physiology – Endocrinology and Metabolism. 300. (2011): 746–751. Print.

Dimitriadis, Efstathios , Markos Daskalakis, Marilena Kampa, Anastasia Peppe, John A. Papadakis, and John Melissas. “Annals of Surgery.”Annals of Surgery. (2012): 1-8. Print.

Folli, Franco , Antonio E. Pontiroli, and Wayne H. Schwesinger. “The Medical Clinics of North America.” Medical Clinics of North America. 91. (2007): 393–414. Print.

Frige, F., M. Laneri, A. Veronelli, F. Folli, M. Paganelli, P. Vedani, M. Marchi, et al. “Nutrition, Metabolism & Cardiovascular Diseases.” Nutrition, Metabolism & Cardiovascular Diseases. 19. (2009): 198-204. Print.

Ochner, CN, C Gibson, M Shanik, V Goel, and A Geliebter. “International Journal of Obesity.”International Journal of Obesity. 35. (2011): 153-166. Print.

Valentino, Michael A. , Andre Terzic, and Scott A. Waldman. “Clin Transl Sci..” Clin Transl Sci.. 3.3 (2010): 123–125. Print.

(Valentino, Terzic, and Waldman 123–125)