Age impact on weight loss and glycolipid profile after laparoscopic sleeve gastrectomy: experience with 308 consecutive patients

Abstract

The aim of this study was to evaluate the impact of age on weight loss and on related glycolipid profile changes at 2-year follow-up after laparoscopic sleeve gastrectomy (LSG). From 2005 to 2010, a total of 308 consecutive patients undergoing LSG were enrolled. Mean age was 39.7 ± 10.7 years, mean weight was 127.9 ± 24.5 kg, and mean body mass index (BMI) was 45.9 ± 6.8 kg/m(2). Patients were divided into three age groups: young (18-29 years, n = 64), intermediate (30-49 years, n = 183), and senior (50-68 years, n = 61). BMI, excess weight loss (%EWL), and several biochemical examinations for the evaluation of glycolipid profile transition, including homeostasis model assessment for insulin resistance (HOMA-IR), were assessed at 6, 12, and 24 months (M6, M12, and M24) after LSG. All three groups had a significant BMI reduction and %EWL at 2 years' follow-up. The young group obtained significantly better %EWL at M6, M12, and M24 (62.6 ± 14.4, 73.4 ± 17.1, and 72.5 ± 18.9 %) compared to intermediate (53.2 ± 18.0, 64.8 ± 19.9, and 66.8 ± 23.0 %) and senior group (48.0 ± 15.5, 54.6 ± 15.3, and 54.4 ± 15.4 %). Fasting serum glucose levels improved significantly in all three groups at all follow-up assessment points (M6, M12, and M24). A significant improvement in HbA1c was also observed in the three groups at M6 and M12, while at M24 only patients in the young and intermediate groups still presented a significantly improved glycemic control. A significantly lower HOMA-IR improvement was observed at M6 in the senior group (2.83 ± 1.86) compared to both young (1.30 ± 0.54) and intermediate (1.43 ± 0.82) groups of patients. Total and low-density lipoprotein cholesterol level was significantly improved only in the young group. An age-dependent trend toward better %EWL and glycolipid profile improvement was observed in young patients after LSG.