Endocrine Abstracts

Bariatric surgery (BS) improves quality of life and health due to the beneficial effect on the metabolism at multiple levels. Specifically, its effectiveness in weight loss and the attenuation or resolution of comorbidities associated with obesity, means lower morbidity and mortality compared to other types of interventions. The objective is to analyze the evolution of obesity-related diseases after twelve months of follow-up.

Methods: Retrospective study with 31 patients who underwent gastric bypass surgery between May 2017 and January 2019 at the Complejo Hospitalario de Navarra. The statistical analysis was carried out by performing Wilcoxon test and linear regression with SPSS.

Results: Average age of patient is 54 years (s.d. 7.9), 45% (14) of them were men and 55% (17) women. The most frequent comorbidities before BS were: arterial hypertension (68%), obstructive sleep apnea (39%), hypercholesterolemia (32%), diabetes (29%), pre-diabetes (29%), microangiopathy (13%), nonalcoholic fatty liver disease (10%), coronary heart disease (2.5%). Pre-surgical BMI was 43.4 kg/m² (s.d. 4.8), dropping to 30 kg/m² (s.d. 2.8) one year after surgery (P < 0,05). Percentage of fat-free mass at the begining, measured by TANITA was 54% (s.d. 6.7), increasing by 21,7% to 66,1% (s.d. 8.6) at 12 months (P < 0,05). The Percentage of Excess BMI Loss (PEBMIL) was 73.65% (s.d. 14.2). Weight loss and decrease in the percentage of fat mass is the basis of the improvement of cardiovascular risk factors. The reduction in prescription of the number of lipid lowering treatments was not significant. However, the lipid profile was significantly improved (P < 0.05). LDL decreased from 112 mg/dl (s.d. 35) to 96 mg/dl (s.d. 31), HDL from 43 mg/dl (s.d. 10) to 52 mg/dl (s.d. 12), and triglycerides from 154 mg/dl (s.d. 61) to 86 mg/dl (s.d. 39). The percentage of hypertensive patients was reduced by 19%, and the average number of drugs prescribed was also reduced from 2 to 1.8 (P > 0,05). Complete remission rate of diabetes was 77% (7), with an average Hb1Ac of 6% and a mean basal glucose of 97 mg/dl. As side effects, 79% had some nutritional deficit, with vitamin D being the most frequently supplemented.

Conclusions: In the study population, BS reaches the quality indicators and objectives of recommendations. Weight and fat reduction was the basis for improving metabolic comorbidities and cardiovascular risk factors associated with obesity.