title: The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries.
abstract: BACKGROUND
  Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.
  
  
  METHODS
  Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.
  
  
  CONCLUSIONS
  The DS procedure resulted in a superior reduction in cardiovascular and proinflammatory risk markers compared with GB and SG.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Nelson
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.
authors.forename: Rees
authors.initials: R
authors.lastname: Porta
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Blair
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA.
authors.forename: Preston
authors.initials: P
authors.lastname: Carter
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Ave., Tacoma, WA 98431, USA. Electronic address: matthew.martin1@us.army.mil.
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
mesh_terms: D000328:Adult; D015904:Biliopancreatic Diversion; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood; D005260:Female; D005743:Gastrectomy; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein