TY - JOUR
T1 - Is bariatric surgery effective for co-morbidity resolution in the super-obese patients?
AU - Hariri, Kamyar
AU - Guevara, Daniela
AU - Dong, Matthew
AU - Kini, Subhash U.
AU - Herron, Daniel M.
AU - Fernandez-Ranvier, Gustavo
N1 - Publisher Copyright:
© 2018 American Society for Bariatric Surgery
PY - 2018/9
Y1 - 2018/9
N2 - Background: Type 2 diabetes (T2D), obstructive sleep apnea (OSA), hypertension (HTN), and hyperlipidemia (HLD) are common co-morbidities that are strongly associated with obesity. Objective: The purpose of this study was to compare the rate of obesity-related co-morbidity remission and percent total body weight loss of super-obese patients with a body mass index (BMI) ≥50 kg/m2 with bariatric patients who have a BMI of 30 to 49.9 kg/m2. Setting: Academic hospital, United States. Methods: A retrospective analysis of outcomes of a prospectively maintained database was done on obese patients with a diagnosis of ≥1 co-morbidity (T2D, OSA, HTN, or HLD) who at the time of initial visit had undergone either a sleeve gastrectomy or a Roux-en-Y gastric bypass at our hospital between 2011 and 2015. The patients were stratified based on their preoperative BMI class, BMI of 30 to 49.9 kg/m2 versus BMI ≥50 kg/m2. Results: Of the 930 patients, 732 underwent sleeve gastrectomy and 198 underwent Roux-en-Y gastric bypass. The 6-month follow-up co-morbidity remission rates for patients with a BMI of 30 to 49.9 kg/m2 (n = 759) versus super-obese patients (n = 171) were 46.0% and 36.7% (P =.348) for T2D; 75.0% and 73.2% (P =.772) for OSA; 35.0% and 22.0% (P =.142) for HTN; and 37.0% and 21.0% (P =.081) for HLD, respectively. The 1-year follow-up co-morbidity remission rates for patients with a BMI of 30 to 49.9 kg/m2 versus super-obese patients were 54.2% and 45.5% (P =.460) for T2D; 87.0% and 89.7% (P =.649) for OSA; 37.4% and 23.9% (P =.081) for HTN; and 43.2% and 34.6% (P =.422) for HLD, respectively. Furthermore, there was no difference in the mean percent total weight loss for patients with a preoperative BMI of 30 to 49.9 kg/m2 versus the super-obese at the 6-month (21.4%, 20.9%, P =.612) and 1-year (28.0%, 30.7%, P =.107) follow-ups. Conclusion: In our study, preoperative BMI did not have an impact on postoperative co-morbidity remission rates or percent total body weight loss. Future studies should investigate the effect of other factors, such as disease severity and duration.
AB - Background: Type 2 diabetes (T2D), obstructive sleep apnea (OSA), hypertension (HTN), and hyperlipidemia (HLD) are common co-morbidities that are strongly associated with obesity. Objective: The purpose of this study was to compare the rate of obesity-related co-morbidity remission and percent total body weight loss of super-obese patients with a body mass index (BMI) ≥50 kg/m2 with bariatric patients who have a BMI of 30 to 49.9 kg/m2. Setting: Academic hospital, United States. Methods: A retrospective analysis of outcomes of a prospectively maintained database was done on obese patients with a diagnosis of ≥1 co-morbidity (T2D, OSA, HTN, or HLD) who at the time of initial visit had undergone either a sleeve gastrectomy or a Roux-en-Y gastric bypass at our hospital between 2011 and 2015. The patients were stratified based on their preoperative BMI class, BMI of 30 to 49.9 kg/m2 versus BMI ≥50 kg/m2. Results: Of the 930 patients, 732 underwent sleeve gastrectomy and 198 underwent Roux-en-Y gastric bypass. The 6-month follow-up co-morbidity remission rates for patients with a BMI of 30 to 49.9 kg/m2 (n = 759) versus super-obese patients (n = 171) were 46.0% and 36.7% (P =.348) for T2D; 75.0% and 73.2% (P =.772) for OSA; 35.0% and 22.0% (P =.142) for HTN; and 37.0% and 21.0% (P =.081) for HLD, respectively. The 1-year follow-up co-morbidity remission rates for patients with a BMI of 30 to 49.9 kg/m2 versus super-obese patients were 54.2% and 45.5% (P =.460) for T2D; 87.0% and 89.7% (P =.649) for OSA; 37.4% and 23.9% (P =.081) for HTN; and 43.2% and 34.6% (P =.422) for HLD, respectively. Furthermore, there was no difference in the mean percent total weight loss for patients with a preoperative BMI of 30 to 49.9 kg/m2 versus the super-obese at the 6-month (21.4%, 20.9%, P =.612) and 1-year (28.0%, 30.7%, P =.107) follow-ups. Conclusion: In our study, preoperative BMI did not have an impact on postoperative co-morbidity remission rates or percent total body weight loss. Future studies should investigate the effect of other factors, such as disease severity and duration.
KW - Bariatric surgery
KW - Co-morbidities
KW - Diabetes
KW - Hyperlipidemia
KW - Hypertension
KW - Obstructive sleep apnea
KW - Percent total weight loss
KW - Super-obese
UR - http://www.scopus.com/inward/record.url?scp=85049535279&partnerID=8YFLogxK
U2 - 10.1016/j.soard.2018.05.015
DO - 10.1016/j.soard.2018.05.015
M3 - Article
C2 - 30001889
AN - SCOPUS:85049535279
SN - 1550-7289
VL - 14
SP - 1261
EP - 1268
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 9
ER -