Key result
One-anastomosis gastric bypass resulted in substantial remission rates for hypertension (38%), diabetes (30%), and dyslipidaemia (41%) at 12 months.
Why the study?
Morbid obesity and vitamin D deficiency both adversely affect cardiovascular disease risk, prompting investigation into changes in CVD risk factors following one-anastomosis gastric bypass.
Does one-anastomosis gastric bypass and adequate vitamin D status improve cardiovascular risk factors in patients with morbid obesity and vitamin D deficiency?
RCT (n=50)
Does one-anastomosis gastric bypass and adequate vitamin D status improve cardiovascular risk factors in patients with morbid obesity and vitamin D deficiency?
One-anastomosis gastric bypass significantly reduces cardiovascular risk factors and improves insulin resistance in morbidly obese patients, with benefits potentially linked to achieving adequate vitamin D status.
OAGB improves CVD risk factors and insulin resistance markers in vitamin D-deficient obese patients; extends bariatric benefits to this high-risk subgroup.
BACKGROUND AND AIMS: Bariatric patients often suffer from vitamin D (VD) deficiency, and both, morbid obesity and VD deficiency, are related to an adverse effect on cardiovascular disease (CVD) risk. Therefore, we assessed the change of known CVD risk factors and its associations during the first 12 months following one-anastomosis gastric bypass (OAGB). METHODS AND RESULTS: In this secondary analysis, CVD risk factors, medical history and anthropometric data were assessed in fifty VD deficient (25-hydroxy-vitamin D (25(OH)D) <75 nmol/l) patients, recruited for a randomized controlled trial of VD supplementation. Based on previous results regarding bone-mass loss and the association between VD and CVD risk, the study population was divided into patients with 25(OH)D ≥50 nmol/l (adequate VD group; AVD) and into those <50 nmol/l (inadequate VD group; IVD) at 6 and 12 months (T6/12) postoperatively. In the whole cohort, substantial remission rates for hypertension (38%), diabetes (30%), and dyslipidaemia (41%) and a significant reduction in CVD risk factors were observed at T12. Changes of insulin resistance markers were associated with changes of total body fat mass (TBF%), 25(OH)D, and ferritin. Moreover, significant differences in insulin resistance markers between AVD and IVD became evident at T12. CONCLUSION: These findings show that OAGB leads to a significant reduction in CVD risk factors and amelioration of insulin resistance markers, which might be connected to reduced TBF%, change in 25(OH)D and ferritin levels, as an indicator for subclinical inflammation, and an adequate VD status. REGISTERED AT CLINICALTRIALS.GOV: (Identifier: NCT02092376) and EudraCT (Identifier: 2013-003546-16).
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Kruschitz et al. (2020) conducted an RCT in Vitamin D deficiency and morbid obesity (n=50). One-anastomosis gastric bypass (OAGB) vs. Baseline was evaluated on Change in cardiovascular disease risk factors. One-anastomosis gastric bypass resulted in substantial remission rates for hypertension (38%), diabetes (30%), and dyslipidaemia (41%) at 12 months.
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