Adolescents with severe obesity who had bariatric surgery showed significant improvements in cardiovascular disease risk factors, according to the most recent “Teen Longitudinal Assessment of Bariatric Surgery” (Teen-LABS) study, published online in the
Before surgery, about one-third of 242 study participants had three or more risk factors. Three years later, only 5 percent did, reducing their overall likelihood of developing cardiovascular disease. The study showed bariatric surgery performed during adolescence may provide unique benefits later in life by altering the probability of the future development of adverse cardiovascular events, including the development and progression of impaired glucose metabolism, atherosclerosis, heart failure and stroke.
Teen-LABS is a multi-center clinical study funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH). It is examining the safety and health effects of surgical weight loss procedures in adolescents. The mean age of participants was 17.
Marc Michalsky, MD
"This is the first large-scale analysis of predictors of change in cardiovascular disease risk factors among adolescents following bariatric surgery," said Marc P. Michalsky, MD, lead study author, surgical director, Center for Healthy Weight and Nutrition and professor, Clinical Surgery and Pediatrics at The Ohio State University College of Medicine. "The study demonstrated early improvement and reduction of cardio-metabolic risk factors, offering compelling support for bariatric surgery in adolescents."
Three years post-surgery, a reduction in cardiovascular disease risk factors was not only associated with weight loss, but also with age at the time of surgery, pre-operative body mass index (BMI), sex and race. Increased weight loss, female sex and younger age at time of surgery serve to predict a higher probability of risk factor resolution. Younger participants were more likely to resolve dyslipidemia compared to older patients, while females were more likely than males to demonstrate improvements in elevated blood pressure.
“Although relationships between change in cardiovascular disease risk factors and postoperative weight reduction were not unexpected, we learned younger patients at time of surgery were more likely to experience dyslipidemia remission and normalization of high sensitivity C-reactive protein (a marker of inflammation), suggesting there may be advantages to undergoing bariatric surgery earlier, even among adolescents,”
said Dr. Michalsky.
The authors concluded, “The elucidation of predictors of change in CVD-RFs (cardiovascular disease risk factors) may lead to refinements in patient selection and optimal timing of adolescent bariatric surgery designed to improve clinical outcomes.”