Endocrine Abstracts

Introduction

Obesity is a chronic disease that is associated with several comorbidities, decreased quality of life, and increased mortality rate. Bariatric surgery is the most effective therapy for obese patients with class III and class II with metabolic diseases. Its effectiveness is not only related to the weight reduction, but also to the improvement of the metabolic profile. The aim of this study is to characterize the effects of gastroplasty with Roux-en-Y (gastric bypass – BG) and vertical gastrectomy (gastric sleeve – SG) in reducing obesity and associated comorbidities.

Methods

Prospective study of patients with class III and class II obesity with metabolic diseases who underwent BG or SG between May 2017 and May 2020. Clinical observation at 0, 6, 12, 18 and 24 months.

Results

43 patients, 53.5% male, mean age 49+9 years, mean BMI 41.9+2.9 kg/m², 67.4% submitted to BG and 32.6% to SG. The average excess weight lost percentage was 74.3+16.3% at 6 months (n = 43), 84.3+20.9% at 12 months (n = 39), 79.3+22% at 18 months (n = 28) and 73.3+24% at 24 months (n = 22). No difference between patients undergoing BG or SG (P-value = 0.2) or between men and women (P-value = 0.114) was observed. Mean abdominal circumference reduction was 20.6+5.5% at 24 months and body fat mass percentage reduction was 27.7+17.2%, with no difference between procedures (P-value = 1 and 0.114). 53.5% of patients had Diabetes mellitus or pre-diabetes, 60.8% achieved total remission at 24 months after surgery and 21.7% partial remission (pre-diabetes). 58% had arterial hypertension, 52% achieved remission and 40% reduced the number of antihypertensive drugs. 86% had altered lipid metabolism, 46% achieved remission and 5% reduced the number of drugs. 60% of patients suffered from obstructive sleep apnea syndrome, with remission achieved in 46% of patients and a 54% reduction in severity. 85.7% of the patients had steatosis on preoperative abdominal ultrasound, with 60% having hepatomegaly. In the reevaluation at 12 months, 53.2% maintained steatosis and 7.6% hepatomegaly.

Conclusion

Bariatric surgery is a treatment option that provides excellent results in reducing weight, abdominal circumference and percentage of fat mass. The underlying modification of the metabolism allows the correction of comorbidities associated with obesity, with remission in a large number of patients.