Endocrine Abstracts

Background: Obesity and related co-morbidities have become an emerging major health concern in South Asia. In addition to the efficacy in weight control, bariatric surgery improves metabolic disorders, thus is a recognized mode of treatment in obesity.

Objectives: To review the outcome of metabolic disorders in a group of obese patients in Sri Lanka following bariatric surgery.

Methods: Patients who underwent bariatric surgery at Professorial Surgical Unit, Colombo South Teaching Hospital, Sri Lanka from January 2014 to October 2017 were identified from a prospective database. Patients who had completed 12 months of post-operative period were included. Changes in the metabolic parameters at 1-year post-operative were statistically analyzed using paired-t-test.

Results: A total of 31 Sri Lankan patients were analyzed. Mean age was 37.7 years (range: 22–53). 28 (90.3%) were females. All patients had undergone sleeve gastrectomies. Initial mean weight 103.4 kg has reduced to 74.08 kg (P<0.001). Mean percentage expected weight loss was 60.28%. Mean BMI shows significant reduction from 42.7 kgm⁻² to 30.8 kgm⁻² (P<0.001). 13 (42%) had type 2 diabetes mellitus; all showing improved HbA1c 12 months post operatively (P<0.001) with complete resolution of diabetes in 61.5%. Among the initial pre-diabetics (7), 71.4% showed normoglycemia. Mean systolic blood pressure was 131 mmHg (range: 110–156), with a significant drop post operatively (P=0.001). 7 (22.5%) were initially hypertensive, of which all became normotenstive requiring no medication. Total cholesterol (P=0.183), LDL (P=0.198), HDL (P=0.442) and Cholesterol/HDL (P=0.856) showed no significant improvement 12 months post operatively. In contrast, triglycerides levels showed an improvement (P<0.001). Pre-operative fatty liver (9/31; 29%) showed an improvement in 88% of patients at 12-months post-bariatric surgery.

Conclusion: Metabolic parameters at 12 months post-operatively following bariatric surgery for obese Sri Lankan patients show significant improvement, comparable to similar studies in other parts of the world.