Long-Term Improvement of Glucose Homeostasis and Body Composition in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Abstract

Context. Laparoscopic sleeve gastrectomy (SG) has gained popularity as a metabolic procedure, but its longterm effectiveness for Romanian patients remains unclear. Objectives. To assess the long-term efficacy of SG for Romanian patients and to evaluate the differences between 5 years and 1 year follow-up. Design. A longitudinal, prospective analysis of collected data from 68 patients undergoing SG between 2009 and 2014 was performed. Long-term outcomes at 5 years were analyzed in terms of total weight loss (%TWL), excess weight loss (%EWL), body composition and glucose homeostasis. Subjects and Methods. All patients meeting the standard criteria for SG before inclusion were prospectively enrolled in the study. Of the 68 patients, eight were lost to follow-up, therefore, 60 patients (41.7±12.5 years, baseline body mass index [BMI] 44.6±9.9Kg/m 2) were analyzed. Results. The BMI decreased at 12 months with 30.7% from the preoperative BMI (p<0.001) and subsequently stabilized at 5 years. TWL and EWL were 30.6% and 83.1%, respectively at 1 year, with a slightly increase at 5 years. Therapeutic success rate (%EWL≥50) and diabetes remission rate (Buchwald criteria) were 93.3% and respectively 63.6% at 5 years. Insulin sensitivity index and metabolic clearance rate of glucose increased with 92.5% and 60.1% respectively, in the third month from baseline (p<0.001), while estimated second phase of insulin secretion decreased with 7.9% in the first month postoperatively (p=0.04), remaining stable afterwards. Conclusions. SG was effective in terms of %EWL, body composition and glucose homeostasis improvement for Romanian patients, the outcomes stabilizing after 1 year follow-up.

Risedronate use may blunt appendicular lean mass loss secondary to sleeve gastrectomy: results from a pilot randomized controlled trial

“…This pilot RCT represents a novel analysis of the impacts of oral risedronate following SG on body composition measures. Our analysis is strengthened by the use of DXA and CT for body composition quantification, whereas a majority of body composition literature following SG relies on bioimpedance analysis 9,29,33 . One author (LEF) performed all CT segmentations, thus eliminating inter‐user variability.…”

“…Our analysis is strengthened by the use of DXA and CT for body composition quantification, whereas a majority of body composition literature following SG relies on bioimpedance analysis. 9,29,33 One author (LEF) performed all CT segmentations, thus eliminating inter-user variability. Although we had a high retention rate at the 6-month timepoint (n = 21/ 24), we were limited by the small sample size and differential group dropout, particularly at the 12-month exploratory timepoint.…”

Long-term improvement of dyslipidaemia, hyperuricemia and metabolic syndrome in patients undergoing laparoscopic sleeve gastrectomy

“…The high prevalence of obesity causes an increase in the incidence of metabolic syndrome, with an increased risk of type 2 diabetes and cardiovascular disease. Dyslipidaemia is a common feature in obese patients and a major risk factor for the development of atherosclerosis and heartrelated diseases (1)(2)(3)(4)(5).…”