Analysis of hepatic markers and lipid profile of patients submitted to gastric by-pass after 2 years – Cohort retrospective

Objetive

To assess the impact of %PEP on liver indicators and lipid profile two years after BS.

Background

The prevalence of weight gain in the adult population continues to increase, 57.8% of the world's adult population will be overweight or obese by 2030.

Methods

This is a retrospective cohort and descriptive study, performed by consulting the database of an Obesity and Digestive Surgery Clinic in the city of Santa Maria – (Rio Grande do Sul, Brazil). The study included 351 patients (284 women, 67 men), aged at least 18 years, who underwent bariatric surgery from March 2014 to March 2016. The following data were obtained from the patients' medical records: Weight, height, age, sex, associated morbidities, biochemical parameters. The data were described by mean and standard deviation, median and interquartile range, count, and percentages.

Results

The results showed a significant reduction in excess loss, triglycerides (TG) and low-density lipoprotein (LDLc) cholesterol variables in the prospective period, while high-density lipoprotein (HDLc) cholesterol levels increased, thus minimizing the hepatic changes. There was a reduction in LDLc and an increase in HDLc at 24 months in both groups 1 and 2. Between 6 and 12 months, total cholesterol (TC) increased in group 2, however, in the period between 12 and 18 months, only G1 had triglycerides reduced. In the period of 18 and 24 months, there was a significant reduction in blood glucose in group 1. The variables AST and ALT were within the normal range, without significance. However, 84.3% of patients had grade I hepatic steatosis.

Conclusion

Bariatric surgery is effective in reducing the %EWL, modifying the lipid profile and liver markers up to 24 months after the bypass, reducing associated comorbidities. More research is needed to clarify the impact of %PEP on liver indicators and lipid profile two years after SB.

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In the study, the prevalence of obesity was higher in females (80.9%).

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The present study showed an important reduction in the percentage of excess weight loss (%EWL), reduction of liver markers and improvement in the lipid profile in the 24 months after the surgical intervention.

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BS can guarantee an improvement in quality of life, while reducing CVR, dyslipidemia and liver changes.

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The effectiveness of BS is an important factor in weight loss, with improvement in anthropometric and biochemical parameters, and reduction of morbidities associated with obesity.

Endothelial Function of Patients with Morbid Obesity Submitted to Roux-en-Y Gastric Bypass With and Without Obstructive Sleep Apnea-Hypopnea Syndrome

BACKGROUND

Obesity is associated with obstructive sleep apnea-hypopnea syndrome (OSA) and both induce endothelial dysfunction. However, the effect of OSA on endothelial function after bariatric surgery has not been investigated yet.

OBJECTIVES

This study aims to evaluate the impact of weight loss on endothelial function in patients with and without obstructive sleep apnea (OSA) in the first 6 months after bariatric surgery.

SETTING

This study was conducted at a university hospital, in Brazil.

METHODS

The sample consisted of 56 patients homogeneously divided into groups with and without OSA. All patients underwent Roux-en-Y gastric bypass (RYGB), and the diagnosis of OSA was performed by polysomnography. The patients were evaluated preoperatively and 6 months after surgery. The evaluations included anthropometric measures, electrical bioimpedance, clinical symptoms of OSA, and endothelial function (flow-mediated dilation). RYGB improved the anthropometric, bioimpedance, and endothelial function results in both groups.

RESULTS

Patients presented a significant clinical improvement in OSA symptoms throughout the study. However, patients with OSA had an improvement in the endothelial function 2.5% lower (p < 0.001) than patients without APNEA syndrome.

CONCLUSION

This study demonstrates that the existence of OSA prior to bariatric surgery interferes in the improvement of endothelial function.