Can serum basal cortisol values predict successful operations for bariatric surgery patients?

Obesity is a chronic metabolic disease declared as the 21st century pandemic by the World Health Organization. Obesity has become an alarming situation for society, and it has to be treated. If the appropriate criteria are met by patients, bariatric surgery is an effective treatment method that provides weight loss in a short time. There are no definitive criteria regarding which groups of patients and characteristics may benefit most from bariatric surgery. In this study, we evaluate whether serum basal cortisol levels can predict successful outcomes of bariatric surgery and whether there is any difference in outcome between diabetic and non-diabetic patients.

This observational study included 244 obese patients who had undergone laparoscopic sleeve gastrectomy (LSG). Preoperative and postoperative 6-month weight, body mass index (BMI), serum basal cortisol, fasting plasma glucose, 1-mg dexamethasone suppression test (DST) results, and Type 2 Diabetes Mellitus (T2D) history were recorded. We analyzed the patients first by dividing them into two groups as excessive weight loss (%EWL) ≥50% and %EWL< 50%, and then into two groups as diabetic and nondiabetic patients.

The mean age of patients with %EWL≥ 50% was found to be statistically significantly lower than that of patients with %EWL< 50% [39 (19-60) vs. 47 (36-61) years; p=0.046]. While there was no significant difference in basal cortisol values (p=0.513), DST results were statistically significantly lower in patients with %EWL≥ 50% than patients with %EWL< 50% [0.6 (0.1-2.1) vs. 0.8 (0.7-1.1); p=0.040].

In obese patients undergoing LSG, serum basal cortisol level may not predict the success of operation. However, the result of 1 mg DST may predict the operation success.