title: Comparison of the Effect of Gastric Bypass and Sleeve Gastrectomy on Metabolic Syndrome and its Components in a Cohort: Tehran Obesity Treatment Study (TOTS).
abstract: Metabolic syndrome (MetS) is a prevalent counterpart of morbid obesity. With the surgical technique of sleeve gastrectomy (SG) gaining widespread acceptance for weight loss in morbid obese patients, we aimed to undertake a study to compare its effectiveness to gastric bypass (GB) for metabolic control in these patients.
  
  
  
  A total of 425 patients from a prospectively collected database of morbid obese subjects between 18 and 65 years of age undergoing a primary bariatric procedure from March 2013 to September 2015 were included. Statistical analysis was performed using general estimation equation and propensity scores, and odds ratios were calculated.
  
  
  
  Three hundred nineteen patients underwent SG and 106 underwent GB. Mean age of the patients was 37.8 ± 11.7, and mean body mass index (BMI) was 44.3 ± 5.9 kg/m2. MetS was present in 61.4% of patients and diabetes mellitus in 48.6%. MetS prevalence decreased from 60 and 64% in the SG and GB groups to 16 and 10% at 12 months, respectively. These improvements were consistent throughout the study period in both groups, with no significant difference between the two groups (for all variables: Ptrend< .001, Pinteraction> .05). After propensity score-adjusted analysis, neither surgical technique showed superiority over the other regarding metabolic improvement (OR for MetS resolution: 0.81, 95% CI: 0.49-1.34).
  
  
  
  In this short-term study with 1-year follow-up, SG showed similar results to GB in terms of weight loss, MetS resolution, and glycemic control in a large Middle Eastern cohort. Long-term studies are needed to further investigate the effectiveness of SG in this regard.
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Barzin
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali Kalantar
authors.initials: MAK
authors.lastname: Motamedi
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Serahati
authors.affiliation: Faculty of Medicine, Shahed University, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Khalaj
authors.affiliation: Faculty of Medicine, Shahed University, Tehran, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Arian
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Valizadeh
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Khalili
authors.affiliation: Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
authors.affiliation: Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. fhospanah@endocrine.ac.ir.|Department of Internal Medicine, School of medicine, Shahid Beheshti Medical University (M.C.) Obesity Research Center, Tehran, Iran. fhospanah@endocrine.ac.ir.
authors.forename: Farhad
authors.initials: F
authors.lastname: Hosseinpanah
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D007492:Iran; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D057216:Propensity Score; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Bariatric surgery; Gastric bypass; Metabolic syndrome; Morbid obesity; Sleeve gastrectomy