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Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass.
Surg Obes Relat Dis. 2009 May-Jun; 5(3):346-51.SO

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.

Authors+Show Affiliations

Department of Surgery, University of California, Davis, School of Medicine, Sacramento, California 95817, USA. mohamed.ali@ucdmc.ucdavis.edu <mohamed.ali@ucdmc.ucdavis.edu>No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19362060

Citation

Ali, Mohamed R., et al. "Detailed Description of Early Response of Metabolic Syndrome After Laparoscopic Roux-en-Y Gastric Bypass." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 5, no. 3, 2009, pp. 346-51.
Ali MR, Fuller WD, Rasmussen J. Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009;5(3):346-51.
Ali, M. R., Fuller, W. D., & Rasmussen, J. (2009). Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 5(3), 346-51. https://doi.org/10.1016/j.soard.2008.10.014
Ali MR, Fuller WD, Rasmussen J. Detailed Description of Early Response of Metabolic Syndrome After Laparoscopic Roux-en-Y Gastric Bypass. Surg Obes Relat Dis. 2009 May-Jun;5(3):346-51. PubMed PMID: 19362060.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detailed description of early response of metabolic syndrome after laparoscopic Roux-en-Y gastric bypass. AU - Ali,Mohamed R, AU - Fuller,William D, AU - Rasmussen,Jason, Y1 - 2008/11/21/ PY - 2008/05/13/received PY - 2008/09/03/revised PY - 2008/10/20/accepted PY - 2009/4/14/entrez PY - 2009/4/14/pubmed PY - 2009/7/30/medline SP - 346 EP - 51 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 5 IS - 3 N2 - 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. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/19362060/Detailed_description_of_early_response_of_metabolic_syndrome_after_laparoscopic_Roux_en_Y_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(08)00827-7 DB - PRIME DP - Unbound Medicine ER -