The Effect of Laparoscopic Sleeve Gastrectomy on Body Mass Index and the Resolution of Other Metabolic Syndrome Components in Patients over 50 Years Old during a Two Year Follow-Up.

Background/Objectives: Metabolic syndrome, defined by the coexistence of central obesity, dyslipidemia, hypertension, and insulin resistance, is a significant contributor to increased cardiovascular morbidity and mortality in the aging population. We aimed to determine whether age influences the efficacy of LSG in treating obesity-related comorbidities. Methods: A retrospective analysis of lipid profiles, glycemic and clinical parameters was conducted in a group of 786 patients in two age groups (under 50 years old and over 50 years old) who underwent laparoscopic sleeve gastrectomy with follow-ups 1, 3, 6, 12 and 24 months after surgery. Results: There was a significant improvement in lipid metabolism with no significant differences between the two age groups in these parameters throughout the observation period. Furthermore, there was significant weight loss (54.82 kg vs. 54.56 kg) and BMI reductions (47.71 kg/m2 vs. 47.01 kg/m2 to 29.03 kg/m2 vs. 30.73 kg/m2). Total cholesterol decreased from 198 mg/dL to 184.9 mg/dL (<50 years old) and from 206.4 mg/dL to 193 mg/dL (>50 years old). LDL dropped from 136.2 mg/dL to 116.7 mg/dL and from 141.0 mg/dL to 121.0 mg/dL. Mean HbA1c decreased to comparable levels (5.66% vs. 5.53%). Both groups showed similar rates of remission for type 2 diabetes and hypertension. Conclusions: Our findings suggest that LSG is an effective method for treating components of metabolic syndrome regardless of age, supporting its use as a therapeutic tool for older patients.

Assessment of Lipid Balance Parameters after Laparoscopic Sleeve Gastrectomy in 1-Year Observation.

Introduction: Currently, the increase in the percentage of obese people observed along with the development of civilization, reaching the level of a global pandemic, has forced a search for methods of effective and permanent obesity treatment. Obesity is a multifactorial disease; it coexists with many disease entities and requires multidisciplinary treatment. Obesity leads to metabolic changes in the form of metabolic syndromes, which include, among others, atherogenic dyslipidemia. The proven relationship between dyslipidemia and cardiovascular risk enforces the need to effectively improve the lipid profile of obese patients. Laparoscopic sleeve gastrectomy is a method of surgical treatment of morbid obesity which improves bariatric and metabolic parameters. The aim of the study was to assess the effectiveness of laparoscopic sleeve gastrectomy (LSG) at improving lipid profile parameters upon a 1-year follow up. Material and Methods: Bariatric parameters of 196 patients who underwent laparoscopic sleeve gastrectomy as well as the lipid profile of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), non-NDL, and triglycerides (TG) in a 1-year observation were analyzed. Results: Improvements in bariatric parameters were observed in patients after LSG. Total cholesterol, low-density lipoprotein (LDL), triglycerides and non-HDL level decreases were observed along with an increase in high-density lipoprotein (HDL) cholesterol levels. Conclusions: Sleeve gastrectomy is an effective method of treating obesity and improving the lipid profile in obese patients.

The Effect of Laparoscopic Sleeve Gastrectomy on the Course of Non-Alcoholic Fatty Liver Disease in Morbidly Obese Patients during One Year of Follow Up.

BACKGROUND: Morbid obesity co-exists with non-alcoholic fatty liver disease in up to 90% of cases. Laparoscopic sleeve gastrectomy leads to a reduction in body mass and thus may improve the course of non-alcoholic fatty liver disease. The aim of this study was to evaluate the effect of laparoscopic sleeve gastrectomy on the resolution of non-alcoholic fatty liver disease. METHODS: The study included 55 patients with non-alcoholic fatty liver disease who underwent laparoscopic sleeve gastrectomy at a tertiary institution. The analysis consisted of preoperative liver biopsy, abdominal ultrasound, weight loss parameters, Non-Alcoholic Fatty Liver Fibrosis Score and selected laboratory parameters. RESULTS: Before the surgery, 6 patients were diagnosed with grade 1 liver steatosis, 33 patients with grade 2 and 16 patients with grade 3. One year after the surgery, only 21 patients had features of liver steatosis at ultrasound. All weight loss parameters showed statistically significant changes during the observation; the median percentage of total weight loss was 31.0% (IQR: 27.5; 34.5) with p = 0.0003, the median percentage of excess weight loss was 61.8% (IQR: 52.4; 72.3) with p = 0.0013 and the median percentage of excess body mass index loss was 71.0% (IQR: 61.3; 86.9) with p = 0.0036 12 months after laparoscopic sleeve gastrectomy. The median Non-Alcoholic Fatty Liver Fibrosis Score at baseline was 0.2 (IQR: -0.8; 1.0) and decreased to -1.6 (IQR: -2.4; -0.4) (p < 0.0001). Moderate negative correlations between Non-Alcoholic Fatty Liver Fibrosis Score and percentage of total weight loss (r = -0.434, p < 0.0001), percentage of excess weight loss (r = -0.456, p < 0.0001) and percentage of excess body mass index loss (r = -0.512, p < 0.0001) were found. CONCLUSIONS: The study supports the thesis that laparoscopic sleeve gastrectomy is an effective method for treatment of non-alcoholic fatty liver disease in patients with morbid obesity.