Prevalence of Peripheral Polyneuropathy Before and After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Peripheral polyneuropathy (PPN) can occur in diabetes mellitus (DM), obesity, and after bariatric surgery (BS). We decided to evaluate PPN prevalence before (PreBS-PPN) and after BS (PostBS-PPN) and to look for variables that may be independently associated with both.

In this cross-sectional study, we evaluated 1467 participants with obesity and without DM before and 10.4 ± 6.8 months after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). The Michigan Neuropathy Screening Instrument and the International Physical Activity Questionnaire were used to define the presence of PPN and the Metabolic Equivalent Task (MET) spent per week, respectively. Using Poisson regression models with a robust estimator, the prevalence of PreBS-PPN and PostBS-PPN was analyzed as dependent variables.

Prevalence of PostBS-PPN (10.5%) was lower than PreBS-PPN (20.4%, p < 0.001), with a prevalence of 12.7% post-RYGB and 8.4% post-SG (p = 0.072). In the univariate analysis, PreBS-PPN was associated with post-menopausal status (PMS), older age, and taller height. In twelve regression models, we found an independent association of PreBS-PPN with older age, PMS, and taller height. PostBS-PPN prevalence was associated with a higher fasting glycemia and stature, and a lower MET on univariate analysis, and with higher fasting glycemia, stature and RYGB in four multivariate regression models.

PPN occurs frequently in subjects with obesity without DM and is lower after BS. SG is not likely to be harmful in the development of neuropathy. Studies of PPN incidence and persistence after BS should clarify these factors.