Comparison of the Effect of Gastric Bypass and Sleeve Gastrectomy on Metabolic Syndrome and its Components in a Cohort: Tehran Obesity Treatment Study (TOTS)

Maryam Barzin | Mohammad Ali Kalantar Motamedi | Sara Serahati | Peyman Arian | Majid Valizadeh | Davood Khalili | Fereidoun Azizi | Farhad Hosseinpanah | Alireza Khlaj

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URL :   http://research.shahed.ac.ir/WSR/WebPages/Report/PaperView.aspx?PaperID=137915
Date :  2017/01/04
Publish in :    Obesity Surgery: The Journal of Metabolic Surgery and Allied Care
DOI :  https://doi.org/doi.org/10.1007/s11695-016-2526-0
Link :  http://dx.doi.org/doi.org/10.1007/s11695-016-2526-0
Keywords : Sleevegastrectomy .Gastricbypass .Bariatric surgery .Morbidobesity .Metabolicsyndrome

Abstract :

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Introduction Metabolicsyndrome(MetS)isaprevalentcounterpart of morbid obesity. With the surgical technique of sleeve gastrectomy (SG) gaining widespread acceptance for weightlossinmorbidobesepatients,weaimedtoundertakea study to compare its effectiveness to gastric bypass (GB) for metabolic control in these patients. Methods A total of 425 patients from a prospectively collecteddatabaseofmorbidobesesubjectsbetween18and65years of age undergoing a primary bariatric procedure from March 2013 to September 2015 were included. Statistical analysis was performed using general estimation equation and propensity scores, and odds ratios were calculated. Results Three hundred nineteen patients underwent SG and 106underwentGB.Meanageofthepatientswas37.8±11.7, andmeanbodymassindex(BMI)was44.3±5.9kg/m2.MetS was present in 61.4 of patients and diabetes mellitus in 48.6. MetS prevalence decreased from 60 and 64 in the SG and GB groups to 16 and 10 at 12 months, respectively. These improvements were consistent throughout the study period in both groups, with no significant difference between the two groups (for all variables: Ptrend .001, Pinteraction .05).Afterpropensityscore-adjustedanalysis,neither surgical technique showed superiority over the other regarding metabolic improvement (OR for MetS resolution: 0.81, 95 CI: 0.49–1.34). Conclusions In this short-term study with 1-year follow-up, SGshowedsimilarresultstoGBintermsofweightloss,MetS resolution, and glycemic control in a large Middle Eastern cohort. Long-term studies are needed to further investigate the effectiveness of SG in this regard.