Endocrine Abstracts

Background and aims: Obesity is a global problem. Laparoscopic sleeve gastrectomy (LSG) was introduced in our hospital since 2008. This study aimed at reviewing the metabolic changes after LSG among Hong Kong Chinese in a regional hospital.

Materials and methods: 47 patients who received LSG in our hospital from June 2008 to October 2012 were retrospectively reviewed. Change in body weight (BW) and glycaemic control up to 5 years were evaluated. Rate of remission of diabetes at 1 year after operation was also reviewed. Statistical method used include Wilcoxon’s signed rank test for paired-related groups and Mann–Whitney U test for paired non-related groups.

Results: The mean age was 43.7 (19–63) years. The mean baseline BW and BMI were 105.7±3.5 and 39.7±4.6 kg/m² respectively. The maximum weight loss was achieved at post-operative 1 year, i.e. 25.1±1.7 kg (23.7±1.49%) (P=0.00). Significant % weight loss was still maintained at post-operative 5 years i.e. 21.9±1.39% (P=0.011, n=9). For diabetic patients, the improvement in diabetic control was already shown before maximum weight loss. The greatest improvement in fasting blood glucose (FBG) was seen at 1 month dropping from 7.8±0.6 to 6.2±0.5 mmol/l (P=0.00). The HbA1c reduced from baseline of 7.9±0.4 to 6.7±0.3% at 3 months (P<0.05). At 1 year after operation, patients achieving remission of diabetes showed statistically significant greater % weight loss (24.9±1.3% vs 17.6±3.6%), lower baseline FBG (6.1±0.2 mmol/l vs 10.2±1.0 mmol/l) and shorter duration of diabetes (2.7 years vs 9.6 years) All diabetic patients who were on diet control before operation achieved remission while the rate for those on oral anti-diabetic drugs and insulin were 58.3 and 27.2% respectively. Remission of diabetes was defined as FBG <7 mmol/l and HbA1c <6.5% without medication.

Conclusion: LSG showed sustainable weight loss 5 years after operation. Characteristics of patients achieving remission of diabetes were evaluated which helped to predict outcome.