Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento

Introducción: La obesidad no es solo un problema estético, es una enfermedad que viene en aumento alcanzando una prevalencia en Colombia del 18% para el 2015 según la encuesta ENSIN, la cual incrementa el riesgo cardiovascular asociado a la resistencia a la insulina (RI) y componente proinflamatorio...

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Autores:
Díaz Posada, Néstor Andrés
Tipo de recurso:
Fecha de publicación:
2023
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/19640
Acceso en línea:
http://hdl.handle.net/20.500.12749/19640
https://doi.org/10.29375/tesis.19640
Palabra clave:
Internal medicine
Medicine
Medical sciences
Health sciences
Obesity
Metabolic syndrome
Weightloss
Insulin resistance
Bariatric surgery
Metabolism disorders
Surgical operations
Stomach
Medicina interna
Medicina
Ciencias médicas
Trastornos del metabolismo
Operaciones quirúrgicas
Estómago
Ciencias de la salud
Cirugía bariátrica
Resistencia a la insulina
Pérdida de peso
Síndrome metabólico
Obesidad
Rights
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
dc.title.translated.spa.fl_str_mv Effect of bariatric surgery on insulin resistance in patients without diabetes mellitus at one year of follow-up.
title Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
spellingShingle Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
Internal medicine
Medicine
Medical sciences
Health sciences
Obesity
Metabolic syndrome
Weightloss
Insulin resistance
Bariatric surgery
Metabolism disorders
Surgical operations
Stomach
Medicina interna
Medicina
Ciencias médicas
Trastornos del metabolismo
Operaciones quirúrgicas
Estómago
Ciencias de la salud
Cirugía bariátrica
Resistencia a la insulina
Pérdida de peso
Síndrome metabólico
Obesidad
title_short Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
title_full Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
title_fullStr Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
title_full_unstemmed Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
title_sort Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimiento
dc.creator.fl_str_mv Díaz Posada, Néstor Andrés
dc.contributor.advisor.none.fl_str_mv Wandurraga Sanchez, Edwin Antonio
López Gómez, Luis Ernesto
dc.contributor.author.none.fl_str_mv Díaz Posada, Néstor Andrés
dc.contributor.cvlac.spa.fl_str_mv Díaz Posada, Néstor Andrés [0001753828]
Wandurraga Sánchez, Edwin Antonio [0001475567]
López Gómez, Luis Ernesto [0001785761]
dc.contributor.orcid.spa.fl_str_mv Díaz Posada, Néstor Andrés [0000-0002-3729-0043]
Wandurraga Sánchez, Edwin Antonio [0000-0002-0529-2343]
López Gómez, Luis Ernesto [0000-0002-3666-2159]
dc.contributor.corporatename.spa.fl_str_mv Adriana Lucila Reyes González
dc.contributor.apolounab.spa.fl_str_mv Wandurraga Sánchez, Edwin Antonio [edwin-antonio-wandurraga-sánchez]
López Gómez, Luis Ernesto [luis-ernesto-lópez-gómez]
dc.subject.keywords.spa.fl_str_mv Internal medicine
Medicine
Medical sciences
Health sciences
Obesity
Metabolic syndrome
Weightloss
Insulin resistance
Bariatric surgery
Metabolism disorders
Surgical operations
Stomach
topic Internal medicine
Medicine
Medical sciences
Health sciences
Obesity
Metabolic syndrome
Weightloss
Insulin resistance
Bariatric surgery
Metabolism disorders
Surgical operations
Stomach
Medicina interna
Medicina
Ciencias médicas
Trastornos del metabolismo
Operaciones quirúrgicas
Estómago
Ciencias de la salud
Cirugía bariátrica
Resistencia a la insulina
Pérdida de peso
Síndrome metabólico
Obesidad
dc.subject.lemb.spa.fl_str_mv Medicina interna
Medicina
Ciencias médicas
Trastornos del metabolismo
Operaciones quirúrgicas
Estómago
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Cirugía bariátrica
Resistencia a la insulina
Pérdida de peso
Síndrome metabólico
Obesidad
description Introducción: La obesidad no es solo un problema estético, es una enfermedad que viene en aumento alcanzando una prevalencia en Colombia del 18% para el 2015 según la encuesta ENSIN, la cual incrementa el riesgo cardiovascular asociado a la resistencia a la insulina (RI) y componente proinflamatorio crónico asociado a la adiposidad. Se desea conocer el impacto de la cirugía bariátrica en la perdida de peso según la resistencia a la insulina medida por HOMA-IR en nuestra población. Metodología: Cohorte mediante análisis de base de datos secundarios-anonimizados, recolectados entre 2016-2021 en una institución de alta complejidad en la ciudad de Bucaramanga, Santander, Colombia que fueron llevados a Gastrectomía vertical (GV) o Bypass gástrico (BGYR) con seguimiento a un año. Resultados: Respecto a la obesidad se logró normalización del IMC en el 42% llevados a GV y 26% a BGYR. En cuanto al síndrome metabólico de 94 pacientes cumplían criterios IDF adaptados a nuestra población previo a la intervención quirúrgica 60% GV y 20% BGYR persistiendo en menos del 2% en cada grupo posterior a un año esta condición. La RI en el grupo de BGYR pasó del 79,7% al 11,3% y en GV pasó del 86,5% al 23%. Conclusiones: La cirugía bariátrica es una herramienta eficaz para disminuir la RI, siendo este efecto mayor en la BGYR. Adicionalmente se demostró remsión del síndrome metabólico en el 98% que tenían esta condición previa al procedimiento.
publishDate 2023
dc.date.accessioned.none.fl_str_mv 2023-04-25T12:51:19Z
dc.date.available.none.fl_str_mv 2023-04-25T12:51:19Z
dc.date.issued.none.fl_str_mv 2023-04-24
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
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spelling Wandurraga Sanchez, Edwin Antonioff29faaa-878f-42f5-a065-b3038814d68fLópez Gómez, Luis Ernesto6343fa52-8869-4c93-80b5-d802847552caDíaz Posada, Néstor Andrés365ce9dd-9b3e-4988-a2ba-a29768e83be8Díaz Posada, Néstor Andrés [0001753828]Wandurraga Sánchez, Edwin Antonio [0001475567]López Gómez, Luis Ernesto [0001785761]Díaz Posada, Néstor Andrés [0000-0002-3729-0043]Wandurraga Sánchez, Edwin Antonio [0000-0002-0529-2343]López Gómez, Luis Ernesto [0000-0002-3666-2159]Adriana Lucila Reyes GonzálezWandurraga Sánchez, Edwin Antonio [edwin-antonio-wandurraga-sánchez]López Gómez, Luis Ernesto [luis-ernesto-lópez-gómez]Floridablanca (Santander, Colombia)2016 - 2021UNAB Campus Bucaramanga2023-04-25T12:51:19Z2023-04-25T12:51:19Z2023-04-24http://hdl.handle.net/20.500.12749/19640instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.cohttps://doi.org/10.29375/tesis.19640Introducción: La obesidad no es solo un problema estético, es una enfermedad que viene en aumento alcanzando una prevalencia en Colombia del 18% para el 2015 según la encuesta ENSIN, la cual incrementa el riesgo cardiovascular asociado a la resistencia a la insulina (RI) y componente proinflamatorio crónico asociado a la adiposidad. Se desea conocer el impacto de la cirugía bariátrica en la perdida de peso según la resistencia a la insulina medida por HOMA-IR en nuestra población. Metodología: Cohorte mediante análisis de base de datos secundarios-anonimizados, recolectados entre 2016-2021 en una institución de alta complejidad en la ciudad de Bucaramanga, Santander, Colombia que fueron llevados a Gastrectomía vertical (GV) o Bypass gástrico (BGYR) con seguimiento a un año. Resultados: Respecto a la obesidad se logró normalización del IMC en el 42% llevados a GV y 26% a BGYR. En cuanto al síndrome metabólico de 94 pacientes cumplían criterios IDF adaptados a nuestra población previo a la intervención quirúrgica 60% GV y 20% BGYR persistiendo en menos del 2% en cada grupo posterior a un año esta condición. La RI en el grupo de BGYR pasó del 79,7% al 11,3% y en GV pasó del 86,5% al 23%. Conclusiones: La cirugía bariátrica es una herramienta eficaz para disminuir la RI, siendo este efecto mayor en la BGYR. Adicionalmente se demostró remsión del síndrome metabólico en el 98% que tenían esta condición previa al procedimiento.Resumen 4 Justificación 6 Marco Teórico 8 Terapia Dietética: 15 Terapia Farmacológica: 15 Cirugía Bariátrica 17 Estado del Arte 25 Objetivos 27 Objetivo General 27 Objetivos Específicos 27 Metodología 27 Tipo de estudio 27 Población 27 Criterios de Inclusión 27 Criterios de Exclusión 27 Cálculo de tamaño de muestra 28 Muestreo 28 Recolección de la información 29 Variables 29 Plan de análisis de datos 30 Análisis univariado: 30 Análisis Bivariado: 30 Consideraciones éticas 30 Resultados 31 Caracterización clínica población total 32 Obesidad 33 Síndrome metabólico 33 Resistencia a la insulina 36 Discusión 38 Conclusiones 47 Referencias Bibliográficas 47 ANEXO 1 54EspecializaciónIntroduction: Obesity is not only an aesthetic problem, it is a disease that is increasing reaching a prevalence in Colombia of 18% for 2015 according to the ENSIN survey, which increases the cardiovascular risk associated with insulin resistance (IR). and chronic proinflammatory component associated with adiposity. We want to know the impact of bariatric surgery on weight loss according to insulin resistance measured by HOMA-IR in our population. Methodology: Cohort through secondary-anonymized database analysis, collected between 2016-2021 in a high complexity institution in the city of Bucaramanga, Santander, Colombia who underwent vertical gastrectomy (VG) or gastric bypass (RYGB) with follow-up. To one year. Results: Regarding obesity, BMI normalization was achieved in 42% taken to GV and 26% to RYGB. Regarding the metabolic syndrome, 94 patients met IDF criteria adapted to our population prior to surgical intervention, 60% GV and 20% RYGB, persisting in less than 2% in each group after one year of this condition. The IR in the RYGB group went from 79.7% to 11.3% and in GV it went from 86.5% to 23%. Conclusions: Bariatric surgery is an effective tool to reduce IR, with this effect being greater in RYGB. Additionally, remission of metabolic syndrome was demonstrated in 98% who had this condition prior to the procedure.Modalidad Presencialapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Efecto de la cirugía bariátrica sobre la resistencia a la insulina en pacientes sin diabetes mellitus a un año de seguimientoEffect of bariatric surgery on insulin resistance in patients without diabetes mellitus at one year of follow-up.Especialista en Medicina InternaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Medicina Internainfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMInternal medicineMedicineMedical sciencesHealth sciencesObesityMetabolic syndromeWeightlossInsulin resistanceBariatric surgeryMetabolism disordersSurgical operationsStomachMedicina internaMedicinaCiencias médicasTrastornos del metabolismoOperaciones quirúrgicasEstómagoCiencias de la saludCirugía bariátricaResistencia a la insulinaPérdida de pesoSíndrome metabólicoObesidad1. 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Available from: https://linkinghub.elsevier.com/retrieve/pii/S2212109919300500https://apolo.unab.edu.co/en/persons/edwin-antonio-wandurraga-s%C3%A1nchezLICENSElicense.txtlicense.txttext/plain; charset=utf-8829https://repository.unab.edu.co/bitstream/20.500.12749/19640/4/license.txt3755c0cfdb77e29f2b9125d7a45dd316MD54open accessORIGINALTesis_Nestor_Diaz.pdfTesis_Nestor_Diaz.pdfTesisapplication/pdf2410270https://repository.unab.edu.co/bitstream/20.500.12749/19640/3/Tesis_Nestor_Diaz.pdf1d09a9a30fb55d66683864a34c7eb941MD53open access2023_Licencia_Nestor_Diaz.pdf2023_Licencia_Nestor_Diaz.pdfLicenciaapplication/pdf305651https://repository.unab.edu.co/bitstream/20.500.12749/19640/5/2023_Licencia_Nestor_Diaz.pdf5386f99abe99ad7198339d1d58e35f0dMD55metadata only accessTHUMBNAILTesis_Nestor_Diaz.pdf.jpgTesis_Nestor_Diaz.pdf.jpgIM Thumbnailimage/jpeg5737https://repository.unab.edu.co/bitstream/20.500.12749/19640/6/Tesis_Nestor_Diaz.pdf.jpg3cfc904401c37b3697ed4d987a128f4eMD56open access2023_Licencia_Nestor_Diaz.pdf.jpg2023_Licencia_Nestor_Diaz.pdf.jpgIM Thumbnailimage/jpeg12872https://repository.unab.edu.co/bitstream/20.500.12749/19640/7/2023_Licencia_Nestor_Diaz.pdf.jpg32bd650e0b0be1de334ed6975828ed9cMD57metadata only access20.500.12749/19640oai:repository.unab.edu.co:20.500.12749/196402023-11-27 11:38:59.159open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.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