Different metabolic response to intagastric balloon treatment between non-morbid and morbid type of obesity
M. Nikolić, G. Mirošević, I. Kruljac, M. Vrkljan, V. Supanc, N. Ljubičić, M. Duvnjak, I. Budimir, B. Pezo Nikolić, M. Sabol, I. Nikolac & M. Bekavac Bešlin
BioEnterics Intragastric Balloon (BIB) is a non-invasive procedure which proved to be effective in short-term treatment of obesity. Its effect on alterations in metabolic parameters is poorly understood. Since our previous study showed different ghrelin and leptin response between groups of morbidly (M) and non-morbidly (NM) patients after BIB placement, we aimed to investigate the alteration dynamics in metabolic parameters between these two groups.
Our prospective single-center study included 44 Caucasians treated with BIB for six months, with age range of 2059, and divided to NM or M type of obesity based on body mass index (BMI) cutoff of 40 kg/m2. Control blood samples were collected at 1, 3, 6 and 12 months after BIB placement. Serum glucose, insulin, C-peptide, glycated hemoglobin, GH, uric acid, lipidogram and homeostatic model assessment 2 (HOMA2) were determined.
Significant differences were observed in anthropometrics without differences between genders or comorbidities. The baseline BMI for NM vs M was 37.65 vs 44.60 kg/m2. Weight loss was statistically different (P<0.001) between the studied groups with a median control weight at 6 months of 33.05 vs 39.65 kg/m2. Fasting insulin, HOMA2, glycated hemoglobin and uric acid decreased to similar values in both groups during sixth month, but significantly greater decrease was observed in NM group during first and third month. GH increased substantially in both groups but significantly greater increase occurred in NM group during third month. Fasting serum glucose, C-peptide, cholesterol and triglycerides slightly decreased but without the difference in dynamics.
To our knowledge this is the most detailed study on metabolic parameters in obesity treatment. The results suggest a potential pattern of individualization between NM and M obese patients which could influence future indications for BIB use. Additionally, further studies are needed in order to enlighten the pathophysiologic mechanisms of obesity.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.