Evaluation of Metabolic Syndrome in morbidly Obese Patients Submitted to Laparoscopic Bariatric Surgery: Comparison of the Results between Roux-En-Y Gastric Bypass and Sleeve Gastrectomy.
Morbid obesity is a state of insulin resistance combined with excess of visceral fat, which contributes to the development of metabolic syndrome (MetS). Nonsurgical treatment of obesity usually improves MetS, but there is no ultimate resolution and weight regain is common. Surgical options like Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) result in a significant and sustained weight loss accompanied by improvement of MetS. The aim of this study was to compare the weight loss and improvement of MetS parameters between degree II and III obese patients with MetS undergoing RYGB or SG in a period of 12 months.



Analysis of medical records of 102 patients diagnosed with MetS (63 undergoing RYGB and 39 undergoing SG) in a reference center (CTO ISCMPA) between 2010 and 2013.



After 1-year follow-up, an excess weight loss (EWL) of 77.2 ± 22.5% and of 63.4 ± 20.1% (p = 0.033) was observed in the RYGB and SG groups, respectively. The rate of MetS resolution was very similar (87.3 and 84.6%, respectively; p = 0.971). The percentage of patients with type 2 diabetes was 3.3% for RYGB and 15.4% for SG (p = 0.025). Fasting blood glucose levels followed the same trend with mean values reaching 87.6 ± 16.9 mg/dl in the RYGB group and 97.7 ± 35.5 mg/dl in the group undergoing SG (p = 0.023).



Among the patients studied, both surgical techniques were safe and effective for MetS resolution in 12 months. However, RYGB was more effective for EWL and improvement of some parameters related to glucose metabolism.
Diabetes and Obesity Education and Research Center and Obesity Treatment Center of Hospital Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Av. Independência, 78/701, Centro. 90020-160, Porto Alegre, RS, Brazil. rkmenguer@gmail.com.
Rodrigo Koprovski
RK
Menguer
Obesity Treatment Center, Hospital Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 78/701, Centro. 90020-160, Porto Alegre, Rio Grande do Sul, Brazil.
Antônio Carlos
AC
Weston
Diabetes and Obesity Education and Research Center and Obesity Treatment Center of Hospital Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Av. Independência, 78/701, Centro. 90020-160, Porto Alegre, RS, Brazil.
Helena
H
Schmid
D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D024821:Metabolic Syndrome / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery
Bariatric surgery; Gastric bypass; Metabolic syndrome; Obesity; Roux-en-Y; Sleeve gastrectomy