Published in May 2014 Issue             

Obese Teens Heading for Bariatric Surgery Already Show Kidney Damage

Seventeen percent of adolescents with severe obese slated for bariatric surgery in the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study already had micro- or macroalbuminuria. In the cross-sectional baseline report on 242 adolescents with a median BMI of 50.5 kg/m2, 14% had microalbuminuria and another 3.1% had macroalbuminuria. Three percent of the teens had stage 3 chronic kidney disease, with estimated glomerular filtration rates below 60 mL/min 1.73 m2. In addition, 45% of the teens were hypertensive before surgery, 74% were dyslipidemic, and 13.6% had diabetes. The ongoing Teen-LABS study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases and is the most comprehensive examination of kidney status in severely obese adolescents undergoing bariatric surgery. Future reports from the ongoing Teen-LABS study will focus on the potential reversal early-in-life loss of kidney function via surgical weight loss.

Can Bariatric Surgery Improve Cardiovascular Risk Factors in the Metabolically Healthy but Morbidly Obese Patient?

Bariatric surgery may benefit metabolically healthy but morbidly obese (MHMO) patients, according to a study published online in SOARD (May 5). In a non-randomized, prospective cohort study, researchers reviewed the outcomes of 222 patients with severe obesity who had either a gastric bypass or sleeve gastrectomy. One year after surgery, MHMO (n=42) patients with only one or no cardiometabolic risk factors demonstrated significant decrease in blood pressure, plasma glucose, HOMA-IR, total cholesterol, Low-Density Lipoprotein Cholesterol (LDL-C) and triglycerides and an increase in High-Density Lipoprotein-Cholesterol. Weight loss was similar in both groups. Researchers concluded, “from a metabolic point of view, MHMO patients benefited from bariatric surgery.”

Quality-of-Life Before and After Laparoscopic Sleeve Gastrectomy. A Prospective Cohort Study

A study of 111 patients with severe obesity published in the online edition of SOARD (May 5) found laparoscopic sleeve gastrectomy results in significant improvements in quality of life and sustained weight loss. All obesity-related conditions significantly improved, including diabetes and sleep apnea, which correlated significantly with a higher quality of life. Researchers used the obesity-specific Moorehead-Ardelt II questionnaire (MAII) to identify parameters associated with QOL outcome. Over a 30-month period researchers used the validated Greek version of the MAII questionnaire and a visual analogue scale, preoperatively and postoperatively. MAII score increased from -0.40±1.30 preoperatively, to 1.75±0.83, 2.18±0.80 and 1.95±0.71 at six, 12 and 24 months postoperatively. Percentage excess BMI loss (%EBL) was 51.1±14.9, 64.2±17.9 and 66.4±18.0 at 6, 12 and 24 months.

Study Backs Bariatric Surgery Center Accreditation

A study of 2,615 patients found accredited bariatric centers have significantly less mortality (0.07% vs. 0.13%), lower failure to rescue rates (0.55% vs. 0.97%), fewer complications (11.3% vs. 12.3%) and lower average total costs ($42,212 vs. $51,189), compared to non-accredited centers. Researchers reviewed the data of 145 U.S. hospitals. The study was presented by Dr. John Morton of Stanford University Medical Center at the American Surgical Association annual meeting, and is expected to be published in an upcoming edition of the
Annals of Surgery.

Bariatric Surgery Recommended for Severely Obese Patients with NAFLD

New data presented at Digestive Disease Week 2014 in May found bariatric surgery improved the overall status of non-alcoholic fatty liver disease (NAFLD) in patients with obesity and showed a potential reversal of early-stage fibrosis. Researchers compared the liver biopsies of 152 patients who had bariatric surgery with additional biopsies occurring during later abdominal surgeries post-procedure between 1998 and 2013. In their biopsies, 93% of patients with steatohepatitis resolved or showed improvement, while 5% remained the same. Further, 56% of patients with any grade of fibrosis showed resolution or improvement post-operatively, while 25% stayed the same, and 16% became worse.