title: Obesity-related cardiovascular risk factors after weight loss: a clinical trial comparing gastric bypass surgery and intensive lifestyle intervention.
abstract: OBJECTIVE
  Weight reduction improves several obesity-related health conditions. We aimed to compare the effect of bariatric surgery and comprehensive lifestyle intervention on type 2 diabetes and obesity-related cardiovascular risk factors.
  
  
  METHODS
  One-year controlled clinical trial (ClinicalTrials.gov identifier NCT00273104).
  
  
  METHODS
  Morbidly obese subjects (19-66 years, mean (s.d.) body mass index 45.1 kg/m(2) (5.6), 103 women) were treated with either Roux-en-Y gastric bypass surgery (n=80) or intensive lifestyle intervention at a rehabilitation centre (n=66). The dropout rate within both groups was 5%.
  
  
  RESULTS
  Among the 76 completers in the surgery group and the 63 completers in the lifestyle group, mean (s.d.) 1-year weight loss was 30% (8) and 8% (9) respectively. Beneficial effects on glucose metabolism, blood pressure, lipids and low-grade inflammation were observed in both groups. Remission rates of type 2 diabetes and hypertension were significantly higher in the surgery group than the lifestyle intervention group; 70 vs 33%, P=0.027, and 49 vs 23%, P=0.016. The improvements in glycaemic control and blood pressure were mediated by weight reduction. The surgery group experienced a significantly greater reduction in the prevalence of metabolic syndrome, albuminuria and electrocardiographic left ventricular hypertrophy than the lifestyle group. Gastrointestinal symptoms and symptomatic postprandial hypoglycaemia developed more frequently after gastric bypass surgery than after lifestyle intervention. There were no deaths.
  
  
  CONCLUSIONS
  Type 2 diabetes and obesity-related cardiovascular risk factors were improved after both treatment strategies. However, the improvements were greatest in those patients treated with gastric bypass surgery.
authors.affiliation: Department of Medicine, Morbid Obesity Centre, Vestfold Hospital Trust, PO Box 2168, 3103 Tønsberg, Norway. dag.hofso@siv.no
authors.forename: D
authors.initials: D
authors.lastname: Hofsø
authors.forename: N
authors.initials: N
authors.lastname: Nordstrand
authors.forename: L K
authors.initials: LK
authors.lastname: Johnson
authors.forename: T I
authors.initials: TI
authors.lastname: Karlsen
authors.forename: H
authors.initials: H
authors.lastname: Hager
authors.forename: T
authors.initials: T
authors.lastname: Jenssen
authors.forename: J
authors.initials: J
authors.lastname: Bollerslev
authors.forename: K
authors.initials: K
authors.lastname: Godang
authors.forename: R
authors.initials: R
authors.lastname: Sandbu
authors.forename: J
authors.initials: J
authors.lastname: Røislien
authors.forename: J
authors.initials: J
authors.lastname: Hjelmesaeth
mesh_terms: D000328:Adult; D031204:Caloric Restriction / Q000379:methods / Q000523:psychology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000523:psychology / Q000628:therapy; D005260:Female; D015390:Gastric Bypass / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000601:surgery*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
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