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Comparison of the Effect of Gastric Bypass and Sleeve Gastrectomy on Metabolic Syndrome and its Components in a Cohort: Tehran Obesity Treatment Study (TOTS)

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Abstract

Introduction

Metabolic syndrome (MetS) is a prevalent counterpart of morbid obesity. With the surgical technique of sleeve gastrectomy (SG) gaining widespread acceptance for weight loss in morbid obese patients, we aimed to undertake a study to compare its effectiveness to gastric bypass (GB) for metabolic control in these patients.

Methods

A total of 425 patients from a prospectively collected database of morbid obese subjects between 18 and 65 years of age undergoing a primary bariatric procedure from March 2013 to September 2015 were included. Statistical analysis was performed using general estimation equation and propensity scores, and odds ratios were calculated.

Results

Three hundred nineteen patients underwent SG and 106 underwent GB. Mean age of the patients was 37.8 ± 11.7, and mean body mass index (BMI) was 44.3 ± 5.9 kg/m2. MetS was present in 61.4% of patients and diabetes mellitus in 48.6%. MetS prevalence decreased from 60 and 64% in the SG and GB groups to 16 and 10% at 12 months, respectively. These improvements were consistent throughout the study period in both groups, with no significant difference between the two groups (for all variables: P trend < .001, P interaction > .05). After propensity score-adjusted analysis, neither surgical technique showed superiority over the other regarding metabolic improvement (OR for MetS resolution: 0.81, 95% CI: 0.49–1.34).

Conclusions

In this short-term study with 1-year follow-up, SG showed similar results to GB in terms of weight loss, MetS resolution, and glycemic control in a large Middle Eastern cohort. Long-term studies are needed to further investigate the effectiveness of SG in this regard.

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Acknowledgments

The authors would like to thank the hospital staff, study assistants, and coordinators that took part in this research. The authors would also like to thank Dr. Mohammad Hassan Kalantar Motamedi for his technical and language edit of the manuscript.

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Authors and Affiliations

  1. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Maryam Barzin, Mohammad Ali Kalantar Motamedi, Sara Serahati, Majid Valizadeh & Farhad Hosseinpanah

  2. Faculty of Medicine, Shahed University, Tehran, Iran

    Alireza Khalaj & Peyman Arian

  3. Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Davood Khalili

  4. Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Fereidoun Azizi

  5. Department of Internal Medicine, School of medicine, Shahid Beheshti Medical University (M.C.) Obesity Research Center, Tehran, Iran

    Farhad Hosseinpanah

Authors
  1. Maryam Barzin
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  2. Mohammad Ali Kalantar Motamedi
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  3. Sara Serahati
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  9. Farhad Hosseinpanah
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Corresponding author

Correspondence to Farhad Hosseinpanah.

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There are no grants associated with this study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for this study was obtained from the Human Research Review Committee of the Endocrine Research Center, Shahid Beheshti University of Medical Sciences (No. 2ECRIES 93/03/13).

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Barzin, M., Motamedi, M.A.K., Serahati, S. et al. Comparison of the Effect of Gastric Bypass and Sleeve Gastrectomy on Metabolic Syndrome and its Components in a Cohort: Tehran Obesity Treatment Study (TOTS). OBES SURG 27, 1697–1704 (2017). https://doi.org/10.1007/s11695-016-2526-0

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  • DOI: https://doi.org/10.1007/s11695-016-2526-0

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