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Bariatric surgery shows multi-organ benefits

OCTOBER 24, 2017
Clinical Congress Daily Highlights, Tuesday Second Edition

Bariatric surgery has grown rapidly as the specialty has matured, as has interest in its clinical impact. Researchers have gone beyond weight loss to examine this surgery’s effects on kidney and heart function as well as type 2 diabetes.  Four studies presented on Tuesday enumerated benefits following bariatric procedures:

  • A study by researchers at the Cleveland Clinic Florida, Weston, FL, reviewed 1,330 laparoscopic sleeve gastrectomies from 2012 to 2015 and found a “clear improvement” of the glomerular filtration rate (GFR) in the kidneys of morbidly obese patients with chronic kidney disease 12 months after the procedure.
  • The same Cleveland Clinic Florida team also examined the effects of bariatric surgery on left ventricular structure in 51 patients. Comparison of echocardiography performed before and after the procedure revealed reversal of concentric remodeling toward a normal heart structure. At one-year follow-up, 25 patients displayed normal left ventricular geometry. The researchers note that further studies are needed to understand the impact of obesity on the diastolic function.
  • A study by researchers at the University of Minnesota in Minneapolis, MN, observed changes in the metabolic activity of subcutaneous adipose tissue (SAT) within seven days of bariatric surgery. Analysis of SAT biopsies taken during the procedure and one week later showed up-regulation of genes involved in fatty acid oxidation.
  • Researchers at Johns Hopkins University in Baltimore, MD, compared two procedures — vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) — to determine whether either is superior in inducing remission and preventing relapse of type 2 diabetes (T2DM). The researchers analyzed pharmacy claims for 2,746 obese individuals with T2DM over age 18 on antidiabetic medication who underwent either VSG or RYGB. The data revealed that both procedures are initially effective at inducing remission, but RYGB may be better at producing lasting effect — patients who underwent the procedure had a 42 percent lower probability of relapse than those who had VSG. Further long-term studies are needed, but the authors conclude that clinicians may want to consider RYGB over VSG for type 2 diabetics undergoing bariatric surgery.

Additional Information:
These four bariatric surgery studies were presented in two Scientific Forums on Oct. 24 at the 2017 Clinical Congress of the American College of Surgeons in San Diego, CA.  Program, webcast and audio information is available online at FACS.org/clincon2017.

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