Resolution of metabolic syndrome and related metabolic disorders after bariatric surgery: comparison of sleeve gastrectomy and gastric bypass

Xiao Du; Xiang-Hui Fu; Bo-Qiang Peng; Rong Luo; Jian-Kun Hu; Zhong Cheng

doi:10.1016/j.soard.2018.05.016

Resolution of metabolic syndrome and related metabolic disorders after bariatric surgery: comparison of sleeve gastrectomy and gastric bypass

Surg Obes Relat Dis. 2018 Sep;14(9):1348-1356. doi: 10.1016/j.soard.2018.05.016. Epub 2018 May 29.

Authors

Xiao Du¹, Xiang-Hui Fu², Bo-Qiang Peng³, Rong Luo³, Jian-Kun Hu¹, Zhong Cheng⁴

Affiliations

¹ Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China.
² Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, P.R. China.
³ Gastrointestinal Tract Reconstruction and Metabolic Surgery Association, West China Medical School, West China Hospital, Sichuan University, Chengdu, P.R. China.
⁴ Department of Gastrointestinal Surgery, Laboratory of Bariatric and Metabolic Surgery, West China Hospital, Sichuan University, Chengdu, P.R. China. Electronic address: zhongcheng1963@126.com.

PMID: 29980464
DOI: 10.1016/j.soard.2018.05.016

Abstract

Background: The effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on metabolic syndrome (MS) in morbidly obese patients have not been well studied.

Objective: To compare the effectiveness of LSG and LRYGB in Chinese morbidly obese patients with MS.

Setting: University Hospital, China.

Methods: Patients who underwent LRYGB or LSG surgery and had completed at least 1 year of follow-up were retrospectively reviewed. Bariatric and metabolic outcomes in the 2 groups were compared. Univariate and multivariate analyses were performed to identify the predictors of MS remission.

Results: Of the 176 patients enrolled in this study, 79 underwent LSG and 97 underwent LRYGB. Eighty-three met 3 of the International Diabetes Federation criteria for diagnosis of MS, 69 met 4 of the criteria, and 24 met 5 of the criteria. At 1 year after bariatric surgery, 79% of patients achieved remission of MS. In both LSG and LRYGB groups, the number of MS criteria met by patients decreased significantly after surgery. The MS remission rate was not significantly different between the 2 groups (74.7% in LSG versus 82.5% in LGB; P = .21). In LSG patients, there was no significant decrease in blood pressure or increase in the high-density lipoprotein cholesterol at 1 year. On logistic regression analysis, younger age, lower body mass index, and lower homeostatic model of assessment-insulin resistance were independently associated with MS remission at 1 year after surgery. Both groups showed satisfactory and comparable weight loss (percentage of excess weight loss: 71.7% in LSG versus 74.4% in LRYGB). No surgery-related mortality occurred.

Conclusions: Both LSG and LRYGB are feasible, safe, and effective in Chinese obese patients with MS. LSG seems to be inferior to LRYGB with regard to control of hypertension and high-density lipoprotein cholesterol.

Keywords: Bariatric surgery; Metabolic syndrome; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy.

Publication types

Comparative Study

MeSH terms

Adult
Female
Gastrectomy / statistics & numerical data*
Gastric Bypass / statistics & numerical data*
Humans
Male
Metabolic Syndrome / complications
Metabolic Syndrome / epidemiology*
Middle Aged
Obesity, Morbid / complications
Obesity, Morbid / epidemiology
Obesity, Morbid / surgery*
Retrospective Studies