Long-term effects of laparoscopic Roux-en-Y gastric bypass on metabolic syndrome in patients with morbid obesity

Background: Diseases associated with obesity such as type 2 diabetes (T2D), hypertension, and dyslipidemia are common and together are defined as metabolic syndrome (MetS). The aim of this study was to evaluate long-term effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) in morbidly obese patients with MetS. Methods: This was a retrospective study of data from a prospective database in a single center from 2005 to 2013 including 3795 LRYGB operated obese patients. Metabolic syndrome was defined according to the International Diabetes Federation Consensus Definition of Metabolic Syndrome from 2006. Results: In the study population, 79% of the patients were women, the preoperative median age was 42.4 years, and median body mass index (BMI, kg/m(2)) was 40.9. MetS was diagnosed in 60% of the patients (2275/3795), with increased frequency in men and in those with higher age, higher BMI, and greater waist circumference; 27.5% of patients had impaired glucose metabolism, 40% hypertension, and 30% dyslipidemia. Postoperative follow-up rate >5 years was 71% (595/839). We found that 86.2% had resolution of MetS. After 5-9 years, complete remission of T2D was achieved in 78%, hypertension in 51%, and dyslipidemia in 89%. Mean excess BMI loss was significantly lower for patients with MetS (73.1%) compared with patients without MetS (75.6%) (P < .01). Early complications (leakage or hemorrhage) occurred in 1.2% (48/3975) and internal hernia in 7.8% (310/3975). Presence of MetS did not increase complication rates. Conclusion: LRYGB in obese patients is associated with a significant and sustained reduction in excessive weight. In the present study, 86.2% of patients with MetS achieved complete remission and complication rates were low. Early bariatric surgery should be considered in patients with obesity and concurrent MetS. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.