Modifications of metabolic and cardiovascular risk factors after weight loss induced by laparoscopic gastric banding.
BACKGROUND
The well-known inverse relation between life expectancy and BMI, particularly in morbid obesity, is presumably in large part due to multiple cardiovascular and metabolic comorbidities. Severely obese patients treated with laparoscopic adjustable silicone gastric banding (LASGB) were evaluated for such risk factors before and 1 year after LASGB.


METHODS
130 individuals (age 20-66, BMI 34-59 kg/m2) who underwent LASGB between 1996 and 2000 were studied; 50 of them were available for reevaluation 12 months after surgery. The presence and severity of diabetes (DM), hypertension (HTN), hypercholesterolemia (HC) and hypertriglyceridemia (HT) were assessed before and after surgery. In 18 of them erythrocyte sedimentation rate (ESR) were also measured.


RESULTS
Comorbidities were highly prevalent at the initial evaluation: DM 10%, HTN 32%, HC 37%, HT 27%. In the subgroup reevaluated after surgery, prevalence of DM decreased from 15% to 6%, HTN from 37% to 25%, HC from 36% to 25%, and HT from 29% to 13%, with an average BMI loss from 44.1 to 35.9. ESR decreased from a preoperative value of 36.7 +/- 22.6 mm/hr to 18.3 +/- 11.9 mm/hr at 1 year (p < 0.001).


CONCLUSIONS
Morbidly obese subjects respond to LASGB with an impressive reduction of comorbidities which is sustained for at least 1 year, well after the initial acute negative energy balance and when weight tends to stabilize. The high prevalence of elevated ESR, which has been considered a strong predictor of coronary mortality, confirms previous reports of its association with obesity, and the clear tendency to normalization with weight loss may represent a further element contributing to lower morbidity.
Bacci
Vincenzo
V
Servizio Speciale di Dietologia, Policlinico Umberto I University Hospital, Italy. mc1635@mclink.it
Basso
Maria Sole
MS
Greco
Francesco
F
Lamberti
Romina
R
Elmore
Ugo
U
Restuccia
Angelo
A
Perrotta
Nicola
N
Silecchia
Gianfranco
G
Bucci
Antonello
A
D000328:Adult; D000368:Aged; D001799:Blood Sedimentation; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D015391:Gastroplasty; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D015228:Hypertriglyceridemia / Q000453:epidemiology*; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery; D011184:Postoperative Period; D012307:Risk Factors