Original articleFasting glycemia: A good predictor of weight loss after RYGB☆
Section snippets
Methods
After approval by the institutional ethics review board and written informed consent from all patients participating in the study, a prospective cohort of 163 consecutive patients who had laparoscopic RYGB were recruited at our Medical Center between January 2009 and June 2011. All patients met the inclusion criteria for bariatric surgery (having a BMI>40 kg/m2 or>35 kg/m2 with obesity-associated co-morbidities) and underwent a multidisciplinary preoperative evaluation and the same clinical and
Results
Most patients were female (90.2%) with a mean age of 38 years (19–60 yr) (Table 1). Follow-up was complete for 161 of 163 patients (98.8%), and the mean %EWL and %WL at 12 months was 78.8% and 35.1%, respectively, with 44% of the patients achieving a %EWL≥80 and 46.6% of the patients achieving a %WL≥35.
Perioperative complications occurred in 9 patients (5%): 3 anastomotic hemorrhages, 1 intraabdominal bleeding, 2 deep vein thrombosis, 1 intraabdominal abscess, 1 pulmonary infection, and 1
Discussion
Weight control (as low perioperative morbidity and co-morbid condition resolution) are the key factors to define a successful bariatric operation. Although there is a significant metabolic improvement after a modest weight loss, greater and long-term weight control are required to achieve all of the long-term benefits related with RYGB [17].
For this study, we selected a 1-year follow-up, because it usually represents the time at which the optimal weight loss is observed after bariatric surgery
Conclusion
Higher preoperative FBG was independently related to a poorer weight loss after RYGB. This association might explain why older patients and patients with T2 DM or insulin resistance have been reported to have a poorer weight loss.
Lowering FBG with antidiabetic medications was unrelated to an improvement in surgical outcomes. Our results suggest the need to offer surgical treatment to obese patients with insulin resistance earlier, before severe metabolic illness progresses. The potential for
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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This work was supported by Fundação Ciência e Tecnologia, through Programa Operacional Potencial Humano da EU (POPH); PEst-OE/SAU/UI0038/2011, and by a grant from the Harvard Medical School Portugal Program—HMSP-ICJ/SAU-ICT/0007/2009).