Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass

Mohamed R Ali, William D. Fuller, Jason Rasmussen

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Background: Previous outcome research in bariatric surgery has been unable to document quantitative changes in co-morbidities associated with obesity owing to a lack of a standardized instrument to grade the severity. We report a detailed description of the early resolution of the metabolic syndrome using our novel scheme for assessing co-morbidities. This study was performed at a tertiary care university hospital. Methods: Co-morbidity data were prospectively collected for 827 patients who underwent laparoscopic Roux-en-Y gastric bypass during a 4-year period using the Assessment of Obesity-Related Co-morbidities (AORC) scale. This scale assigns a score of 0-5 for the major medical conditions associated with obesity. The co-morbid conditions of obesity and biochemical markers of the metabolic syndrome were examined preoperatively and at the follow-up visits. Results: Of the 827 patients who underwent laparoscopic Roux-en-Y gastric bypass, 72 (8.7%) met the AORC criteria for the metabolic syndrome (AORC score >2 for diabetes mellitus [DM], hypertension [HTN], and dyslipidemia [DYS]). Overall, 75% of patients with DM, 69.4% of patients with HTN, and 76.4% of patients with DYS showed improvement in these co-morbidities (decrease from the preoperative AORC score) within 2 months after surgery. Within this period, DM, HTN, and DYS resolved in 65.3%, 51.4%, and 73.6% of patients, respectively. Concurrent decreases in hemoglobin A1c, serum lipids, and blood pressure were observed (P <.05). Patients exhibited a modest excess body weight loss of 27.7% during this period. However, the mean AORC score for the whole group decreased significantly for DM, DYS, and HTN (P <.001) before significant weight loss occurred. Conclusion: We have demonstrated a new and novel approach to categorize and more accurately define the magnitude of improvement in co-morbidities after laparoscopic Roux-en-Y gastric bypass. This improvement preceded the weight loss effects on the metabolic syndrome.

Original languageEnglish (US)
Pages (from-to)346-351
Number of pages6
JournalSurgery for Obesity and Related Diseases
Volume5
Issue number3
DOIs
StatePublished - May 2009

Keywords

  • Bariatric surgery
  • Co-morbidities
  • Diabetes mellitus
  • Hyperlipidemia
  • Hypertension
  • Laparoscopy
  • Metabolic syndrome
  • Morbid obesity
  • Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Surgery

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