Key result
Laparoscopic Roux-en-Y gastric bypass resulted in a 59.2% metabolic syndrome remission rate at 36 months, with excess body mass index loss serving as a strong predictor of remission.
Why the study?
Does laparoscopic Roux-en-Y gastric bypass with a long biliopancreatic limb improve metabolic syndrome remission in obese patients with BMI > 35 kg/m2?
Cohort (n=153)
No
Does laparoscopic Roux-en-Y gastric bypass with a long biliopancreatic limb improve metabolic syndrome remission in obese patients with BMI > 35 kg/m2?
Long-limb laparoscopic Roux-en-Y gastric bypass induces significant and sustained weight loss, leading to high rates of metabolic syndrome remission and discontinuation of metabolic medications in severely obese patients.
Answers are grounded in this paper and cite their sources.
Supports metabolic syndrome remission after long-limb RYGB in severe obesity; leaves open superiority to standard techniques or medical therapy.
BACKGROUND: Metabolic syndrome (MS) is a condition associated with obesity that identifies individuals with increased cardiovascular risk. Gastric bypass improves several MS components, such as glucose, lipid metabolism and hypertension. The aim of this study was to evaluate the effect of long-limb gastric bypass on the remission of MS criteria associated with morbid obesity. METHODS: Obese patients who met the "harmonized" criteria for MS (n = 153) that underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) with a long biliopancreatic limb were prospectively evaluated with regards to body weight, body mass index (BMI), percentage of excess BMI lost (% EBMIL), fasting glucose, blood pressure and lipid profile up to 36 months after surgery. RESULTS: Before surgery, patients had a BMI of 44.3 ± 0.5 kg/m2; 66% were under anti-diabetic treatment; 78.4% were under anti-hypertensive treatment and 44.3% were under anti-dyslipidemic treatment. After a mean follow-up time of 2.4 ± 0.1 years, MS remission rates were 32.7% at 6 months, 69.7% at 12 months, 63.4% at 24 months, and 59.2% at 36 months; when only 32.9%, 43.4% and 15.8% of patients were still under anti-diabetic, anti-hypertensive and anti-dyslipidemic treatment, respectively. The %EBMIL and BMI were the parameters that showed the highest accuracy to predict the MS remission at all-time points after the surgery. CONCLUSIONS: Long limb gastric bypass in obese patients results in significant and sustained weight loss which predicts a high remission rate of MS and allows the discontinuation of drug therapy for several metabolic disturbances in most patients.
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Nora et al. (2014) conducted a cohort in Morbid obesity with metabolic syndrome (n=153). Laparoscopic Roux-en-Y gastric bypass (LRYGB) with a long biliopancreatic limb vs. Baseline (pre-surgery) was evaluated on Metabolic syndrome remission rate at 36 months (p=<0.001). Laparoscopic Roux-en-Y gastric bypass resulted in a 59.2% metabolic syndrome remission rate at 36 months, with excess body mass index loss serving as a strong predictor of remission.
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