| Background: Obesity has become the fifth major risk of death over the world.bariatric surgery can not only achieve sustained mass loss,but also may provide additional benefits for obese patients including reducing the risk factors of cardiovascular disease by suppressing blood glucose,blood lipids and blood pressure,and improving renal function via improving the obesity related complications,such as type 2 diabetes,dyslipidemia and hypertension.Objectives: In a controlled trial,patients combined with obesity and associated complications were divided into the operation group and the non-operation group.After 1-year follow-up,the improvement of body weight,blood glucose,blood lipid,blood pressure and cardiovascular risks after medical treatment and operation were observed,and the possible mechanisms of inflammation and postoperative complications were analyzed.In addition,the improvement of different operation methods for obesity related complications,and the incidence of complications induced by different operation methods were also analyzed.Methods: A total of 45 patients were enrolled from the First Affiliated Hospital of Dalian Medical University from February 2014 to November 2017.Inclusion criteria were:(1)received bariatric surgery or non-operation treatment in the department of laparoscopic surgery;(2)age≥18 years old;(3)obesity combined with diabetes and other diseases.Among them,30 patients received bariatric surgery,including 21 females and 9 males;15 patients received non-operation treatment,including 6 females and 9 males.After 1-year follow-up,we observed patients’ body weight,abdominal circumference,BMI,high sensitive C reactive protein(hs-CRP),blood glucose,glycosylated hemoglobin(HBA1c),blood lipid,blood pressure and cardiovascular disease risk,as well as postoperative related complications.Results: After followed-up one year,The average BMI in the operation group was significantly lower than that in the non-operation group(25.52±4.34 vs 28.48±4.52 Kg /m~2),the abdominal circumference in the operation group was significantly lower than that in the non-operation group(90.10±11.52 vs 100.27±8.23cm),the fasting plasma glucose in the operation group was significantly lower than that in the non-operation group(5.77±1.63vs6.91±1.82 mmol / L),Hb A1 c in the operation group was significantly lower than that in non-operation group(6.10 ± 1.01 vs 6.84 ± 1.16%),total cholesterol in the operation group was significantly lower than that in non-operation group(4.30 ± 0.87 vs 4.82 ± 0.66 mmol / L),the LDL-C in the surgery group was significantly lower than that in the non-surgery group(2.62 ± 0.70 vs.2.97 ± 0.37mmol/L),and the diastolic blood pressure in the surgery group was significantly lower than that in the non-surgery group(80.77 ± 5.55 vs.84.80 ± 5.44 mm Hg),the cardiovascular risk in the operation group was significantly lower than that in the non-operation group(2.23 ± 3.44 vs.6.13 ± 6.05),with statistical significance(P <0.05).After one year,the complete remission rate of diabetes(CR=76%)in the operation group was significantly higher than that of the non-operation group(CR=33%),the difference was statistically significant(P<0.05).The remission rate of lipid metabolism disorder(CR=60%)in the operation group was higher than that of non-operation group(CR=21.4%),the difference was statistically significant(P<0.05).the remission rate of hypertension(CR = 66.7%)in the operation group was higher than that of non-operation group(CR = 12.5%),the difference was statistically significant(P<0.05).After one-year follow-up,19 patients underwent laparoscopic Roux-en-Y gastric bypass(LRYGB),11 patients underwent laparoscopic sleeve gastrectomy,LSG),the total cholesterol and LDL-C of patients who underwent LRYGB was significantly lower than patients who underwent LSG(4.05 ± 0.54 vs 4.72 ± 1.16 mmol / L)(2.38 ± 0.57 vs 3.04 ± 0.74 mmol / L),the difference was statistically significant significance(P<0.05).In terms of complications,The complications of the operation group were: 1 cases of LRYGB patients had cholecystitis and gallstone,1 cases of anemia and hypoalbuminemia,and 1 cases of LSG patients had gastroesophageal refluxConclusion: Bariatric surgery can not only effectively improve obesity,body weight and BMI,but also may alleviate the complications caused by obesity,such as diabetes,hypertension and lipid metabolism disorders,and effectively reduce the risk of cardiovascular diseases.LRYGB is more obvious than the decrease of blood lipid in LSG.However,post-operative complications and the rebound of body weight are still a problem that cannot be ignored,which may require us to better manage patients’ lifestyle and psychology. |
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