Study On Changing Of Weight,Glucose And Lipids In Patients With Obesity After Bariatric Surgery

Objective1.To observe postoperative weight,glucose and lipids levels after bariatric surgery patients.2.Analysis of the differences in postoperative weight,glucose and lipids between laparoscopic Roux-en-Y gastric bypass surgery(LRYGB)and laparoscopic gastric sleeve(LSG).MethodPatients undergoing bariatric surgery included LRYGB and LSG at Obesity and Metabolic Surgery in a top three hospital in Guangzhou from October 2016 to November 2018.Weight,serum glucose(Glu),glycated hemoglobin(HbA1c),total cholesterol(TC),high-density lipoprotein(HDL-c),low-density lipoprbariatric(LDL-c),and triacylglycerol(TG)levels were collected before and one month and six months after bariatric surgery,body mass index(BMI),percentage of excess weight loss(%EWL)were calculated on the basis of weight.After that,contrast the differences of weight,glucose and lipids before and after surgery firstly,and then contrast the differences between two surgical methods.Results1.Totally 65 patients were enrolled,39(60%)males and 26(40%)females,34(52.3%)patients with LRYGB,and 31(47.7%)patients with LSG,there did not have a significant difference in the gender and surgical methods(P>0.05).2.There had significant differences in body weight,BMI,%EWL,glucose and lipid metabolism between the 1 month and the 6 months after surgery(P<0.05).The baseline of body weight and BMI were 114.77±27.65kg and 40.60±8.77kg/m~2 which were decreased by 27%in 6months after surgery,the body weight and BMI had been decreased to 83.70±20.52kg and29.61±6.43kg/m~2 after 6 months.The median%EWL was 31.4%(24.9,40.8)in 1 months and61.4%(47.4,74.6)in 6 months,there was significant difference in the%EWL between the two groups(P<0.05).The glucose and lipids metabolism index were postoperative,the decline was greatest in 1 month,the TG and Glu levels were decreased most significantly.All the glucose and lipids in 6 months were lower than pre-operation except HDLc(P<0.05),the TC,HDL-c,TG levels were increased to different degrees,but overall was lower than preoperative,LDL-c,Glu,HbA1c showed a continuous downward trend with the largest per-operative,which was 57%lower than per-operative.3.There was no statistically significant difference in the%EWL between the LRYGB group and the LSG Group(P>0.05),but the trend of the two groups was difference with statistically significant(P<0.05),the LSG group was more rapid than the LRYGB.The weight and BMI of the LRYGB and the LSG were a significant difference(P<0.05),LRYGB group was higher than LSG,the weight and BMI of LRYGB group were 92.88±22.22kg and 32.55±7.02kg/m~2 in 6months after operation,the weight and BMI of LRYGB group were 73.11±11.65kg and26.22±3.38kg/m~2,the weight and BMI were with the same trend of time.The Glu of the LRYGB group was higher than the LSG(P<0.05),the median Glu of LRYGB and LSG were 5.46(5.16,6.07)mmol/L and 5.28(4.79,5.52)mmol/L in 1 months after surgery,and 5.156(4.80,5.49)mmol/L and 4.85(4.58,5.26)mmol/L in 6 months after surgery,the time and operative interaction effect of the two groups of Glu were not different.There was no difference in others glucose and lipids between LRYGB and LSG(P>0.05).Conclusion1.The weight and BMI of the patients decreased significantly after bariatric surgery,and it was effective in treating obesity(%EWL>50%).2.The glucose and lipids was improved after bariatric surgery.3.The LRYGB were with higher weight and BMI than the LSG in 6 months after surgery,there was no difference in the%EWL between two groups,so there has no difference in weight loss LRYGB and LSG.4.The LRYGB was with higher Glu than the LSG in 6 months after surgery,there was no difference in others glucose and lipids between LRYGB and LSG.