Pauline Faucher1, Judith Aron-Wisnewsky1,2, Cécile Ciangura1, Laurent Genser2,3, Adriana Torcivia3, Jean-Luc Bouillot4, Christine Poitou1,2, Jean-Michel Oppert5. 1. Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France. 2. NutriOmics team, INSERM UMRS U1166, Sorbonne Universités, Paris, France. 3. Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Hepato-Biliary and Pancreatic Surgery, Sorbonne University, Paris, France. 4. Assistance Publique-Hôpitaux de Paris (AP-HP), Department of General, Digestive and Metabolic Surgery, Ambroise Paré Hospital, Versailles-Saint-Quentin-en-Yvelines University, Boulogne-Billancourt, France. 5. Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Nutrition Department, Sorbonne University, Institute of Cardiometabolism and Nutrition (ICAN), 47-83 boulevard de l'Hôpital, 75013, Paris, France. jean-michel.oppert@aphp.fr.
Abstract
BACKGROUND: To provide greater insight into bariatric surgery outcomes in aging patients, we compared changes in body weight, body composition, obesity-related comorbidities, and nutritional status between older and younger subjects. METHODS: We analyzed data collected between January 2004 and December 2014 from our prospective bariatric cohort. Older patients (OP, ≥ 60 years at the time of surgery, n = 93; 66% Roux-en-Y gastric bypass, 34% sleeve gastrectomy) were compared with younger patients (YP, < 60 years, n = 186), matched 1:2 on sex, body mass index, diabetes, and surgical procedure. Body composition was assessed by dual-energy X-ray absorptiometry. RESULTS: Weight loss and excess weight loss at 12 months were lower in OP vs. YP (mean ± SD, 30.1 ± 10.1 vs. 34.1 ± 11.9 kg, 60.6 ± 21.2 vs. 66.8 ± 23.4%, respectively, p < 0.05 for both). Both lean body mass and fat mass loss were lower in OP vs. YP (8.4 ± 3.4 vs. 9.2 ± 9.0 kg, 19.4 ± 8.7 vs. 21.9 ± 9.1 kg, respectively, p < 0.05). The remission rate for type 2 diabetes was significantly lower in OP vs. YP (24 vs. 45%), as well as improvement in hypertension (14 vs. 46%), dyslipidemia (27 vs. 47%), and knee pain. There was no difference in micronutrient deficiencies between groups. CONCLUSIONS: These data indicate that although bariatric surgery is not as effective for weight loss in older as in younger subjects, it is a safe option regarding a comprehensive set of nutritional variables which enables significant improvement in obesity-related outcomes.
BACKGROUND: To provide greater insight into bariatric surgery outcomes in aging patients, we compared changes in body weight, body composition, obesity-related comorbidities, and nutritional status between older and younger subjects. METHODS: We analyzed data collected between January 2004 and December 2014 from our prospective bariatric cohort. Older patients (OP, ≥ 60 years at the time of surgery, n = 93; 66% Roux-en-Y gastric bypass, 34% sleeve gastrectomy) were compared with younger patients (YP, < 60 years, n = 186), matched 1:2 on sex, body mass index, diabetes, and surgical procedure. Body composition was assessed by dual-energy X-ray absorptiometry. RESULTS:Weight loss and excess weight loss at 12 months were lower in OP vs. YP (mean ± SD, 30.1 ± 10.1 vs. 34.1 ± 11.9 kg, 60.6 ± 21.2 vs. 66.8 ± 23.4%, respectively, p < 0.05 for both). Both lean body mass and fat mass loss were lower in OP vs. YP (8.4 ± 3.4 vs. 9.2 ± 9.0 kg, 19.4 ± 8.7 vs. 21.9 ± 9.1 kg, respectively, p < 0.05). The remission rate for type 2 diabetes was significantly lower in OP vs. YP (24 vs. 45%), as well as improvement in hypertension (14 vs. 46%), dyslipidemia (27 vs. 47%), and knee pain. There was no difference in micronutrient deficiencies between groups. CONCLUSIONS: These data indicate that although bariatric surgery is not as effective for weight loss in older as in younger subjects, it is a safe option regarding a comprehensive set of nutritional variables which enables significant improvement in obesity-related outcomes.
Entities:
Keywords:
Bariatric surgery; Body composition; Comorbidities; Elderly; Obesity
Authors: M Fried; V Hainer; A Basdevant; H Buchwald; M Deitel; N Finer; J W M Greve; F Horber; E Mathus-Vliegen; N Scopinaro; R Steffen; C Tsigos; R Weiner; K Widhalm Journal: Int J Obes (Lond) Date: 2007-02-27 Impact factor: 5.095
Authors: Stephanie E Dunkle-Blatter; Michael R St Jean; Carly Whitehead; William Strodel; Peter N Bennotti; Christopher Still; Mary Jane Reed; Craig G Wood; Anthony T Petrick Journal: Surg Obes Relat Dis Date: 2007-02-27 Impact factor: 4.734
Authors: Christopher D Still; G Craig Wood; Peter Benotti; Anthony T Petrick; Jon Gabrielsen; William E Strodel; Anna Ibele; Jamie Seiler; Brian A Irving; Melisa P Celaya; Robin Blackstone; Glenn S Gerhard; George Argyropoulos Journal: Lancet Diabetes Endocrinol Date: 2014-01 Impact factor: 32.069
Authors: C Lloret-Linares; P Faucher; M Coupaye; R Alili; A Green; A Basdevant; K Clément; C Poitou Journal: Int J Obes (Lond) Date: 2013-01-15 Impact factor: 5.095
Authors: Ana B Emiliano; Natalie R Lopatinsky; Marko Kraljević; Sei Higuchi; Ying He; Rebecca A Haeusler; Gary J Schwartz Journal: Am J Physiol Endocrinol Metab Date: 2022-06-06 Impact factor: 5.900
Authors: Malou A H Nuijten; Thijs M H Eijsvogels; Valerie M Monpellier; Ignace M C Janssen; Eric J Hazebroek; Maria T E Hopman Journal: Obes Rev Date: 2021-10-19 Impact factor: 10.867
Authors: Malou A H Nuijten; Valerie M Monpellier; Thijs M H Eijsvogels; Ignace M C Janssen; Eric J Hazebroek; Maria T E Hopman Journal: Obes Surg Date: 2020-08 Impact factor: 4.129