Introduction: Obesity is a complex multifactorial disease and its prevalence in pediatric age has increased. Obesity prejudices the individual metabolic profile due to the adipotoxicity involved in this condition. Bariatric surgery improves the weight of obese patients along with metabolic comorbidities, being today one of the most effective treatments for obesity. Time of exposure to adipotoxicity appears to be an important risk factor for the development of metabolic complications.
Objective: To assess the impact of bariatric surgery in the metabolic profile of adolescents.
Methods: Observational cohort study in obese adolescents selected to the criteria for sleeve surgery between 2013 and 2021. Clinical and laboratory parameters were evaluated before retro surgery and at 6 and 12 months after surgery. The effects of surgery were used to test the functioning test and the McNemmar test.
Results: The population included (n=24) had a mean age of 17.5 [17.0; 18.0] years at the time of surgery and 70.8% were female. The mean body mass index (BMI) at the time of surgery was 46.0±6.0 kg/m2; 45.8% arterial hypertension, 50.0% dyslipidemia and 54.2% used metformin. After 6 months of follow-up, there was a significant reduction in weight (127±20.5 vs 96.2±17.3 kg, P<0.001), BMI (46.7±5.7 vs 35.6±5.4 Kg/m2, P<0.01) and percentage of fat mass (47.6±8.3 vs 39.0±12.0%, P<0.001). At the end of one year, the decrease in weight gain, BMI and percentage of fat mass remained statistically significant. Glycated hemoglobin levels significantly decreased compared to baseline (5.4±0.2%), at 6 (5.2±0.3%, P=0.01) and 12 months (5.2±0.0.3%, P=0.01). Also, a significant reduction in HOMA-IR was observed, compared to the initial value (5.7±2.6 mg/dl), at 6 (2.3±0.9 mg/dl, P<0.001) and at 12 months (2, 1±1.2, P=0.002) after surgery. These changes culminated in a reduction in metformin use, from 54% to 6% (P=0.05), 6 months after surgery.
Conclusion: These results evidence that bariatric surgery has a beneficial effect on the metabolic profile. Knowing the cumulative effects of obesity, performing this surgery earlier will reduce the time exposed to adiposity and glucotoxicity, and may mitigate the long-term consequences of obesity. Longer follow-up is needed to assess these benefits.
21 May 2022 - 24 May 2022