title: Effects of Laparoscopic Sleeve Gastrectomy on Central Obesity and Metabolic Syndrome in Indian Adults- A Prospective Study.
abstract: BACKGROUND
  Increasing incidence of obesity in Indian population has led to an exponential rise in the number of bariatric operations performed annually. Laparoscopic Sleeve Gastrectomy (LSG) has been proposed to cause rapid remission of Type 2 Diabetes Melitus (T2DM) and metabolic syndrome in a weight loss independent manner.
  
  
  OBJECTIVE
  To evaluate the effects of LSG on metabolic syndrome and central obesity in morbidly and severely obese Indian adults.Material and Methods:Study was conducted on 91 morbidly obese [Body Mass Index (BMI)>40 kg/m2] and severely obese (BMI>35 kg/m2) individuals who were suffering from diabetes, hypertension or dyslipidemia. The patients were followed up for six months and the trends of glycaemic control, mean blood pressure, lipid profile, weight loss parameters and changes in parameters of central obesity were studied.
  
  
  RESULTS
  Weight loss was significant at three months postsurgery and was sustained through six months. There was significant improvement in glycaemic control leading to reduction in need for oral hypoglycaemic agents or insulin in majority of them and even discontinuation of these medications in few patients. Hypertension and dyslipidemia also showed an improving trend through six months postsurgery. There was a significant impact on reduction of central obesity in these patients as marked by significant reduction in waist to hip ratio.
  
  
  CONCLUSIONS
  LSG produces sustainable weight loss with significant improvement in glycaemic status and control of metabolic syndrome in severe to morbidly obese patients. LSG is also efficacious in reducing central obesity in Indian population which is a major depressive ailment amongst obese individuals.
authors.affiliation: Senior resident, Department of G.I Surgery, Amrita institute of Medical Sciences and Research , Kochi, Kerala, India .
authors.forename: Pulkit
authors.initials: P
authors.lastname: Sethi
authors.affiliation: Senior resident, Department of G.I Surgery, Amrita institute of Medical Sciences and Research , Kochi, Kerala, India .
authors.forename: Manoj
authors.initials: M
authors.lastname: Thillai
authors.affiliation: Professor, Department of General surgery, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors.forename: Prabhdeep Singh
authors.initials: PS
authors.lastname: Nain
authors.affiliation: Associate professor, Department of General Surgery, Dayanand Medical College and Hospital , Ludhiana, Punjab, India .
authors.forename: Ashish
authors.initials: A
authors.lastname: Ahuja
authors.affiliation: Professor, Department of G.I Surgery, Amrita institute of Medical Sciences and Research , Kochi, Kerala, India .
authors.forename: Sudheer Othiyil
authors.initials: SO
authors.lastname: Vayoth
authors.affiliation: Assistant professor, Department of Anaesthesia, Amrita Institute of Medical Sciences , Kochi, Kerala, India .
authors.forename: Preetika
authors.initials: P
authors.lastname: Khurana
keywords: Dyslipidemia; Glycosylated haemoglobin; Hypertension; Weight loss