Reduction of Framingham BMI score after rapid weight loss in severely obese subjects undergoing sleeve gastrectomy: a single institution experience
- 260 Downloads
There is vast evidence that supports the importance of obesity in the pathogenesis and progression of cardiovascular disease. Rapid weight loss induced by laparoscopic Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (LAGB) has proven beneficial. The aim of this study is to evaluate laparoscopic sleeve gastrectomy (LSG) as an alternative treatment modality and its impact on the Framingham-BMI 10-year risk score.
We retrospectively reviewed all patients that underwent bariatric surgery at our institution between 2010 and 2014. Patients who met the criteria for calculating the Framingham BMI 10-year risk score were included. Data collected included baseline demographics, perioperative parameters such as tobacco use, diagnosis of diabetes, treatment for hypertension, BMI and postoperative outcomes at 3 and 12 months.
From our 1129 bariatric patients, 358 (31.7%) met criteria for the Framingham BMI 10-year risk score calculation. LSG was the most prevalent surgery 61.45% (N = 220) followed by LRYGB 22.06% (N = 79). Females composed 69% (N = 248) of our population. The average age for females was 52.3 ± 10.8 years and for males 54.07 ± 11.2 years. The initial Framingham 10-year score risk was significantly higher in males compared with females (36.16% ± 22.3 vs. 16.97% ± 15.6 (p < 0.001)). After 12-month follow-up, the absolute risk reduction in males was 11.58% (p < 0.001) and 6.17% in females (p < 0.001). The preoperative heart age was high in females and males (69.23 ± 15.72 years and 73.55 ± 13.55 years, respectively (p = 0.012)), and after 12 months it was reduced 7.19 years in females (p < 0.001) and 7.04 years in males (p < 0.001). The percentage of estimated BMI loss at 1 year was 64.43% in females and 60.69% in males.
Sleeve gastrectomy has demonstrated to be an effective method of treatment for obesity. Our results suggest that rapid weight loss after LSG has a positive impact in the reduction of the 10-year cardiovascular disease risk. Further prospective studies may be needed to better assess these findings.
KeywordsBariatric surgery Framingham score risk reduction Cardiovascular risk reduction
Compliance with ethical standards
Dr. David Gutierrez-Blanco, Dr. David Funes-Romero, SriGita Madiraju, Dr. Federico Perez-Quirante, Dr. Emanuele Lo Menzo, Dr. Samuel Szomstein and Dr. Raul J. Rosenthal have no conflicts of interest or financial ties to disclose.
- 2.Statistics NC for H (2012) Healthy people 2010: final reviewGoogle Scholar
- 3.Rabkin SW, Mathewson FA, Hsu PH, Epstein F, Ostrander L, Johnson B et al, Kannel W, LeBauer E, Dawber T et al, Stamler J, Berkson D, Morjonner L et al, Chapman J, Coulson A, Clark V et al, Paul O, Lepper M, Phelon W et al, Keys A, Aronovis C, Blackburn H et al, Mathewson F, Varnam G, Mathewson F, Brereton D, Keltie W et al, Paul O, Schatz M, Walker S, Duncan D, Paffenbarger R, Wing A, Brozek J, Seltzer C, Keys A, Fedonza F, Kornonen M et al, Goldbourt U, Medalie J, Kannel W, Dawber T, Kagan A et al, Chapman J, Massey F, Gordon T, Kannel W, Gordon T, Schwartz M, Palmieri MG, Costos R, Schiffman J et al, Kannel W, Doyle J, McNamara P et al, Ashley F, Kannel W, Heyden S, Tyroler H, Hames C, Walker W, Medalie J, Snyder M, Groen J et al, Kieller L, Lilienfeld A, Fisher R, Spain D, Brodess V, Mohr C, Liberthson R, Nagel E, Herschman J et al, Alexander J, Han J, Haeren J, Corday E, Corday S (1977) Relation of body weight to development of ischemic heart disease in a cohort of young North American men after a 26 year observation period: the Manitoba Study. Am J Cardiol 39:452–458. doi: 10.1016/S0002-9149(77)80104-5
- 4.Gomes F, Telo DF, Souza HP, Nicolau JC, Halpern A, Serrano CV (2010) Obesity and coronary artery disease: role of vascular inflammation. Arq Bras Cardiol 94:255–261, 273–279, 260–266Google Scholar
- 8.Framingham T, Study H (2015) Annals of internal medicine a risk score for predicting near-term incidence of hypertension. Ann Intern MedGoogle Scholar
- 9.Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, Bucher HC, Nordmann AJ (2013) Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials. BMJ 347:f5934. doi: 10.1136/bmj.f5934 CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Madura JA, Dibaise JK (2012) Quick fix or long-term cure? Pros and cons of bariatric surgery. F1000 Med Rep 4:19. doi: 10.3410/M4-19
- 12.Colquitt JL, Pickett K, Loveman E, Frampton GK (2014) Surgery for weight loss in adults. Cochrane Database Syst Rev 8:CD003641. doi: 10.1002/14651858.CD003641.pub4
- 17.What the numbers reveal. http://connect.asmbs.org/may-2014-bariatric-surgery-growth.html. Accessed 12 November 2015
- 18.ASMBS Estimate of Bariatric Surgery Numbers, 2011–2015Google Scholar
- 20.Benaiges D, Goday A, Ramon JM, Hernandez E, Pera M, Cano JF (2011) Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surg Obes Relat Dis 7:575–580. doi: 10.1016/j.soard.2011.03.002 CrossRefPubMedGoogle Scholar
- 22.Iancu M, Copăescu C, Şerban M, Ginghină C (2013) Laparoscopic sleeve gastrectomy reduces the predicted coronary heart disease risk and the vascular age in obese subjects. Chirurgia (Bucur) 108:659–665Google Scholar
- 27.Perrone F, Bianciardi E, Benavoli D, Tognoni V, Niolu C, Siracusano A, Gaspari AL, Gentileschi P (2015) Gender influence on long-term weight loss and comorbidities after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass: a prospective study with a 5-year follow-up. Obes Surg. doi: 10.1007/s11695-015-1746-z Google Scholar