title: Mild elevation of fasting plasma glucose is a strong risk factor for postoperative complications in gastric bypass patients.
abstract: BACKGROUND
  Bariatric surgery may be associated with surgical complications. The aim of the study was to identify significant risk factors for postoperative complications in patients undergoing Roux-en-Y gastric bypass (RYGBP).
  
  
  METHODS
  The study consisted of 75 consecutive patients undergoing RYGBP. Full medical examination was performed, and the following parameters were assessed in the fasting state: plasma glucose, insulin, leptin, serum lipids, liver function tests, and lipoprotein Lp(a). All subjects had oral 75 g glucose tolerance test before the surgery. All complications occurring within 6 months after the RYGBP were recorded. The patients were divided into Group 1 - patients in whom complications occurred, and Group 2 - patients with no complications in the 6-month period.
  
  
  RESULTS
  Postoperative complications occurred in 16 patients (wound infection, hernia, splenic injury, gastro-jejunal obstruction, duodenal ulcer, lower limb deep vein thrombosis). 3 significant risk factors for postoperative complications within 6 months after gastric bypass were found: 1) fasting plasma glucose >/= 6.0 mmol/l (OR 11.0; 95% confidence interval (CI) 2.1-77.3), 2) age >/=40 years (OR 5.89, 95% CI 1.35-29.4), and 3) BMI >/=45 kg/m(2) (OR 4.1, 95% CI 1.04-17.2).
  
  
  CONCLUSIONS
  RYGBP is associated with increased risk of developing early postoperative complications in subjects with even slightly elevated fasting plasma glucose, age >/=40 and BMI >/=45 kg/m(2).
authors.affiliation: Department of Diabetology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland. leszek.czupryniak@dtu.ox.ac.uk
authors.forename: Leszek
authors.initials: L
authors.lastname: Czupryniak
authors.forename: Janusz
authors.initials: J
authors.lastname: Strzelczyk
authors.forename: Maciej
authors.initials: M
authors.lastname: Pawlowski
authors.forename: Jerzy
authors.initials: J
authors.lastname: Loba
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000379:methods; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D005951:Glucose Tolerance Test; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D001786:Blood Glucose