Introduction: Obesity, defined as a BMI ≥30 kg/m2, is the most common chronic metabolic disease in the world and its prevalence has strongly increased. Obesity is associated with multiple comorbidities, including cardiovascular disease, hypertension, insulin resistance, dyslipidemia, type 2 diabetes, sleep apnea and certain cancers. Bariatric surgery is the most effective treatment for severe obesity and produces dramatic and durable weight loss. The aim of the study was to evaluate weight loss and changes in the metabolic profile in a period between 6 months and 5 years after laparoscopic sleeve gastrectomy (LSG).
Methods: An observational study was conducted. It included 40 patients having morbid obesity and undergoing bariatric surgery, respectively LSG. Preoperative and postoperative data (6 months and 5 years) was collected and analyzed. The following parameters were measured: weight, height, waist, hip; BMI and EWL (excess weight loss) were calculated. Fasting glucose, insulin level, uric acid and lipid profile were measured and HOMA IR (homeostasis model assessment of insulin resistance) was calculated.
Results: Preoperatively, the mean age was 44.55±8.95 years, mean BMI was 46.61±10.06 kg/m2, mean waist was 131.25±20.30 cm, and mean cholesterol level was 210±41.47 mg/dl. After 6 months, mean BMI decreased to 33.95±7.28 kg/m2 and to 35.11±7.28 kg/m2 after 5 years. On average, patients had EWL of 66.71% at 6-month follow-up and 57.29% at 5-years follow-up. There were remarkable improvements in lipid profile. The mean levels of high-density lipoprotein (HDL) cholesterol after surgery were significantly higher (41.95±9.53 mg/dl vs 47.42±12.09 mg/dl six months after surgery vs 54.25±12.52 mg/dl after 5 years, P<0.05). Triglycerides, uric acid and glucose levels were significantly reduced from 159.69±66.644 mg/dl, 7.39±4.81 mg/dl and 118.64 mg/dl at baseline to 108.23±79 mg/dl, 5.07±1.55 mg/dl, and 86.08±9.72 mg/dl after 6 months and 105.24±51.86 mg/dl, 5.49±1.25 mg/dl, and 93.96±13.73 mg/dl after 5 years. After 6 months, HOMA index improved from 7.62±7.25 to 1.44±1.59 (P<0.05). Compared to baseline, improvement was maintained in the data collected after 5 years (2.97±3.58, P<0.05).
Conclusion: LGS determines both short and long term improvements in weight loss and metabolic parameters.
19 - 22 May 2018
European Society of Endocrinology