Relación entre cambios en hemoglobina glucosilada y mejora de la composición corporal en pacientes con obesidad mórbida tras gastrectomía tubular laparoscópica / Relationship between changes in hemoglobin glycosilated and improvement of body composition in patients with morbid obesity after tubular laparoscopic gastrectomy

Introducción y objetivo: El objetivo de nuestro estudio es analizar la posible relación entre los cambios en el perfil glucémico y los parámetros de composición corporal en pacientes con obesidad mórbida tras gastrectomía tubular laparoscópica. Material y métodos: Se realiza un estudio observacional prospectivo de cohortes donde el tamaño muestral es de 69 pacientes. Las variables analizadas son peso corporal, glucemia, hemoglobina glucosilada, lipoprotein high density, lipoprotein low density, triglicéridos y circunferencia cintura y cadera. Para llevar a cabo el objetivo de este estudio se ha utilizado un análisis de la variancia de medidas repetidas (ANOVA) y un posterior análisis de correlación a través del test de Pearson. Resultados: Tras el análisis estadístico se han encontrado una reducción significativa del peso tras la cirugía p < 0,001, una reducción significativa de la hemoglobina glucosilada entre los valores preintervención y a los 6 meses de la cirugía (p<0,036) y un descenso significativo de los perímetros de cintura y cadera (p< 0,001). No existieron diferencias significativas en el resto de variables estudiadas. En el análisis de correlación, se encontró una correlación positiva significativa entre el cambio en concentración de hemoglobina glucosilada y perímetro de cadera (p=0,047; r=0,237), a menor diámetro de cadera, menor concentración de hemoglobina glucosilada. Conclusiones: La gastrectomía tubular laparoscópica se muestra como una técnica efectiva para el tratamiento de pacientes obesos mórbidos con diabetes mellitus tipo 2. La reducción en el perímetro de cadera está relacionada con la reducción de hemoglobina glucosilada a los 6 meses de la intervención

Background and objective: The objective of our study is to analyze the possible relationship between changes in glycemic profile and body composition parameters in morbid obesity patients after tubular laparoscopic gastrectomy. Material and methods: A prospective observational cohort study with 69 patients was performed. The variables analyzed were body weight, blood glucose, hemoglobin, glycosylated, high density lipoprotein, low density lipoprotein, triglycerides, and waist and hip circumference. An analysis of variance of repeated measurements (ANOVA) and a correlation analysis through the Pearson test were carried out. Results: A significant reduction in weight (p<.001 after surgery) and in glycosylated hemoglobin (p<.036) and waist hip (p<.001) were found at 6 months after surgery. There was no significant difference in the rest of the variables studied. In correlation analysis, a significant positive correlation was found between the change in concentration of hemoglobin glycosylated and hip circumference (p=.047; r=0.237), the smaller the hip circumference, the lower the concentration of glycosylated hemoglobin. Conclusions: Tubular laparoscopic gastrectomy is an effective technique for the treatment of morbidly obese patients with type 2 diabetes mellitus. The reduction in the perimeter of hip is related to glycosylated hemoglobin reduction 6 months after intervention

Relationship between changes in hemoglobin glycosilated and improvement of body composition in patients with morbid obesity after tubular laparoscopic gastrectomy. / Relación entre cambios en hemoglobina glucosilada y mejora de la composición corporal en pacientes con obesidad mórbida tras gastrectomía tubular laparoscópica.

BACKGROUND AND OBJECTIVE: The objective of our study is to analyze the possible relationship between changes in glycemic profile and body composition parameters in morbid obesity patients after tubular laparoscopic gastrectomy. MATERIAL AND METHODS: A prospective observational cohort study with 69 patients was performed. The variables analyzed were body weight, blood glucose, hemoglobin, glycosylated, high density lipoprotein, low density lipoprotein, triglycerides, and waist and hip circumference. An analysis of variance of repeated measurements (ANOVA) and a correlation analysis through the Pearson test were carried out. RESULTS: A significant reduction in weight (p<.001 after surgery) and in glycosylated hemoglobin (p<.036) and waist hip (p<.001) were found at 6 months after surgery. There was no significant difference in the rest of the variables studied. In correlation analysis, a significant positive correlation was found between the change in concentration of hemoglobin glycosylated and hip circumference (p=.047; r=0.237), the smaller the hip circumference, the lower the concentration of glycosylated hemoglobin. CONCLUSIONS: Tubular laparoscopic gastrectomy is an effective technique for the treatment of morbidly obese patients with type 2 diabetes mellitus. The reduction in the perimeter of hip is related to glycosylated hemoglobin reduction 6 months after intervention.

Remission of type 2 diabetes mellitus after bariatric surgery - comparison between procedures.

INTRODUCTION: We aimed to assess the mid-term type 2 diabetes mellitus recovery patterns in morbidly obese patients by comparing some relevant physiological parameters of patients of bariatric surgery between two types of surgical procedures: mixed (roux-en-Y gastric bypass and biliopancreatic diversion) and restrictive (sleeve gastrectomy). MATERIAL AND METHODS: This is a prospective and observational study of co-morbid, type 2 diabetes mellitus evolution in 49 morbidly obese patients: 37 underwent mixed surgery procedures and 12 a restrictive surgery procedure. We recorded weight, height, body mass index, and glycaemic, lipid, and nutritional blood parameters, prior to procedure, as well as six and twelve months post-operatively. In addition, we tested for differences in patient recovery and investigated predictive factors in diabetes remission. RESULTS: Both glycaemic and lipid profiles diminished significantly to healthy levels by 6 and 12 months post intervention. Type 2 diabetes mellitus showed remission in more than 80% of patients of both types of surgical procedures, with no difference between them. Baseline body mass index, glycated haemoglobin, and insulin intake, among others, were shown to be valuable predictors of diabetes remission one year after the intervention. CONCLUSIONS: The choice of the type of surgical procedure did not significantly affect the remission rate of type 2 diabetes mellitus in morbidly obese patients. (Endokrynol Pol 2017; 68 (1): 18-25).

Health-Related Fitness Improvements in Morbid Obese Patients After Laparoscopic Sleeve Gastrectomy: a Cohort Study.

OBJECTIVE: Laparoscopic sleeve gastrectomy (LSG) has demonstrated high long-term effectiveness and major advantages over other techniques. The objective of this study was to analyze changes in physical fitness parameters in morbidly obese patients during 6 months after LSG. METHODOLOGY: We conducted a descriptive observational study with 6-month follow-up in 72 LSG patients, evaluating changes in body mass index (BMI), functional capacity (6-min walking test), hand grip strength (manual dynamometry), flexibility (fingertip-to-floor test), balance (Flamingo test), physical activity level (International Physical Activity Questionnaire, IPAQ), and perception of general physical fitness (International Fitness Scale [IFIS] questionnaire). RESULTS: The ANOVA revealed significant improvements in BMI, functional capacity, flexibility, balance, and physical activity level (P < 0.001) at 6 months, with an improvement in the perception of physical fitness in most cases. No significant changes were found in dominant hand (P = 0.676) or non-dominant hand (P = 0.222) dynamometry. General physical fitness was positively correlated with BMI and distance in the 6-min test, and was negatively correlated with fingertip-to-floor distance. CONCLUSION: Morbidly obese patients showed major improvements at 6 months after LSG in functional capacity, balance, mobility, and physical activity, with no change in grip strength. These improvements were related to a better self-perception of general physical fitness.