Profiles of patients qualified for bariatric surgeries with Roux-en-Y gastric bypass and sleeve gastrectomy methods

Abstract

Introduction: Bariatric surgery is one of the methods of extreme obesity treatment used in case of patients with body mass index (BMI) ≥ 40 kg/m2 or BMI ≥ 35 kg/m2 and accompanying diseases (e.g. hypertension) for whom previous conservative treatment was not successful. Aim of the study: To determine the anthropometric and biochemical profiles of patients qualified for Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Material and methods: The study involved 60 patients qualified for surgical treatment. The standardized Food Frequency Questionnaire supplemented by a survey which contained questions on previous attempts to lose weight and their results (including yo-yo effect) were administered. The anthropometric measurements included weight, height, waist and hip circumference. Biochemical analysis of blood (lipid profile, liver profile, glucose, glycated haemoglobin and C-reactive protein) were performed using calorimetric method. All the results were statistically analysed using the STATISTICA 12 software. Results: The patients had a history of numerous attempts (≥ 6) to lose weight using unbalanced diets. Women qualified for SG had higher levels of parameters indicating the presence of inflammatory state, dyslipidaemia and improper glycaemia. Men qualified for RYGB had significantly higher values of γ-glutamyl transpeptidase. Conclusions: Numerous unsuccessful attempts to lose weight can signify a low level of nutritional knowledge and the need to educate the patients both before and after the surgery. Patients at higher perioperative risk (due to anthropometric and biochemical parameters) were qualified to less invasive surgery treatment. Higher risk of developing cholelithiasis after the surgery would be attributed to irrational attempts of body weight loss before the procedure, and not to the RYGB itself. KeY wOrds: bariatric surgery, obesity, diet, cholestasis, dyslipidemias. address fOr cOrrespOndence: Małgorzata Szczuko, Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 24 Broniewskiego St., 71-460 Szczecin, Poland, e-mail: malgorzata.szczuko@pum.edu.pl DOI: https://doi.org/10.5114/jhi.2020.96972 IntroductIon Obesity is a problem which has affected humanity for centuries. In the past it was sometimes considered a sign of prosperity, wealth and high social class. However, with the development and progress of civilization obesity became increasingly common and threatening to population health, and is regarded as an epidemic of the 20th and 21st centuries [1, 2]. Bariatric surgery has been recognized as the most effective treatment of pathological obesity, with a high percentage of weight reduction and a relatively small number of complications. Currently, the most frequent bariatric procedures are sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) [3]. SG is a restrictive surgery technique. It consists of an almost entire resection of the stomach along the greater curvature and formation on a passage based on