Most recent update: Monday, October 22, 2018 - 14:53

Bariatric News - Cookies & privacy policy

You are here

RYGB and comorbidities

RYGB controls comorbidities in the first year

Before surgery, 51% of the patients had a BMI>50, these superobese individuals had lower HDLc concentrations before surgery and higher TG levels 12 months after surgery

Roux-en-Y gastric bypass (RYGB) is an important instrument for weight loss and for the control of comorbidities such as diabetes and dyslipidaemia, at least during the first postoperative year according to researchers from University of São Paulo, Ribeirao Preto and Sao Jose do Rio Preto Medical School, Sao Jose do Rio Preto, SP, Brazil. However, in their study, ‘Weight loss and metabolic outcomes 12 months after Roux-en-Y gastric bypass in a population of Southeastern Brazil.’, published in Nutricion Hospitalaria, they note that studies with a longer follow-up time are needed to determine the efficacy of RYGB during the late postoperative period.

The authors state that obesity in Brazil has significantly increased over the last 30 years and according to the WHO, the country currently occupies 77th position in the ranking of obesity. According to the 2013 paper by Buchwald et al, the total number bariatric procedures in Brazil was 65,000 of which approximately 45,000 were RYGB.

Therefore, the researchers wanted in investigate the impact of RYGB on weight loss and on the resolution of diseases associated with obesity and to determine whether the preoperative BMI influences the response to surgical treatment of patients treated in the public health service in the state of São Paulo and followed up for 12 months.

Study

They collected the medical records of 598 patients with grade III from two hospitals in Southeastern Brazil: University Hospital (n=442) and Base Hospital (n=156). Anthropometric, demographic and biochemical data and a personal history were collected a three different time points: preoperatively, six and 12 months after surgery. Biochemical evaluation consisted of the determination of serum concentrations of glycaemia, total cholesterol (TC), low density lipoprotein cholesterol (LDLc), high density lipoprotein cholesterol (HDLc) and triglycerides (TG). Remission of diabetes was defined as blood glucose levels were within normal limits after 12 months of surgery. The patients were divided into two groups, BMI≤ 50 and BMI>50, to assess the impact of preoperative BMI on the resolution of comorbidities associated with obesity.

Outcomes

The mean patient age was 40.2±9.8 years and there was a prevalence of females (82.3%). Overall, there was a loss of 45.5±13.7 kg (33.5%) during the first year after surgery (p<0.05) and a reduction of serum glucose, TC and LDLc concentrations during the first six months after RYGB, which was maintained out to 12 months. A reduction of weight and TG occurred throughout the study period (12 months). Furthermore, glycaemia was reduced by 18%, TC by 12.2%, LDLc by 12.4%, TG by 32.6%, and HDLc increased by 30.3%. Figure 1 illustrates the percentage of patients with diseases associated with obesity before and after surgery. The prevalence of DM and dyslipidaemia was reduced after bariatric surgery (p <0.001).

Figure 1: Prevalence of patients with comorbidities associated with obesity before and 12 months after Roux-en-Y gastric bypass (RYGB); PO: Postoperative; *t test; p<0.05

Before surgery, 51% of the patients had a BMI>50, these superobese individuals had lower HDLc concentrations before surgery and higher TG levels 12 months after surgery. Figure 2 illustrates the prevalence of comorbidities among the patient groups before and 12 months after RYGB. No difference in the frequency of comorbidities was observed between individuals with BMI≤50 and BMI>50 at any time point in the study.

Figure 2: Prevalence of patients with comorbidities associated with a BMI of less or more than 50 kg/m² before and after Rouxen-Y gastric bypass. PO: Postoperative; No significant difference was detected; t test; p<0.05

“The present study confirmed the high prevalence of diseases associated with obesity among candidates for bariatric surgery and also demonstrated that surgical treatment is an effective tool for weight loss and for the improvement of T2DM and dyslipidemia within one year after the procedure,” the authors state. “…it is still unclear how much of a weight loss should occur for a complete resolution of the comorbidities in severely obese individuals…studies with a longer follow-up time are needed to determine the efficacy of RYGB during the late postoperative period.

To access this paper, please click here

Want more stories like this? Subscribe to Bariatric News!

Bariatric News
Keep up to date! Get the latest news in your inbox. NOTE: Bariatric News WILL NOT pass on your details to 3rd parties. However, you may receive ‘marketing emails’ sent by us on behalf of 3rd parties.