Endocrine Abstracts

The prevalence of obesity has greatly increased worldwide in the last decades, particularly in Europe and Portugal. It is associated with many health problems, including cardiovascular diseases, cancer and diabetes.

Methods: Revision of the clinical records of all 61 patients who underwent bariatric surgery between 2013 and 2015. Analysis of their metabolic profile prior to surgery and its evolution after the operation.

Results: 61 patients were reviewed, namely 90.2% females and 9.8% males. The mean age was 43.6 years. All patients had class II or III obesity according to their BMI, with an average score of 46.4 kg/m². The associated cardiovascular risk factors include: hypertension (47.5%), total cholesterol >200 mg/dl (35.8%) and type 2 diabetes mellitus (10.6%). 60% had an apnea–hypopnea index great than 5/h. Most patients underwent gastric sleeve surgery (93.4%) and only 6.6% received a bypass surgery. Six patients were treated with an endoscopic intragastric balloon prior to surgery. Weight was evaluated at 3 months’ intervals in the first 1.5 years, and then every 6 months. 13.6 months was the mean follow-up time after the procedure. The average weight loss prior to surgery was 9.6% of the initial body weight. After the operation, weight loss was more pronounced between the first and third months (7.4% of the initial body weight). The trend of weight loss remained until 9 months, stabilizing afterwards. The mean BMI reduction was 27.1% at the end of the follow-up time. Both HbA1c and triglycerides were reduced by 11% and 15%, respectively, after surgery. HDL increased by 16%.

Conclusions: The majority of patients eligible for bariatric surgery were young females with class II or III obesity. Many had other cardiovascular risk factors, particularly hypertension and dyslipidemia. Gastric sleeve was the preferred technical procedure and only a few patients received an endoscopic intragastric balloon to aid weight loss prior to surgery. Weight loss was more pronounced in the first 3 months after surgery, but that tendency was mitigated after only 9 months. Nevertheless, body mass index was reduced by a quarter at the end of follow-up. These results show the importance of the multidisciplinary approach to obesity and the potential benefits with bariatric surgery. However, we emphasize the short follow-up time and the need to maintain evaluation of these patients in the future.