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Evaluation of Metabolic Syndrome in morbidly Obese Patients Submitted to Laparoscopic Bariatric Surgery: Comparison of the Results between Roux-En-Y Gastric Bypass and Sleeve Gastrectomy

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Abstract

Background

Morbid obesity is a state of insulin resistance combined with excess of visceral fat, which contributes to the development of metabolic syndrome (MetS). Nonsurgical treatment of obesity usually improves MetS, but there is no ultimate resolution and weight regain is common. Surgical options like Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) result in a significant and sustained weight loss accompanied by improvement of MetS. The aim of this study was to compare the weight loss and improvement of MetS parameters between degree II and III obese patients with MetS undergoing RYGB or SG in a period of 12 months.

Methods

Analysis of medical records of 102 patients diagnosed with MetS (63 undergoing RYGB and 39 undergoing SG) in a reference center (CTO ISCMPA) between 2010 and 2013.

Results

After 1-year follow-up, an excess weight loss (EWL) of 77.2 ± 22.5% and of 63.4 ± 20.1% (p = 0.033) was observed in the RYGB and SG groups, respectively. The rate of MetS resolution was very similar (87.3 and 84.6%, respectively; p = 0.971). The percentage of patients with type 2 diabetes was 3.3% for RYGB and 15.4% for SG (p = 0.025). Fasting blood glucose levels followed the same trend with mean values reaching 87.6 ± 16.9 mg/dl in the RYGB group and 97.7 ± 35.5 mg/dl in the group undergoing SG (p = 0.023).

Conclusions

Among the patients studied, both surgical techniques were safe and effective for MetS resolution in 12 months. However, RYGB was more effective for EWL and improvement of some parameters related to glucose metabolism.

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References

  1. International Diabetes Federation: The IDF consensus worldwide definition of the metabolic syndrome. 2006; 1–24. Available from: http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf

  2. McCullough AJ. Epidemiology of the metabolic syndrome in the USA. J Dig Dis. 2011;12(5):333–40.

    Article  PubMed  Google Scholar 

  3. Inabnet 3rd WB, Winegar DA, Sherif B, et al. Early outcomes of bariatric surgery in patients with metabolic syndrome: an analysis of the bariatric outcomes longitudinal database. J Am Coll Surg. 2012;214(4):550–6. discussion 556-7

    Article  PubMed  Google Scholar 

  4. Sjöström L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65.

    Article  PubMed  Google Scholar 

  5. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(8):1171–7.

    Article  PubMed  Google Scholar 

  7. Lee WJ, Chong K, Ser KH, et al. Gastric bypass vs sleeve gastrectomy for type 2 diabetes mellitus: a randomized controlled trial. Arch Surg. 2011;146(2):143–8.

    Article  PubMed  Google Scholar 

  8. Sumithran P, Prendergast LA, Delbridge E, et al. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011;365(17):1597–604.

    Article  CAS  PubMed  Google Scholar 

  9. Kashyap SR, Bhatt DL, Schauer PR. STAMPEDE Investigators. Bariatric surgery vs. advanced practice medical management in the treatment of type 2 diabetes mellitus: rationale and design of the Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently trial (STAMPEDE). Diabetes Obes Metab. 2010;12(5):452–4.

    Article  PubMed  Google Scholar 

  10. Melissas J. IFSO guidelines for safety, quality, and excellence in bariatric surgery. Obes Surg. 2008;18(5):497–500.

    Article  PubMed  Google Scholar 

  11. de Hollanda A, Ruiz T, Jiménez A, et al. Patterns of weight loss response following gastric bypass and sleeve gastrectomy. Obes Surg. 2015;25(7):1177–83.

    Article  PubMed  Google Scholar 

  12. O’Brien PE, McPhail T, Chaston TB, et al. Systematic review of medium-term weight loss after bariatric operations. Obes Surg. 2006;16(8):1032–40.

    Article  PubMed  Google Scholar 

  13. Gracia-Solanas JA, Elia M, Aguilella V, et al. Metabolic syndrome after bariatric surgery. Results depending on the technique performed. Obes Surg. 2011;21(2):179–85.

    Article  PubMed  Google Scholar 

  14. Schmid H, Goelzer Neto CF, Dias LS, et al. Metabolic syndrome resolution by Roux-en-Y gastric bypass in a real world: a case control study. Rev Assoc Med Bras (1992). 2015;61(2):161–9.

    Article  Google Scholar 

  15. Zambon S, Romanato G, Sartore G, et al. Bariatric surgery improves atherogenic LDL profile by triglyceride reduction. Obes Surg. 2009;19(2):190–5.

    Article  PubMed  Google Scholar 

  16. Malin SK, Bena J, Abood B, et al. Attenuated improvements in adiponectin and fat loss characterize type 2 diabetes non-remission status after bariatric surgery. Diabetes Obes Metab. 2014;16(12):1230–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ahima RS, Sabri A. Bariatric surgery: metabolic benefits beyond weight loss. Gastroenterology. 2011;141(3):793–5.

    Article  PubMed  Google Scholar 

  18. Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250(2):234–41.

    Article  PubMed  Google Scholar 

  19. Schumann R, Shikora SA, Sigl JC, et al. Association of metabolic syndrome and surgical factors with pulmonary adverse events, and longitudinal mortality in bariatric surgery. Br J Anaesth. 114(1):83–90.

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Correspondence to Rodrigo Koprovski Menguer.

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The study was approved by the appropriate Ethics Committee.

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The authors have no financial relationships relevant to this article to disclose.

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The authors declare that they have no conflict of interest.

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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.

Informed Consent

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

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Menguer, R.K., Weston, A.C. & Schmid, H. Evaluation of Metabolic Syndrome in morbidly Obese Patients Submitted to Laparoscopic Bariatric Surgery: Comparison of the Results between Roux-En-Y Gastric Bypass and Sleeve Gastrectomy. OBES SURG 27, 1719–1723 (2017). https://doi.org/10.1007/s11695-017-2547-3

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