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Substantial Decrease in Comorbidity 5 Years After Gastric Bypass: A Population-based Study From the Scandinavian
Magnus Sundbom1, Jakob Hedberg, Richard Marsk
1*Department of Surgical Sciences, Upper Gastrointestinal Surgery, Uppsala University, Uppsala, Sweden †Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden ‡Department of Surgery, Lycksele Hospital, Lycksele, Sweden §Department of Surgery, Ersta Hospital, Stockholm, Sweden ¶Aleris Obesity & Clinical Sciences, Lund University, Lund, Sweden ||Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, The Sahlgrenska Academy, Gothenburg, Sweden **Österlenskirurgin, Simrishamn Hospital, Simrishamn, Sweden ††Department of Surgery, Kalmar County Hospital, Kalmar, Sweden ‡‡Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Objective:
To evaluate effect on comorbid disease and weight loss 5 years after Roux-en-Y gastric bypass (RYGB) surgery for morbid obesity in a large nationwide cohort.
Background:
The number patients having surgical procedures to treat obesity and obesity-related disease are increasing. Yet, population-based, long-term outcome studies are few.
Methods:
Data on 26,119 individuals [75.8% women, 41.0 years, and body mass index (BMI) 42.8 kg/m] undergoing primary RYGB between May 1, 2007 and June 30, 2012, were collected from 2 Swedish quality registries: Scandinavian Obesity Surgery Registry and the Prescribed Drug Registry. Weight, remission of type 2 diabetes mellitus, hypertension, dyslipidemia, depression, and sleep apnea, and changes in corresponding laboratory data were studied. Five-year follow-up was 100% (9774 eligible individuals) for comorbid diseases.
Results:
BMI decreased from 42.8 ± 5.5 to 31.2 ± 5.5 kg/m at 5 years, corresponding to 27.7% reduction in total body weight. Prevalence of type 2 diabetes mellitus (15.5%-5.9%), hypertension (29.7%-19.5%), dyslipidemia (14.0%-6.8%), and sleep apnea (9.6%-2.6%) was reduced. Greater weight loss was a positive prognostic factor, whereas increasing age or BMI at baseline was a negative prognostic factor for remission. The use of antidepressants increased (24.1%-27.5%). Laboratory status was improved, for example, fasting glucose and glycated hemoglobin decreased from 6.1 to 5.4 mmol/mol and 41.8% to 37.7%, respectively.
Conclusions:
In this nationwide study, gastric bypass resulted in large improvements in obesity-related comorbid disease and sustained weight loss over a 5-year period. The increased use of antidepressants warrants further investigation.
