Effects of bariatric surgery in different obesity phenotypes: Tehran Obesity Treatment Study (TOTS)

Maryam Barzin | Shayan Aryannezhad | Alireza Khlaj | Maryam Mahdavi | Majid Valizadeh | Sahar Ghareh | Feridoun Azizi | Farhad Hosseinpanah

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URL :   http://research.shahed.ac.ir/WSR/WebPages/Report/PaperView.aspx?PaperID=137921
Date :  2019/10/25
Publish in :    Obesity Surgery: The Journal of Metabolic Surgery and Allied Care
DOI :  https://doi.org/10.1007/s11695-019-04182-y
Link :  http://dx.doi.org/10.1007/s11695-019-04182-y
Keywords : Bariatricsurgery .Morbidobesity .Obesityphenotype

Abstract :

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Background Not all morbid obese patients suffer from metabolic co-morbidities; thus, a sub-group of metabolically healthy morbidobese(MHMO)individualsareidentified.However,theroleofbariatricsurgeryisnotwellunderstoodinthissubgroup. Methods A total of 2244 morbid obese individuals aged 18–65 years undergoing bariatric surgery were selected. Patients were considered MHMO according to the joint interim statement (JIS) definition, as having two or less abnormalities in these five parameters: waist circumference (WC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), systolic or diastolic blood pressure (SBP or DBP), and fasting plasma glucose (FPG). Otherwise, they were considered metabolically unhealthy morbid obese (MUMO). Follow-up data were collected at 6, 12, and 24 months post-surgery. Results Priortosurgery,36.2ofparticipantswereMHMOandhadsignificantlylowerBMI,WC,TG,FPG,SBP,andDBPand higher HDL-C compared to MUMO. Both MHMO and MUMO participants showed a significant decrease in BMI, WC, TG, SBP,DBP,andFPGandincreaseinHDL-Candthepercentageofexcessweightloss(EWL).Two-yearpost-operativechanges (frombaseline)ofBMI,WC,andEWLweregreaterinMHMOsubjectsandchangesofTG,HDL-C,DBP,SBP,andFPGwere greaterinMUMOsubjects.Furthermultivariateregressionanalysisfordelta(Δ)changeinthesecharacteristicsrevealedthatonly the delta (Δ) changes of WC and EWL were statistically different between the two phenotypes and were greater in MHMO subjects, 2 years after the surgery (− 3.077 cm decrease in WC and + 3.612 higher EWL compared to MUMO subjects). Conclusion BariatricsurgeryisaneffectivemethodforreductionofmetabolicabnormalitiesandweightlossinbothMUMOand MHMO phenotypes. Benefits of this intervention are comparable between patients with these two obesity phenotypes