Additional metabolic effects of bariatric surgery in patients with a poor mid-term weight loss response: a 5-year follow-up study

Benaiges Foix, David; Bisbe Maria; Pedro-Botet, Juan Carlos; Vargas-Machuca, Aleix de; Ramón Moros, José Manuel; Pera Roman, Manuel Ramón; Villatoro Moreno, Montserrat; Fontane Francia, Laia; Julià, Helena; Climent Biescas, Elisenda; Castañer, Olga; Flores-Le-Roux, Juana Antonia; Goday Arno, Alberto

doi:http://dx.doi.org/10.3390/jcm9103193

Additional metabolic effects of bariatric surgery in patients with a poor mid-term weight loss response: a 5-year follow-up study

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Citació

Benaiges D, Bisbe M, Pedro-Botet J, de Vargas-Machuca A, Ramon JM, Pera M, et al. Additional metabolic effects of bariatric surgery in patients with a poor mid-term weight loss response: a 5-year follow-up study. J Clin Med. 2020 Oct 1; 9(10): 3193. DOI: 10.3390/jcm9103193

Resum

To ascertain the 5-year metabolic effects of bariatric surgery in poor weight loss (WL) responders and establish associated factors. Methods: Retrospective analysis of a non-randomised prospective cohort of bariatric surgery patients completing a 5-year follow-up. Mid-term poor WL was considered when 5-year excess weight loss was <50%. Results: Forty-three (20.3%) of the 212 included patients were mid-term poor WL responders. They showed an improvement in all metabolic markers at 2 years, except for total cholesterol. This improvement with respect to baseline was maintained at 5 years for plasma glucose, HbA1c, HOMA, HDL and diastolic blood pressure; however, LDL cholesterol, triglycerides and systolic blood pressure were similar to presurgical values. Comorbidity remission rates were comparable to those obtained in the good WL group except for hypercholesterolaemia (45.8% vs. poor WL, p = 0.005). On multivariate analysis, lower baseline HDL cholesterol levels, advanced age and lower preoperative weight loss were independently associated with poor mid-term WL. Conclusions: Although that 1 in 5 patients presented suboptimal WL 5 years after bariatric surgery, other important metabolic benefits were maintained.