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Effects of Obesity Surgery on Metabolic Syndrome
How Gastric Banding and Bypass Affect Insulin Resistance Syndrome
Effects of Bariatric Surgery on Metabolic Syndrome
Individuals with metabolic syndrome (MS), a clustering of risk factors (high levels of triglycerides and serum glucose, low level of high-density-lipoprotein cholesterol, high blood pressure, abdominal obesity) are at high risk of developing coronary heart disease and type 2 diabetes mellitus and may benefit from surgically induced weight loss.
From December 1, 1999, to March 31, 2002, 645 consecutive morbidly obese patients were enrolled in a surgically supervised weight loss program, and the efficacy of weight loss 1 year after laparoscopic banding/bypass surgery was examined. Outcome measures included prevalence of the metabolic syndrome as defined by the ATPIII: waist circumference greater than 102 cm in men and 88 cm in women; serum triglyceride level of at least 150 mg/dL ; high-density lipoprotein cholesterol level less than 40 mg/dL in men and 50 mg/dL in women; blood pressure of at least 130/85 mm Hg; and serum glucose level of at least 110 mg/dL.
Of 645 individuals, 337 (52.2%) met the ATPIII definition of metabolic syndrome. Individuals with the metabolic syndrome had significant differences in age (31.5 years vs 28.1 years), and many metabolic abnormalities compared with patients without the MS. Laparoscopic vertical banded gastroplasty was performed in 528 patients (81.9%) and laparoscopic gastric bypass in 117 (18.1%). A significant decrease in weight was found in both groups, but individuals who underwent laparoscopic gastric bypass lost significantly more weight (mean +/- SD, 38.4 +/- 14.4 kg vs 35.1 +/- 16.8 kg) and achieved a lower body mass index than individuals who underwent laparoscopic vertical banded gastroplasty. Substantial mean weight reduction (31.9%) of patients with the metabolic syndrome resulted in a substantial reduction of systolic and diastolic blood pressure and levels of glucose, triglycerides, and total cholesterol 1 year after surgery. These improvements resulted in a 95.6% resolution of the MS 1 year after surgery. There was no difference between operations (laparoscopic vertical banded gastroplasty or laparoscopic gastric bypass) in the resolution rate of the MS 1 year after surgery (95.0% vs 98.4%, respectively).
Metabolic syndrome is prevalent in 52.2% of morbidly obese individuals enrolling in an obesity surgery program. Significant weight reduction 1 year after surgery markedly improved all aspects of the metabolic syndrome and resulted in a cure rate of 95.6%. Obesity surgery performed by laparoscopic surgery is recommended for obese patients with the metabolic syndrome.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources