Bariatric surgery and its role in the management of metabolic syndrome

Background Obesity has become a worldwide pandemic health problem, and morbid obesity leads to high rate of complications associated with metabolic syndrome, including type 2 diabetes mellitus (DM), hypertension, and hyperlipidemia. Bariatric procedures have become a main therapeutic option allowing improved diabetes, hypertension, and hyperlipidemia control in most patients Patients and methods A prospective study which was done between December 2015 and December 2017, this randomized study included 120 obese patients with metabolic syndrome who were divided into two groups: group 1 included 60 patients who were treated by laparoscopic sleeve gastrectomy (SG). Group 2 included 60 patients who were treated by laparoscopic minigastric bypass (MGB). The outcome for weight loss, DM control, blood pressure control, and hyperlipidemia were assessed and compared. Results A total of 120 patients were included in the study. The average age was 43.7 years and majority of them were women (80%). In the SG group: 40 (66.7%) patients were resolved (glycosylated hemoglobin<6.5% with no postoperative diabetic medication) from DM and 16 (26.7%) patients showed improvement. As regards hypertension 22 (55%) patients were resolved (no antihypertensive medications). As regards hyperlipidemia, 20 (41.6%) patients were resolved. In the MGB group: 48 (80%) patients were resolved (glycosylated hemoglobin<6.5% with no postoperative diabetic medication) from DM and 12 (20%) patients showed improvement. As regards hypertension 26 (59%) patients were resolved (no antihypertensive medications). As regards hyperlipidemia 30 (62.5%) patients were resolved. In comparison the MGB group has a statistically significant better effect in improvement of DM in early 6 months, and better outcome after 12 months but is not statistically significant. Conclusion SG and MGB are highly effective in the control of diabetes, hypertension, and hyperlipidemia but MGB has better and earlier effect than SG in diabetes remission.