Excess body mass index loss predicts metabolic syndrome remission after gastric bypass

Abstract

BackgroundMetabolic syndrome (MS) is a condition associated with obesity that identifies individuals with increased cardiovascular risk. Gastric bypass improves several MS components, such as glucose, lipid metabolism and hypertension. The aim of this study was to evaluate the effect of long-limb gastric bypass on the remission of MS criteria associated with morbid obesity.MethodsObese patients who met the “harmonized” criteria for MS (n = 153) that underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) with a long biliopancreatic limb were prospectively evaluated with regards to body weight, body mass index (BMI), percentage of excess BMI lost (% EBMIL), fasting glucose, blood pressure and lipid profile up to 36 months after surgery.ResultsBefore surgery, patients had a BMI of 44.3 ± 0.5 kg/m2; 66% were under anti-diabetic treatment; 78.4% were under anti-hypertensive treatment and 44.3% were under anti-dyslipidemic treatment. After a mean follow-up time of 2.4 ± 0.1 years, MS remission rates were 32.7% at 6 months, 69.7% at 12 months, 63.4% at 24 months, and 59.2% at 36 months; when only 32.9%, 43.4% and 15.8% of patients were still under anti-diabetic, anti-hypertensive and anti-dyslipidemic treatment, respectively. The %EBMIL and BMI were the parameters that showed the highest accuracy to predict the MS remission at all-time points after the surgery.ConclusionsLong limb gastric bypass in obese patients results in significant and sustained weight loss which predicts a high remission rate of MS and allows the discontinuation of drug therapy for several metabolic disturbances in most patients.

Time trends in adult chronic disease inequalities by education in Brazil: 1998–2013

“…Diabetes, on the other hand, tends to be underreported which suggests that our results provide a lower bound of the diabetes burden in Brazil. For instance, data from the Brazilian Longitudinal Study of Adult Health, a cohort study of adult civil servants aged 35–74 years found that 50.4 % of the individuals with diabetes were undiagnosed [15]. In addition, accuracy of self-reports may also vary depending on socioeconomic characteristics, such as educational level and access to health insurance.…”

“…Importantly in Brazil, as in most countries, socioeconomic differences in health are largely driven by differences in educational attainment [10] whereby those with low levels of education tend to be in vulnerable positions leading to worse health outcomes relative to those with high education (this is commonly referred to as educational gradients in health). For instance, most studies in Brazil have found higher prevalence of diabetes among adults with lower education than among those with higher educational levels [11–15]. Goldenberg and colleagues found that whereas women that are more educated had lower prevalence of diabetes, the reverse was found among men in Sao Paulo [16].…”

Uncontrolled Hypertension and Its Determinants in Patients with Concomitant Type 2 Diabetes Mellitus (T2DM) in Rural South Africa

“…Globally, hypertension is the leading cause of cardiovascular diseases (CVD) and deaths [ 1 ], and accounts for about 7.5 million deaths per year [ 2 ]. Hypertension tends to occur in clusters with other cardiovascular diseases such as type 2 diabetes (T2DM) and dyslipidaemia.…”

Stricture Rate after Laparoscopic Roux-en-Y Gastric Bypass with a 21-mm Circular Stapler versus a 25-mm Linear Stapler

“…In fact, in the United States, the prevalence of this syndrome in the 40-59 year age group is 40% and 34% in men and women, respectively. 15 Osteoarthritis secondary to morbid obesity is also a well-described and expected finding.…”