[Effect of gastric bypass on the metabolic syndrome and on cardiovascular risk].
BACKGROUND
Obesity is associated with increased morbimortality cardiovascular. Individual with metabolic syndrome (MS) are a high risk of developing cardiovascular disease (CVD). The aim of this study was to determine the prevalence of the MS in morbidly obese patients enrolling in a bariatric surgery program and to evaluate the impact of weigh loss induced by gastric bypass on the MS and on the predicted 10-year cardiovascular risk.


METHODS
We studied 46 morbidly obese patients who underwent laparoscopic gastric bypass and were followed for 2 years. MS was defined following the IDF 2005 criteria and the insulin resistance (IR) was calculated by using HOMA index. Risk assessment for estimating 10-year ECV risk was carried out according to Framingham score.


RESULTS
Before surgery, 67.2% of patients had IR and 60,9% met the definition of the MS. 17.3% of patients had an elevated cardiovascular risk category. 2 years after gastric bypass, the percentage of excess body weight lost was 72%. All patients restored their HOMA index and only 1 patient (3.6%) had MS. Resolution of hypertension, disglucemia and dislipemia has been observed in 85%, 93.8% and 95.6% of patients. Estimated cardiovascular risk decreased from 4.5% at baseline to 1% at 2 years after surgery.


CONCLUSIONS
SM is common in morbidly obese patients. Bypass gastric is associated with an improvement or resolution in cardiovascular risk factors and IR and result in a significant reduction in MS prevalence and of predicted 10-year cardiovascular risk.
Ocón Bretón
Julia
J
Unidad de Nutrición, Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. mjocon@salud.aragon.es
García
B
B
Benito
P
P
Gimeno
S
S
García
R
R
López
P
P
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D015390:Gastric Bypass; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy; D012307:Risk Factors; D015431:Weight Loss