PMID- 25027982
OWN - NLM
STAT- MEDLINE
DCOM- 20151006
LR  - 20221207
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 24
IP  - 11
DP  - 2014 Nov
TI  - Long-term effects of laparoscopic Roux-en-Y gastric bypass on diabetes mellitus, 
      hypertension and dyslipidaemia in morbidly obese patients.
PG  - 1835-42
LID - 10.1007/s11695-014-1310-2 [doi]
AB  - BACKGROUND: Severely obese patients have an increased risk for developing 
      metabolic complications such as type 2 diabetes mellitus (T2DM), dyslipidaemia 
      (DL) and hypertension (HT). The aim of the present study is to research the 
      effect of a primary laparoscopic Roux-en-Y gastric bypass (LRYGB) on T2DM, HT and 
      DL in the long-term. METHODS: Fifty-two out of 89 (58 %) adult severely obese 
      patients with T2DM who had received a LRYGB between January 2000 and December 
      2008 were evaluated. Primary outcome of evaluation was remission of T2DM 
      according to the definition of 2009 consensus statement. Complete remission was 
      defined as achievement fasting plasma glucose (FPG) of <5.6 mmol/l (<100.8 mg/dL) 
      and HbA1c <42 mmol/mol (<6.0 %)) without glucose-lowering medication for at least 
      1 year. Partial remission was defined as a FPG of 5.6-6.9 mmol/l (100.8-124.2 
      mg/dL) and HbA1c 42-48 mmol/mol (6.0-6.5 %), without glucose-lowering medication 
      for at least 1 year. Remission of T2DM was considered if the patient met the 
      criteria for complete or partial remission. Secondary outcomes were remission of 
      HT, DL and changes in medication use. RESULTS: Patients had a mean age of 47.5 +/- 
      9.6 years, body mass index of 46.6 +/- 6.4 kg/m(2) and a mean duration of T2DM of 
      6.1 +/- 5.4 years at the time of surgery. The mean post-operative follow-up period 
      was 6.9 +/- 2.3 years. At the end of the follow-up, mean weight loss was 60 +/- 24 % 
      excess weight loss (EWL) and 26 +/- 10 % total body weight loss (TBWL). Mean HbA1c 
      level had significantly decreased from 64.8 +/- 19.7 mmol/mol to 46.4 +/- 12.9 mmol/l 
      (p < 0.0001). Overall medication use was reduced from 85 % to 37 % of the 
      patients (p < 0.0001), while the number of insulin users was reduced from 40 % to 
      6 % (p < 0.0001). Nineteen percent of the patients had a relapse of T2DM during 
      follow-up. Pre-operative HbA1ac level (odds ratio 0.911, p = 0.020) and duration 
      of T2DM (odds ratio 0.637, p = 0.010) were independent risk factors for failed 
      remission of T2DM. The number of patients with HT was significantly reduced from 
      73 % to 54 % (p = 0.042), and number of patients with DL was non-significantly 
      decreased from 71 % to 54 % (p = 0.068). CONCLUSIONS: The laparoscopic RYGB 
      operation results in a sustained EWL of 60 % (26 % TBWL) with 52 % long-term 
      remission of T2DM. However, 19 % of the patients had a relapse of their T2DM. 
      Furthermore, HT and DL improved markedly.
FAU - Dogan, K
AU  - Dogan K
AD  - Department of Surgery, Rijnstate Hospital, Postal number 1190, P.O. Box 9555, 
      6800 TA, Arnhem, The Netherlands, dogan_kemal@hotmail.com.
FAU - Betzel, B
AU  - Betzel B
FAU - Homan, J
AU  - Homan J
FAU - Aarts, E O
AU  - Aarts EO
FAU - Ploeger, N
AU  - Ploeger N
FAU - de Boer, H
AU  - de Boer H
FAU - Aufenacker, Th J
AU  - Aufenacker TJ
FAU - van Laarhoven, C J H M
AU  - van Laarhoven CJ
FAU - Janssen, I M C
AU  - Janssen IM
FAU - Berends, F J
AU  - Berends FJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adult
MH  - Blood Glucose
MH  - Diabetes Mellitus, Type 2/complications
MH  - Dyslipidemias/complications
MH  - Female
MH  - Gastric Bypass/*methods
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypertension/complications
MH  - Laparoscopy/methods
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/blood/complications/*surgery
MH  - Postoperative Period
MH  - Treatment Outcome
MH  - Weight Loss
EDAT- 2014/07/17 06:00
MHDA- 2015/10/07 06:00
CRDT- 2014/07/17 06:00
PHST- 2014/07/17 06:00 [entrez]
PHST- 2014/07/17 06:00 [pubmed]
PHST- 2015/10/07 06:00 [medline]
AID - 10.1007/s11695-014-1310-2 [doi]
PST - ppublish
SO  - Obes Surg. 2014 Nov;24(11):1835-42. doi: 10.1007/s11695-014-1310-2.