Endocrine Abstracts

Background: Bariatric surgery has shown to effectively reduce body weight and the prevalence of obesity associated comorbidities. However, especially data concerning diabetes is still conflicting. Also the benefit of surgical therapy varies strongly depending on individual patient characteristics.

Methods: Therefore we intended to investigate a heterogeneous group of obese patients (n=215) undergoing bariatric surgery in terms of related comorbidities and subgroup benefits.

Results: After one year mean reduction of body weight was 45±17 kg (BMI 15.4±5.1 P<0.05). High density cholesterol (HDL) increased on average by 8.0±9.2 mg/dl (P<0.05), low density cholesterol (LDL)-Levels were reduced by 14.5±27.3 mg/dl (P<0.05). The amount of patients who suffered from sleep apnoea reduced from 29.6 to 5.2% (P<0.05) after one and 5.3% after two years, those suffering from arthropathia from 83 to 20.7% (P<0.05) and 11.1% (P<0.05) respectively after one and two years. The prevalence of hypertension declined from 65.3 to 34.7% after 1 year (P< 0.05) and 33, 3% after two years. If albuminuria was initially above 20 mg, available data demonstrated an average decrease of 126.9±214.3 mg without reaching statistical significance.

Diabetes parameters showed a u-shaped curve with initial amelioration but deterioration of values from visit three on. However 85% of patients taking antidiabetics reduced the amount of oral antidiabetics and 100% the injected amount of insulin.

Subgroup analysis demonstrated a greater overall benefit regarding comorbidities for women or patients below 40 years (except for sleep apnoea). Reduction of HbA1c and loss of insulin was seen to a greater extent in patients with BMI >50 kg/m².

Conclusion: Bariatric surgery is an effective treatment of obesity which leads to a significantly lower BMI and has an immense impact on the improvement of comorbidities. Regarding the effect on diabetes close follow-up should be provided in order to optimise therapy after bariatric surgery.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.