Inflammation, insulin resistance, lipid disturbances, anthropometrics, and metabolic syndrome in morbidly obese patients: a case control study comparing laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy

Surgery. 2011 Mar;149(3):364-70. doi: 10.1016/j.surg.2010.08.013. Epub 2010 Oct 8.

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure that has several advantages over Roux-en-Y gastric bypass, but data on the effectiveness of this procedure on metabolic syndrome have rarely been reported.

Methods: This case control study compared the incidence of low grade systemic inflammation, insulin resistance, anthropometrics, lipid disturbances, and metabolic syndrome in 12 patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGBP) and 10 patients undergoing LSG, matched for age, sex, body mass index (BMI), and HbA1c.

Results: At 6 months after surgery, there was no significant difference in any of the parameters investigated. Metabolic syndrome improved in all five patients undergoing LRYGBP and in 4 out of 6 patients undergoing LSG (ns). At 1 year after surgery, patients in the LRYGBP group had a significantly lower BMI (32.6 ± 5.1 vs 36.5 ± 2.5 kg/m(2); P < .05) and percent of excess BMI lost (70.1 ± 20.5 vs 55.3 ± 12.8; P < .05), and had significantly lower plasma levels of C-reactive protein (2.3 ± 1.5 vs 5.1 ± 4.6 mg/L; P < .05), total cholesterol (4.7 ± 1 vs 5.6 ± 0.3 mmol/L; P < .001) and LDL cholesterol (2.7 ± 0.7 vs 3.7 ± 0.3 mmol/L; P < .001). Remission of metabolic syndrome was significantly less common after LSG at 1 year than LRYGBP (3 vs 0 patients; P < .05).

Conclusion: In this limited study patients undergoing LRYGBP demonstrated significantly lower BMIs, improved lipid profiles, decreased systemic low-grade inflammation and less metabolic syndrome than those with LSG at 1-year follow-up.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Female
  • Gastrectomy / methods*
  • Gastric Bypass / methods*
  • Humans
  • Inflammation / prevention & control*
  • Insulin Resistance*
  • Laparoscopy / methods*
  • Lipids / blood
  • Male
  • Metabolic Syndrome / prevention & control*
  • Middle Aged
  • Obesity, Morbid / metabolism
  • Obesity, Morbid / surgery*
  • Weight Loss

Substances

  • Lipids
  • C-Reactive Protein