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2013, Número 2

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RCAN 2013; 23 (2)


La microbiota y el metabolismo energético después de la cirugía bariátrica

Ochoa C

Idioma: Español
Referencias bibliográficas: 71
Paginas: 309-321
Archivo PDF: 266.62 Kb.


RESUMEN

En un mundo acosado por la epidemia de la obesidad, la cirugía bariátrica ha emergido como una alternativa de control de la progresión de la evolución de esta comorbilidad hacia las complicaciones del Síndrome metabólico como la Diabetes mellitus y la arterioesclerosis. El bypass gástrico seguido de una yeyuno-yeyunostomía en Y de Roux ha sido el proceder bariátrico más efectivo en el control de las complicaciones asociadas a la obesidad. La cirugía bariátrica produce cambios en la anatomía, la motilidad y la funcionalidad del tubo digestivo; modifica el patrón enterohormonal paracrino, y reduce los ingresos alimentarios del obeso. Todos estos cambios conducen a la reducción de la insulinorresistencia, y con ello, una mejor utilización de la glucosa por las células, tejidos y órganos de la periferia, restauración de la glucosa sérica a la normalidad, y disminución de los valores de la hemoglobina glicosilada. La cirugía bariátrica también afecta la composición bacteriana de la microbiota, y se cree que este evento puede también ayudar en una mejor utilización de la glucosa por la periferia. Los resultados de modelos experimentales en animales, combinados con observaciones de pacientes bariatrizados, han llevado a muchos a sugerir que la microbiota puede ejercer un rol importante en el desarrollo del Síndrome metabólico, y a la vez, contribuir con la paliación del mismo, una vez realizada la cirugía bariátrica.


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