Influence of metabolic state and diabetes on the outcome at the end of first year after gastric banding.
BACKGROUND
The influence of metabolic state and the presence of diabetes before surgery on the weight changes following non-adjustable gastric banding, were studied.


METHODS
The total of 50 patients referred for gastric banding had the following parameters measured: insulinemia, glycemia, total cholesterol, triglycerides (TAG), dehydroepiandrostendione (DHEA) and its sulphate (DHEA-S), triiodothyronine, thyroxine, and thyroxine-stimulating hormone. We evaluated 28 of these, who completed at least 6 months of follow-up. 12 of these patients had diet-treated non-insulin dependent diabetes mellitus (NIDDM) and 16 were non-diabetics, and 9 of them had a positive family history of NIDDM (FH DM). We compared the change in weight of the diabetics, non-diabetics and those with positive FH DM, at 3, 6 and 12 months after the operation. Multiple linear regression tested the influence of the measured parameters on patients' weight.


RESULTS
Weight loss was greatest in the group of patients without a positive family history of diabetes, and lowest in the diabetic group. Due to the high dispersion, differences in the t-test are not significant. When individual factors and their influence on weight development were tested by multiple linear regression, weight loss was greatest in patients with high TAG and low insulin levels and lowest in patients with diabetes or positive FH DM.


CONCLUSIONS
Although post-operative weight can be influenced by other factors, eg. psychological ones, it is advisable to test each patient pre-operatively for insulin and TAG levels, and to establish family history of diabetes and presence of diabetes to give an idea of the prognosis of weight change.
Nedelníková
K
K
1st Surgical Department of the 1st Medical Faculty, Charles University, Prague, Czech Republic. knedelnikova@yahoo.com
Svacina
S
S
Haas
T
T
Matoulek
M
M
Fried
M
M
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D009765:Obesity; D011237:Predictive Value of Tests; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D007328:Insulin; D014280:Triglycerides