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.
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.
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/m2; 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).
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.
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Published online: October 08, 2010
Accepted: August 24, 2010
A.I. and R.A. contributed equally to this manuscript.
Supported by grants from the Institut National de la Santé et de la Recherche Médicale (France); the University of Nice, the Programme Hospitalier de Recherche Clinique (CHU of Nice), and charities (AFEF/Schering-Plough/ROCHE and SNFGE to AT).
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.