title: Primary Inadequate Weight Loss After Roux-en-Y Gastric Bypass Is not Associated with Poor Cardiovascular or Metabolic Outcomes: Experience from a Single Institution.
abstract: It is well accepted that bariatric surgery has cardiovascular and metabolic effects independent of weight loss.
  
  
  
  Weight loss outcomes of patients undergoing Roux-en-Y gastric bypass (RYGB) at a high volume referral center were collected at 1 year postoperatively. Patients with failed primary weight loss were identified. Primary inadequate weight loss was defined as total body weight loss less than 15 %. Changes in hypertension (HTN), dyslipidemia, type 2 diabetes mellitus (T2DM), and metabolic syndrome profiles were investigated using Student's t test.
  
  
  
  A total of 2500 patients underwent RYGB from the years 2001-2013 at our institution. One hundred five (4.2 %) patients had primary inadequate weight loss. Within this cohort, 81 (77.1 %) patients had hypertension, 67 (63.8 %) had dyslipidemia, 53 (50.5 %) had type 2 diabetes mellitus, and 66 (62.9 %) patients had metabolic syndrome. At 1 year postoperatively, all metabolic parameters were significantly improved. Measures of metabolic disease included high-density lipoprotein (HDL) (46.3 ± 11.6 versus 54.1 ± 12.7 mg/dL, p < 0.01), low-density lipoprotein (LDL) (103.6 ± 35.8 versus 89.2 ± 30.0 mg/dL, p < 0.01), triglycerides (177.3 ± 139.1 versus 117.6 ± 59.3 mg/dL, p < 0.01), mean plasma glucose (128.9 ± 55.3 versus 102.7 ± 27.3 mg/dL, p < 0.01), and hemoglobin A1C (7.3 ± 1.9 versus 6.1 ± 1.0 %, p < 0.01). HTN was noted to improve in 27 (33.3 %) patients based on a decrease in the number of anti-hypertensives used (1.7 ± 1.0 versus 1.3 ± 1.3, p < 0.01), and 21 (31.8 %) patients had resolution of their metabolic syndrome.
  
  
  
  Improvement in cardiometabolic comorbidities still occurs despite suboptimal weight loss following RYGB.
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA. haskini@ccf.org.|Clinical Research Fellow, Cleveland Clinic Foundation, 9500 Euclid Avenue, A100, Cleveland, OH, 44195, USA. haskini@ccf.org.
authors: Ivy N
authors: IN
authors: Haskins
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Ricard
authors: R
authors: Corcelles
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Dvir
authors: D
authors: Froylich
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Mena
authors: M
authors: Boules
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Amani
authors: A
authors: Hag
authors: Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Bartolome
authors: B
authors: Burguera
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Phillip R
authors: PR
authors: Schauer
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Matthew
authors: M
authors: Kroh
authors: Bariatric and Metabolic Institution, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors: Stacy A
authors: SA
authors: Brethauer
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D015390:Gastric Bypass / Q000379:methods / Q000706:statistics & numerical data; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D006442:Glycated Hemoglobin
keywords: Diabetes mellitus; Gastric bypass; Metabolic outcomes; Obesity; Weight loss