Dynamics of body weight and comorbidities in obese patients after sleeve gastrectomy vs. gastric bypass
https://doi.org/10.14341/serg10279
Abstract
Background: Bariatric surgery methods have proven to be most effective in treating obesity. Weight regain (WR) is often found after various types of bariatric surgery. The clinical significance of WR is not clearly defined.
Aims: to assess the dynamics of body weight and determine the amount of clinically significant WR based on the study of carbohydrate metabolism and blood pressure in patients with obesity after performing sleeve gastrectomy (SG) and gastric bypass (GB).
Materials and methods: 68 patients with obesity after SG (40) and GB (28) were observed for 3 years. Body mass index (BMI), percentage of excess BMI lost (% EBMIL), WR, glycated hemoglobin, blood pressure were evaluated.
Results: A comparable efficiency (EBMIL more than 50%) of the SG and the GB was at the nadir point. % EBMIL over 50% was achieved in 78.8% of patients after SG and 80.0% of patients after GB. WR more than 15% was associated with a significant increase in systolic blood pressure. Clinically significant WR in the SG group was detected in 32.5% of patients, in the GB group – in 17.2% of patients (p > 0.05).
Conclusion: WR of more than 15% was associated with a significant increase in systolic blood pressure in patients with obesity after SG and GB, which makes it possible to consider WR of more than 15% clinically significant. A clinically significant WR 36 months after surgery was detected in 32.5% of patients after SG and 17.2% of patients after GB.
About the Authors
Anna R. Volkova
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
MD, PhD, Professor
Michael B. Fishman
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
MD, professor of faculty surgery, Pavlov First St.Petersburg State Medical University, Saint Petersburg, Russian Federation
Galina V. Semikova
Pavlov First Saint Petersburg State Medical University
Russian Federation
Competing Interests:
Russian Federation
assistant of faculty therapy Pavlov First St.Petersburg State Medical University
Competing Interests:
-
References
1. who.int [интернет]. Ожирение и избыточный вес: данные Всемирной организации здравоохранения [доступ от 21.12.2019]. [Obesity and overweight: WHO data. (In Russ.)] Доступ по ссылке https://www.who.int/ru/news-room/fact-sheets/detail/obesity-and-overweight.
2. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822-1832. doi: https://doi.org/10.1007/s11695-015-1657-z.
3. Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012; 308(11):1122-1131. doi: https://doi.org/10.1001/2012.jama.11164.
4. Vidal J, Jiménez A, de Hollanda A, et al. Metabolic surgery in type 2 diabetes: Roux-en-Y gastric bypass or sleeve gastrectomy as procedure of choice? Curr Atheroscler Rep. 2015; 17(10):58. doi: https://doi.org/10.1007/s11883-015-0538-1.
5. Monaco-Ferreira DV, Leandro-Merhi VA. Weight regain 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017;27(5):1137-1144. doi: https://doi.org/10.1007/s11695-016-2426-3.
6. Shantavasinkul PC, Omotosho P, Corsino L, et al. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12(9): 1640-1645. doi: https://doi.org/10.1016/j.soard.2016.08.028.
7. Castagneto Gissey L, Casella Mariolo JR, Genco A, et al. 10-year follow-up after laparoscopic sleeve gastrectomy: outcomes in a monocentric series. Surg Obes Relat Dis. 2018;14(10):1480-1487. doi: https://doi.org/10.1016/j.soard.2018.06.021.
8. Cooper TC, Simmons EB, Webb K, et al. Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery. Obes Surg. 2015;25(8):1474-1481. doi: https://doi.org/10.1007/s11695-014-1560-z.
9. Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153(5):427-434. doi: https://doi.org/10.1001/jamasurg.2017.5025.
10. Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587-606. doi: https://doi.org/10.1007/s11695-015-1645-3.
11. Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4): 516-525. doi: https://doi.org/10.1016/j.soard.2010.10.019.
12. Mans E, Serra-Prat M, Palomera E, et al. Sleeve gastrectomy effects on hunger, satiation, and gastrointestinal hormone and motility responses after a liquid meal test. Am J Clin Nutr. 2015;102(3):540-547. doi: https://doi.org/10.3945/ajcn.114.104307.
13. Rottenstreich A, Elazary R, Ezra Y, et al. Hypoglycemia during oral glucose tolerance test among post-bariatric surgery pregnant patients: incidence and perinatal significance. Surg Obes Relat Dis. 2018;14(3):347-353. doi: https://doi.org/10.1016/j.soard.2017.11.031.
14. Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349-356. doi: https://doi.org/10.1007/s11695-009-9895-6.
Supplementary files
|
|
1. Fig. 1. Loss of excess BMI (% EBMIL) in obese patients at the nadir point after performing sleeve gastroplasty and gastroshunting. RG - sleeve gastroplasty; GSH - gastroshunting. Bariatric surgery is effective if the patient has achieved a loss of excess body weight or excess BMI of 50% or more. | |
| Subject | ||
| Type | Other | |
View
(154KB)
|
Indexing metadata ▾ | |
|
|
2. Fig. 2. Systolic blood pressure in obese patients with varying degrees of re-gaining body weight after performing bariatric surgery (sleeve gastroplasty, gastroshunting). HELL syst - systolic blood pressure; PNMT - repeated weight gain; * - statistically significant differences between the level of systolic blood pressure 3 years after bariatric surgery in patients without repeated weight gain and in patients with repeated weight gain of more than 25% (p = 0.027); ** - statistically significant differences between the level of systolic blood pressure 3 years after bariatric surgery in patients without repeated weight gain and in patients with repeated weight gain of 15-24.9% (p = 0,000). | |
| Subject | ||
| Type | Other | |
View
(172KB)
|
Indexing metadata ▾ | |
Review
For citations:
Volkova A.R., Fishman M.B., Semikova G.V. Dynamics of body weight and comorbidities in obese patients after sleeve gastrectomy vs. gastric bypass. Endocrine Surgery. 2019;13(4):175-182. (In Russ.) https://doi.org/10.14341/serg10279
Views:
1764
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
