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Outcomes After Metabolic Surgery in Asians—a Meta-analysis

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Abstract

Background

Obesity and type 2 diabetes mellitus (T2DM) are now increasingly epidemic in Asia. As obesity and T2DM have different disease patterns in Asians compared to Westerners, outcomes after metabolic surgery may differ. The aim of this meta-analysis was to gather the current available evidence on the outcomes after metabolic surgery in Asians.

Methods

A literature search was conducted in September 2017. Four outcome measures were examined: (1) % excess weight loss (EWL), (2) post-intervention body mass index (BMI), (3) T2DM resolution or improvement, and (4) hypertension resolution.

Results

Thirteen publications with a total of 1052 patients were analyzed, of which nine were randomized controlled trials, and four were case-matched studies. All the studies had a minimum follow-up duration of at least 1 year. % EWL was significantly higher in those who have undergone Roux-en-Y gastric bypass (RYGB) (SMD 0.53, 95% CI 0.12 to 0.94) versus sleeve gastrectomy (SG). T2DM resolution/improvement was favorable in those who have undergone RYGB (pooled OR 1.39, 95% CI 0.53 to 3.67) versus SG, although not statistically significant. Hypertension resolution was not significantly different between patients who have undergone SG versus RYGB (pooled OR 0.96, 95% CI 0.44 to 2.11).

Conclusion

RYGB results in better weight loss compared to SG in Asians, but the rate of T2DM resolution/improvement and improvement of hypertension appears to be similar. In Asian patients without symptoms of gastro-esophageal reflux disease in whom metabolic surgery is performed mainly for T2DM and metabolic syndrome, SG may be the surgery of choice.

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Authors and Affiliations

  1. Upper Gastrointestinal Surgery Unit, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Danson Yeo, Charleen Yeo, Tze Yi Low, Saleem Ahmed, Sheena Phua, Aung Myint Oo, Jaideepraj Rao, Aaryan Koura & Sanghvi Kaushal

  2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Kavita Venkataraman

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  1. Danson Yeo
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  2. Charleen Yeo
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  3. Tze Yi Low
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  4. Saleem Ahmed
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Correspondence to Danson Yeo.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Yeo, D., Yeo, C., Low, T.Y. et al. Outcomes After Metabolic Surgery in Asians—a Meta-analysis. OBES SURG 29, 114–126 (2019). https://doi.org/10.1007/s11695-018-3484-5

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  • DOI: https://doi.org/10.1007/s11695-018-3484-5

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