September 18, 2012

Gastric bypass reduced cardiovascular, metabolic risks in severely obese

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Severely obese patients who underwent gastric bypass surgery had greater diabetes remission rates and were less likely to experience cardiovascular events than controls in a recent study.

In a prospective study, researchers evaluated 1,156 patients with a BMI of 35 or more who underwent Roux-en-Y gastric bypass surgery (n=418) (RYGB), sought weight loss surgery but did not undergo it (n=417, control group 1) or did not seek surgery (n=321, control group 2) between July 2000 and June 2011 in Utah.

Among evaluable participants, those who underwent bypass lost 27.7% of their initial weight, compared with 0.2% of control group 1 and 0% of control group 2. More than 20% of lost weight was maintained by the RYGB group in 94% of cases after 2 years and in 76% after 6 years.

Incidence rates for diabetes were lower in the RYGB group (2% compared with 17% in control group 1, OR=0.11, 0.04-0.34, and 15% in control group 2, OR=0.21, 0.06-0.67). Remission rates for diabetes after 6 years also were significantly greater in the bypass group (62% compared with 8% in control group 1, OR=16.5, 4.7-57.6, and 6% in control group 2, OR=21.5, 5.4-85.6) (95% CI for all).

Hypertension remission rates also improved for RYGB patients compared with control groups (42% vs. 18% in control group 1, OR=2.9, 1.4-6.0 and with 9% in control group 2, OR=5.0, 2.1-11.9). Remission rates for low high-density lipoprotein cholesterol levels saw gains in more bypass patients (67% of patients compared with 34% in control group 1, OR=3.8, 2.0-7.2 and with 18% in control group 2, OR=6.2, 2.7-14.1) (95% CI for all).

“Our study reports significant weight loss and 6-year improvements in major cardiovascular and metabolic risk factors in patients receiving RYGB surgery compared with severely obese control participants,” the researchers wrote. “In contrast, cardiovascular and metabolic status of several obese control participants generally worsened. These findings are important considering the rapid increase in total numbers of bariatric surgical operations performed in the United States and worldwide, and may have significant ramifications for the projected 31 million US individuals meeting criteria for bariatric surgery.”

Disclosure: See the study for a full list of relevant disclosures.