Document Detail


Health benefits of gastric bypass surgery after 6 years.
MedLine Citation:
PMID:  22990271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Extreme obesity is associated with health and cardiovascular disease risks. Although gastric bypass surgery induces rapid weight loss and ameliorates many of these risks in the short term, long-term outcomes are uncertain.
OBJECTIVE: To examine the association of Roux-en-Y gastric bypass (RYGB) surgery with weight loss, diabetes mellitus, and other health risks 6 years after surgery.
DESIGN, SETTING, AND PARTICIPANTS: A prospective Utah-based study conducted between July 2000 and June 2011 of 1156 severely obese (body mass index [BMI] ≥ 35) participants aged 18 to 72 years (82% women; mean BMI, 45.9; 95% CI, 31.2-60.6) who sought and received RYGB surgery (n = 418), sought but did not have surgery (n = 417; control group 1), or who were randomly selected from a population-based sample not seeking weight loss surgery (n = 321; control group 2).
MAIN OUTCOME MEASURES: Weight loss, diabetes, hypertension, dyslipidemia, and health-related quality of life were compared between participants having RYGB surgery and control participants using propensity score adjustment.
RESULTS: Six years after surgery, patients who received RYGB surgery (with 92.6% follow-up) lost 27.7% (95% CI, 26.6%-28.9%) of their initial body weight compared with 0.2% (95% CI, -1.1% to 1.4%) gain in control group 1 and 0% (95% CI, -1.2% to 1.2%) in control group 2. Weight loss maintenance was superior in patients who received RYGB surgery, with 94% (95% CI, 92%-96%) and 76% (95% CI, 72%-81%) of patients receiving RYGB surgery maintaining at least 20% weight loss 2 and 6 years after surgery, respectively. Diabetes remission rates 6 years after surgery were 62% (95% CI, 49%-75%) in the RYGB surgery group, 8% (95% CI, 0%-16%) in control group 1, and 6% (95% CI, 0%-13%) in control group 2, with remission odds ratios (ORs) of 16.5 (95% CI, 4.7-57.6; P < .001) vs control group 1 and 21.5 (95% CI, 5.4-85.6; P < .001) vs control group 2. The incidence of diabetes throughout the course of the study was reduced after RYGB surgery (2%; 95% CI, 0%-4%; vs 17%; 95% CI, 10%-24%; OR, 0.11; 95% CI, 0.04-0.34 compared with control group 1 and 15%; 95% CI, 9%-21%; OR, 0.21; 95% CI, 0.06-0.67 compared with control group 2; both P < .001). The numbers of participants with bariatric surgery-related hospitalizations were 33 (7.9%), 13 (3.9%), and 6 (2.0%) for the RYGB surgery group and 2 control groups, respectively.
CONCLUSION: Among severely obese patients, compared with nonsurgical control patients, the use of RYGB surgery was associated with higher rates of diabetes remission and lower risk of cardiovascular and other health outcomes over 6 years.
Authors:
Ted D Adams; Lance E Davidson; Sheldon E Litwin; Ronette L Kolotkin; Michael J LaMonte; Robert C Pendleton; Michael B Strong; Russell Vinik; Nathan A Wanner; Paul N Hopkins; Richard E Gress; James M Walker; Tom V Cloward; R Tom Nuttall; Ahmad Hammoud; Jessica L J Greenwood; Ross D Crosby; Rodrick McKinlay; Steven C Simper; Sherman C Smith; Steven C Hunt
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  308     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-19     Completed Date:  2012-09-20     Revised Date:  2013-08-20    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1122-31     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Utah School of Medicine, 420 Chipeta Way, Room 1160, Salt Lake City, UT 84108, USA. ted.adams@utah.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiovascular Diseases / epidemiology
Case-Control Studies
Diabetes Mellitus
Female
Follow-Up Studies
Gastric Bypass*
Health Status*
Humans
Male
Middle Aged
Obesity / physiopathology,  surgery*
Quality of Life
Risk
Risk Factors
Weight Loss
Young Adult
Grant Support
ID/Acronym/Agency:
DK-55006/DK/NIDDK NIH HHS; M01-RR00064/RR/NCRR NIH HHS; R01 DK055006/DK/NIDDK NIH HHS
Comments/Corrections
Comment In:
JAMA. 2012 Sep 19;308(11):1160-1   [PMID:  22990275 ]
Nat Rev Endocrinol. 2012 Nov;8(11):626   [PMID:  23032178 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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