Metabolic changes after bariatric surgical procedures

Abstract

Introduction: Obesity is associated with diabetes, dyslipidemia and increased cardiovascular disease risks. Bariatric surgeries are one of the most reliable ways to treat obesity. Bariatric Surgical procedures started in Basra at 2009 and since then, thousands of surgeries had been made, mainly in Al-Sadr Teaching Hospital. Objective: To prospectively evaluate the short term effect of bariatric surgical procedures on body mass index (BMI), lipid profile and glycosylated hemoglobin (HbA1C) and compare the effects of various types of these surgical procedures. Methods: A 12-month prospective study on 73 patients who underwent three types of bariatric surgeries, laparoscopic sleeve gastrectomy surgery (LSG), laparoscopic REUX-EN-Y gastric bypass surgery (LRYGB) and minigastric bypass surgery (MGB). Body mass index (BMI), HbA1C, total cholesterol (TC), High-Density-Lipoprotein cholesterol (HDL), Low-Density-Lipoprotein cholesterol (LDL) and triglycerides (TG) levels were evaluated before surgery and at 3 and 6 months postoperatively. Results: All bariatric procedures show significant improvement in all parameters (increment in HDL, reduction in BMI, A1C, HDL, LDL, TC, TG) at 3 months that continue to improve more at 6 months postoperatively (p<0.001), however, bypass surgeries (LRYGB and MGB) has additional favorable independent effect on A1C and LDL seen at 6 months post operatively. Conclusion: All of the studied bariatric surgeries improve BMI, HbA1C and lipid profile significantly, however, bypass procedures have more effect on LDL and HbA1C that seem to be procedure related and independent from weight loss or other changes.