R de La Harpe1,2, S Rüeger3,4, Z Kutalik4,5, P Ballabeni4,5,6, M Suter7,8,9, N Vionnet10, B Laferrère11, F Pralong12. 1. Service of Internal Medicine, Morges, Switzerland. roxidelaharpe@hotmail.com. 2. Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland. roxidelaharpe@hotmail.com. 3. School of Life Sciences, EPFL, Lausanne, Switzerland. 4. Swiss Institute of Bioinformatics, Lausanne, Switzerland. 5. Center for Primary Care and Public Health (Unisanté), University of Lausanne (UNIL), Lausanne, Switzerland. 6. Clinical Research Center (CRC), Lausanne University Hospital (CHUV), Lausanne, Switzerland. 7. Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland. 8. Department of Visceral Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland. 9. Department of Surgery, Riviera-Chablais Hospital, Aigle-Monthey, Switzerland. 10. Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital (CHUV), Lausanne, Switzerland. 11. New York Obesity Nutrition Research Center, Divison of Endocrinology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, United States. 12. Center for Endocrinology, Diabetology and Obesity, La Tour Private Hospital, Meyrin, Switzerland.
Abstract
PURPOSE: Roux en Y gastric bypass surgery (RYGB) is an effective therapy for patients with severe obesity. It induces both significant weight loss and rapid improvements of metabolic complications. This study was undertaken to better define the direct role of weight loss in the metabolic improvements. METHODS: A retrospective, case-control study of a cohort of 649 patients with obesity who underwent RYGB, comparing higher and lower responders at 2 years after surgery (n = 100 pairs). Pairs of patients were matched for age, gender, and initial BMI. The rates of remission of diabetes, hypertension, dyslipidemia, and hyperuricemia were compared using a mixed effects logistic regression analysis. RESULTS: Diabetes before surgery was present in 12/100 lower responders and 17/100 higher responders. Remission at 2 years was observed in 4/12 (33%) of lower responders, compared to 15/17 (88%) of higher responders. Thus, the odds of diabetes remission was significantly smaller in lower responders (OR = 0.067, 95% CI 0.01-0.447). A mixed model regression analysis of all the parameters for each patient showed that the odds of achieving remission of any comorbidity was significantly lower in lower responders (OR = 0.62, 95% CI = 0.39-0.97). CONCLUSION: We could demonstrate that weight loss is a significant determinant of the remission of diabetes 2 years after RYGB. These data underline the importance of weight loss in the benefits of this procedure.
PURPOSE: Roux en Y gastric bypass surgery (RYGB) is an effective therapy for patients with severe obesity. It induces both significant weight loss and rapid improvements of metabolic complications. This study was undertaken to better define the direct role of weight loss in the metabolic improvements. METHODS: A retrospective, case-control study of a cohort of 649 patients with obesity who underwent RYGB, comparing higher and lower responders at 2 years after surgery (n = 100 pairs). Pairs of patients were matched for age, gender, and initial BMI. The rates of remission of diabetes, hypertension, dyslipidemia, and hyperuricemia were compared using a mixed effects logistic regression analysis. RESULTS: Diabetes before surgery was present in 12/100 lower responders and 17/100 higher responders. Remission at 2 years was observed in 4/12 (33%) of lower responders, compared to 15/17 (88%) of higher responders. Thus, the odds of diabetes remission was significantly smaller in lower responders (OR = 0.067, 95% CI 0.01-0.447). A mixed model regression analysis of all the parameters for each patient showed that the odds of achieving remission of any comorbidity was significantly lower in lower responders (OR = 0.62, 95% CI = 0.39-0.97). CONCLUSION: We could demonstrate that weight loss is a significant determinant of the remission of diabetes 2 years after RYGB. These data underline the importance of weight loss in the benefits of this procedure.
Entities:
Keywords:
Metabolic comorbidities; Obesity; Remission of diabetes mellitus; Roux-en-y gastric bypass surgery; Weight loss
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