AGE AND GENDER MAY INFLUENCE THE RESULTS OF ROUX-EN-Y
					GASTRIC BYPASS? Metabolic syndrome parameters

ANDRADE-SILVA, Stephan Garcia; CARANTI, Danielle Arisa; SALLET, José Afonso; LEAL, Lucas Pedroso Fernandes Ferreira; LEAL, Antonio Joaquim Ferreira; DÂMASO, Ana Raimunda

doi:10.1590/S0004-2803201400030002

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Arquivos de Gastroenterologia

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Original Articles • Arq. Gastroenterol. 51 (3) • Jul-Sep 2014 • https://doi.org/10.1590/S0004-2803201400030002 copy

AGE AND GENDER MAY INFLUENCE THE RESULTS OF ROUX-EN-Y GASTRIC BYPASS? Metabolic syndrome parameters

Idade e gênero podem influenciar nos resultados da derivação gástrica em Y de Roux? Parâmetros da síndrome metabólica

Authorship SCIMAGO INSTITUTIONS RANKINGS

Context

Severe obesity affects the body favoring the development of serious diseases, including hypertension, diabetes mellitus, atherosclerosis and non alcoholic fatty liver disease. Bariatric procedures increased in Brazil in the last decade.

Objectives

The purpose of this study was to verify if gender and age in date of procedure resulted significant differences in metabolic syndrome parameters after surgery.

Methods

The study involved 205 medical records of adult patients undergoing Roux-en-Y gastric bypass, stratified by gender and age groups and followed one year by a multidisciplinary team.

Results

It was observed significant decrease in body mass index, fasting glucose and insulin at all ages and both genders. Lipid profile showed significant improvements except high density lipoprotein cholesterol. Ectopic fat in the liver has decreased after 6 months in patients classified with steatosis at baseline. Patients classified as hypertensive blood pressure levels decreased 6 months after surgical intervention.

Conclusions

Roux-en-Y gastric bypass proved to be an important tool in remission of metabolic syndrome parameters. The reduction of body mass accompanied to decrease in insulin resistance resulted in lower prevalence of comorbidities associated with obesity. The benefits were similar and extended both genders and all age groups between 18 and 65 years old.

Bariatric surgery; Metabolic syndrome X; Roux-en-Y anastomosis; Fatty liver

	G	N		Body Mass
	G	N	Baseline	Short-term ^x	Long-term^y,z
Group 1	M	8	143.5 ± 11.40	98.94 ± 12.99^a	87.75 ± 10.95^a,a
Group 1	F	37	120.76 ± 17.67	86.60 ± 14.57^a	77.48 ± 12.11^a,a
Group 2	M	8	132.25 ± 20.40	93.75 ± 15.40^a	87.87 ± 13.73^a,a
Group 2	F	64	117.42 ± 13.39	86.03 ± 11.85^a	76.93 ± 10.97^a,a
Group 3	M	6	139.83 ± 8.45	102.33 ± 7.68^a	94.83 ± 4.62^a,a
Group 3	F	41	115.87 ± 18.85	85.87 ± 14.96^a	78.38 ± 13.44^a,a
Group 4	M	6	140.33 ± 16.16	102.83 ± 11.47^a	98.33 ± 11.00^a,a
Group 4	F	26	111.19 ± 16.65	80.67 ± 13.57^a	74.13 ± 13.18^a,a
Group 5	M	1	132.00**	89.00**	80.00**
Group 5	F	8	113.00 ± 14.70	84.16 ± 12.33^a	74.00 ± 8.17^a,a

	Gender	QUICKI							HOMA-IR
	Gender	Baseline			Long-term^y.z				Baseline			Long-term^y.z
Group 1	M	0.317	±	0.015	0.386	±	0.015	^a,a	3.70	±	1.04	0.99	±	0.23	^a,a
Group 1	F	0.321	±	0.042	0.402	±	0.028	^a,a	4.13	±	1.95	0.87	±	0.42	^a,a
Group 2	M	0.303	±	0.029	0.376	±	0.019	^a,a	6.57	±	5.17	1.17	±	0.38	^a,a
Group 2	F	0.315	±	0.026	0.387	±	0.026	^a,a	4.42	±	2.10	1.04	±	0.41	^a,b
Group 3	M	0.311	±	0.026	0.370	±	0.023	^a,d	5.32	±	4.57	1.33	±	0.52	^a,b
Group 3	F	0.305	±	0.027	0.387	±	0.027	^a,b	5.86	±	3.28	1.07	±	0.52	^a,a
Group 4	M	0.289	±	0.029	0.377	±	0.022	^a,c	9.78	±	7.53	1.18	±	0.48	^a,d
Group 4	F	0.302	±	0.021	0.382	±	0.027	^a,c	5.98	±	3.46	1.18	±	0.75	^a,c
Group 5	M	0.331		*	0.380		*		2.57		*	1.02		*
Group 5	F	0.306	±	0.035	0.383	±	0.022	^a,b	6.61	±	5.23	1.11	±	0.54	^c,d

	Baseline		Short-term		P*	Long term		P**
	n	%	n	%	P*	n	%	P**
Glucose impaired tolerance	42	20.49	15	7.32	<0.001	4	1.95	<0.001
Diabetes Mellitus 2	24	11.71	3	1.46	<0.001	0	0.00	<0.001
QUICKI Altered	189	92.20	75	36.59	<0.001	21	10.24	<0.001
HOMA-IR Altered	162	79.02	18	8.78	<0.001	1	0.49	<0.001
Total Cholesterol elevated	28	13.66	1	0.49	<0.001	0	0.00	<0.001
HDL-C Altered	97	47.32	116	56.59	<0.055	105	51.22	<0.223
LDL-C Altered	140	68.29	83	40.49	<0.001	38	18.54	<0.001
Triglycerides elevated	98	47.80	35	17.07	<0.001	10	4.88	<0.001
Metabolic syndrome	108	52.68	49	23.90	<0.001	17	8.29	<0.001
Arterial hypertension	110	53.66	72	35.12	<0.010	71	34.63	<0.010

	G	High Density Lipoprotein Cholesterol - HDL (mg/dL)
	G	Baseline			Short-term ^x				Long-term ^y.z
Group 1	M	43.12	±	5.61	41.37	±	6.94	^c	43.25	±	7.12	^d,c
Group 1	F	51.72	±	14.34	51.37	±	11.17	^d	50.21	±	8.37	^d,d
Group 2	M	38.87	±	10.85	41.00	±	8.41	^b	43.62	±	6.92	^a,b
Group 2	F	50.53	±	11.46	47.39	±	9.99	^b	48.00	±	7.71	^c,d
Group 3	M	64.67	±	36.12	51.00	±	18.61	^a	51.67	±	12.31	^a,d
Group 3	F	50.48	±	11.66	46.02	±	8.88	^d	48.48	±	8.19	^d,d
Group 4	M	48.67	±	8.11	47.50	±	9.42	^d	47.83	±	8.35	^d,d
Group 4	F	51.58	±	14.39	47.31	±	11.03	^d	48.31	±	8.75	^d,d
Group 5	M	43.00		*	45.00		*		46.00		*
Group 5	F	51.62	±	15.90	46.63	±	9.87	^d	48.75	±	13.83	^d,d

Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. Rua Dr. Seng, 320, 01331-020 São Paulo - SP Brasil, Tel./Fax: +55 11 3147-6227 - São Paulo - SP - Brazil
E-mail: secretariaarqgastr@hospitaligesp.com.br

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[1] Correspondence: Stephan Garcia Andrade-Silva. Universidade Federal de São Paulo - UNIFESP - Grupo de Estudo da Obesidade - GEO. Av. Ana Costa, 178 - CEP 11060- 001 - São Paulo, SP, Brasil. E-mail: stephangarcia@uol.com.br