Introducción: El Objetivo fue evaluar los parámetros metabólicos en pacientes adultos ≥ 65 años en comparación con adultos < 65 años sometidos a CB pre y post intervención.Materiales y métodos: Estudio analítico de cohorte prospectiva en 40 pacientes sometidos a CB durante el periodo julio de 2015 y marzo de 2018. Los pacientes fueron divididos en dos grupos (A: ≥65 años; B: < 65 años) y se evaluaron previo a la cirugía (basal), y a los 3 y 6 meses posteriores al acto quirúrgico parámetros antropométricos y parámetros bioquímicos. Se calculó el porcentaje de peso perdido (PEPP) y se evaluó el índice Triglicéridos/HDLc (TAG/HDLc) como marcador de insulinorresistencia.Resultados: De los 40 pacientes sometidos a la CB, se incluyeron 36: 21 pacientes eran del grupo A (mediana de edad: 59, RIQ: 48-61 años) y 15 pacientes del grupo B (mediana de edad: 67, RIQ: 66-69 años), el porcentaje de pacientes con diabetes mellitus tipo 2 era de 53%(n=8) en B vs 43% (n=9) en A. Luego de 3 y 6 meses post CB se observó en el grupo B un descenso en el peso, índice de masa corporal y porcentaje de exceso de peso perdido (PEPP) no significativo, disminución en los niveles de glucemia y HbA1c sumado a un aumento significativo en los niveles de HDLc, además de un descenso significativo del índice TAG/HDLc en el grupo B. Se encontró una correlación positiva entre los niveles de HbA1c y PEPP, HDLc y el índice TAG/HDLc así como el descenso del uso de antidiabéticos e hipolipemiantes en el grupo B. Conclusiones: la CB logró similares resultados antropométricos en el grupo de pacientes ≥ de 65 años presentando una mejoría significativa en los paramétricos metabólicos a los 3 y 6 meses, principalmente en la insulinorresistencia, lo cual apoyaría el beneficio de la CB en este grupo etario.
Aim: We compared the anthropometric and metabolic parameters before and after six months of bariatric surgery (BS) between a group of patients aged ≥65 and <65 years old (y/o) with or without comorbidities. Materials and Methods: We did a prospective study with patients who had undergone BS and followed them for six months from July, 2015 to May, 2018 at Milstein hospital, Argentina and divided them into two cohorts: older and younger than 65 y/o. Outcomes were compared (lost weight [LW], excess weight loss percentage [EWLP], BMI, A1c hemoglobin [HbA1c], HDL, Triglycerides [Tg] and Tg/HDL ratio) and we considered a p <0.05 as statistically significant. Results: We included 36 patients, 15 were ≥65 y/o and 21 <65 y/o. There were more patients with type 2 diabetes mellitus (DM2) in the oldest group. We found no statistical difference between groups in WL and the EWLP but observed a statistical rise in the levels of HDL (43, RIQ 95% CI: 39-48 vs. 51, RIQ 95% CI: 44-55, p=0.026) and the decrease of the Tg/HDL ratio (1.6 RIQ 95% CI: 1.4-2.1 vs. 3.1 RIQ 95% CI: 2.2-4.6, p=0.02) in the group of ≥65 y/o. The HbA1c levels were significantly higher in the > 65 y/o with DM2 and the decrease was statistically greater after the follow-up. When we compared initial treatment for DM2 after 3 and 6 months of BS, there was a statistically significant decrease in the use of oral antidiabetic drugs and insulin (chi2= 19%, p=0.004 at 3 months, chi2: 27%, p<0.001 at 6 months after surgery). If we analyzed this result by age, there was no difference between both cohorts (chi2=3.73, p=0.15 and chi2=1.46, p=0.4 at 3 and 6 months after surgery respectively). Conclusion: We found a significant benefit in metabolic effects of BS in the ≥65 y/o cohort, especially by decreasing insulin resistance, even in those patients without diagnosis of DM2. We need more studies and a greater sample size to generalize these results. Disclosure C. Musso: None. F.A. Di Fermo Gomez: None. J. Rosenfarb: None. L. Bosio: None. J. Santamaria: None. M. Hansen: None. C. Gimenez: None. A.G. Errasti: None. D. Caruso: Other Relationship; Self; Novartis Pharmaceuticals Corporation. M.C. Faingold: None.
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