Endocrine Abstracts

Aim: Malabsorptive bariatric procedures lead to significant metabolic improvement with ongoing weight loss. The aim of our retrospective analysis was to assess the impact of bariatric surgery on three important metabolic and biochemical abnormalities associated with obesity: diabetes, liver function test (LFT), and dyslipidaemia.

Methods: All patients who had laparoscopic gastric bypass (LGB) or sleeve gastrectomy (SG) over the last 7 years were identified. Patients who did not have sufficient data or 12 months of follow-up post-operatively were excluded (n=67). Data on HbA1c, LFT, and lipids were obtained.

Results: Of the 204 patients identified (169 LGB, and 36 SG) baseline parameters were: age 45 (20–70) years; 28% males; BMI 49.7 (36.9–80.0); excess body weight (EBW) 65.8 (31.5–153.6) kg. The mean duration for follow-up was 526 days. Mean weight loss 45.6(4–104) kg. EBW loss achieved 70.5% (9–145%).

Diabetes: 60 patients had diabetes before the surgery (Five diet treated, and 22 insulin treated). 80% of these patients had improvement in diabetes with 45% having complete resolution of diabetes (all with LGB). 19 of the 22 insulin-treated patients came off insulin. Mean number of medication improved from 1.9 (1–5) pre-operative to 0.7 (0–4) at follow-up (P<0.05).

Cholesterol: Data available on 146 patients: 25% of the statin-treated patients were weaned off the treatment after surgery. Of the drug naïve patient (n=126), 84 had reduction in total cholesterol (mean 1.0 mmol/l, range 0.1–3.9).

LFT: 46 patients had abnormal LFT (based on ALT), of whom 80% (n=37) normalised post-surgery.

Conclusion: Bariatric surgery, especially gastric bypass procedures, offers a significant treatment option to achieve clinical remission with various metabolic disorders, which has tremendous implication on morbidity rates and long term costs to healthcare economy.