Journal of metabolic and bariatric surgery最新文献

{"title":"Efficacy of Combined Lifestyle Interventions as a Complement to Bariatric Surgery (ECLIBS): Short Term Outcomes of a Pilot Study.","authors":"Pieter de Jong, Robert Smeenk, Miranda Janssen","doi":"10.17476/jmbs.2025.14.1.65","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.65","url":null,"abstract":"<p><strong>Purpose: </strong>Combined lifestyle interventions (CLI) is a program designed to treat (morbid) obesity and can possibly be an adjunct to bariatric surgery. Bariatric surgery can lead to 25-50% total weight loss (TWL) and up to 71% excess weight loss, yet the longevity of the weight reduction remains variable, primarily attributed to a lack of lifestyle change. This pilot study aims to assess the effect of a 3-year structured CLI program, additional to a 5-year bariatric surgery program in a regional hospital, on the short-term outcome following bariatric surgery.</p><p><strong>Materials and methods: </strong>A single-center prospective cohort study was performed on patients who underwent bariatric surgery between September 2021 and October 2022 (n=28). A structured CLI program was organized and offered by an official out-of-hospital CLI provider. CLI participants were matched with patients following regular follow-up. Primary outcome was quarterly measured excess weight loss (EWL). Secondary outcomes were TWL, fat measurements, sports participation and comorbidities.</p><p><strong>Results: </strong>There were significant differences in sports participation after 1 year (92.9% vs. 62.5%; P=0.050), EWL at 21 months (18.3 kg; 95% confidence interval [CI], 0.14-36.4; P=0.049), fat mass at 18 months (-8.7 kg; 95% CI, -14.1, -3.3; P=0.008) and fat percentage at 18 months (-10.0%; 95% CI, -17.9, -2.0; P=0.017) in the CLI group compared to the control group.</p><p><strong>Conclusion: </strong>Preliminary short-term results show that a structured additional CLI program to bariatric surgery could benefit in terms of weight loss, perhaps due to better sports participation, but long-term results have to be awaited for.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"65-75"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bariatric Surgery Reduces Lipid Profile and Oxidative Stress in Patients With Obesity: A Prospective Cohort Study.","authors":"Gabriela de Souza Bett, Fabiana Schuelter-Trevisol, Ricardo Reis do Nascimento, Bruna Barros Fernandes, Larissa Espindola da Silva, Mariella Reinol da Silva, Jefferson Luiz Traebert, Eliane da Silva Azevedo Traebert, Gislaine Tezza Rezin, Daisson José Trevisol","doi":"10.17476/jmbs.2025.14.1.32","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.32","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate inflammatory and biochemical parameters in the serum of patients with obesity before and after bariatric surgery.</p><p><strong>Materials and methods: </strong>An epidemiological study of the prospective cohort type was conducted to follow patients classified with grade II or III obesity undergoing bariatric surgery. Body mass index (BMI), lipid profile, C-reactive protein (CRP), reactive oxygen species production using dichlorofluorescein (DCF), and antioxidant defenses superoxide dismutase (SOD) and reduced glutathione (GSH) were analyzed before and 3 months after Roux-en-Y bariatric surgery.</p><p><strong>Results: </strong>A paired analysis was conducted, evaluating 23 patients in the pre- and post-surgical period. A statistically significant reduction was observed after bariatric surgery in BMI (P value<0.001), total cholesterol (CT) (P value=0.0006), total triglycerides (P value=0.0025), high-density lipoprotein cholesterol (P value=0.0010), low-density lipoprotein cholesterol (P value=0.0189), CRP (P value=0.0130), DCF (P value=0.0069), and GSH (P value<0.0001), as well as an increase in SOD activity (P value=0.0005).</p><p><strong>Conclusion: </strong>Bariatric surgery effectively reduced inflammatory and lipid markers and reversed oxidative stress, indicating that the procedure improves the health of bariatric patients across various parameters.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"32-42"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Korean Society for Metabolic and Bariatric Surgery (KSMBS) Position Statement on Female Candidates of Reproductive Age for Metabolic Bariatric Surgery.","authors":"Yoona Chung, In Cho, Yun Suk Choi, Yoo Min Kim, Yoontaek Lee, Shin-Hoo Park, Mi Ran Jung, In Gyu Kwon, Jongmin Kim, Sang Eok Lee, Jihun Kim, Seong-Ho Kong, Kyung Won Seo, Sung Il Choi, Jong-Han Kim, Tae Kyung Ha, Jin-Jo Kim, Young Suk Park, Moon-Won Yoo, Dong Jin Kim, Ji Yeon Park, Han Mo Yoo, Hyuk-Joon Lee, Sang Hyun Kim, Han Hong Lee, Do Joong Park, Sungsoo Park, Sang-Moon Han, Yong Jin Kim, Joong-Min Park, Seung-Wan Ryu, Sang Kuon Lee, Jee Yoon Park, Jong Won Kim","doi":"10.17476/jmbs.2025.14.1.1","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.1","url":null,"abstract":"<p><p>Obesity has emerged as a major global health issue. The ratio of male to female patients undergoing metabolic bariatric surgery (MBS) is 1:3.5. Although not as dramatic compared to the global trend, the rate of obesity in women of reproductive age in Korea has been steadily increasing over the past several decades. The impact of obesity on reproductive health and perinatal outcomes should be carefully considered when consulting female candidates of reproductive age for MBS. Obesity adversely affects reproductive health by causing menstrual irregularities, anovulation, subfertility, and increased miscarriage risk, as well as impairing the success of assisted reproductive technologies. Maternal obesity also heightens the risk of adverse perinatal outcomes, including childhood obesity and metabolic disorders. MBS has been shown to improve fertility outcomes and reduce obesity-related pregnancy complications, although concerns remain regarding potential risks such as small-for-gestational-age infants due to rapid weight loss and nutritional deficiencies. Despite these implications, current MBS guidelines rarely address the unique needs of reproductive-age women. In response, the Korean Society for Metabolic and Bariatric Surgery convened a task force to develop evidence-based recommendations tailored to this population. This position statement aims to guide the management of obesity in women of reproductive age to optimize reproductive and perinatal outcomes.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bariatric Surgery for a Patient With Myosin Heavy Chain 9-Related Disorders (MYH9RD): A Case Report.","authors":"Sa-Hong Kim, Kyoyoung Park, Chungyoon Kim, Jeesun Kim, Seong-Ho Kong, Hyuk-Joon Lee, Han-Kwang Yang, Do-Joong Park","doi":"10.17476/jmbs.2025.14.1.81","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.81","url":null,"abstract":"<p><p>Myosin heavy chain 9-related disorders (MYH9RD) are rare autosomal dominant genetic conditions caused by <i>MYH9</i> mutations, leading to macrothrombocytopenia, renal complications such as focal segmental glomerulosclerosis (FSGS), and other systemic manifestations. We report a case of 28-year-old male with MYH9RD and body mass index exceeding 47 kg/m², who successfully underwent laparoscopic sleeve gastrectomy. Despite challenges from bleeding tendency caused by macrothrombocytopenia and renal impairment caused by FSGS, thorough preoperative evaluation and management, including platelet transfusion, enabled surgery to proceed without complications. The patient achieved significant weight loss, from 147.6 kg preoperatively to 90.15 kg at 1 year postoperatively, with improvements in hypertension and metabolic parameters, including aspartate aminotransferase/alanine aminotransferase, hemoglobin A1c, triglycerides, and low-density lipoprotein levels. While MYH9RD is not directly associated with morbid obesity, this case highlights that comprehensive preoperative evaluation and risk management can lead to successful outcomes in bariatric surgery for MYH9RD patients.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"81-84"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laparoscopic Single-Anastomosis Duodenal-Jejunal Bypass With Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass on Short-term Outcomes in Patients With Obesity.","authors":"Sang Hyun Kim","doi":"10.17476/jmbs.2025.14.1.43","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.43","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare postoperative course of laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy (SADJB-SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) during a 1-year follow-up period.</p><p><strong>Materials and methods: </strong>Electronic medical records of all patients who underwent SADJB-SG and RYGB between March 2019 and June 2021 at a single institution were retrospectively reviewed. Surgical outcomes, weight loss, resolution of co-morbidities, episode of dumping syndrome, and marginal ulcer at endoscopy were assessed.</p><p><strong>Results: </strong>Eighty-four patients who underwent SADJB-SG and RYGB were enrolled. One-year follow-up rate was 78.6%. There were no significant differences in operative time, estimated blood loss, length of postoperative stay, postoperative complications, readmission, or reoperation rate between SADJB-SG and RYGB. Percent of total weight loss (%TWL) was 26.9±9.3% in SADJB-SG and 29.6±7.6% in RYGB (P=0.209). Remission rates of T2DM, hypertension, dyslipidemia, and GERD were 78.3%, 63.6%, 44.4%, and 40% in SADJB-SG and 71.4%, 52.9%, 56.2%, and 12.5% in RYGB (P=0.318, P=0.480, P=0.417, and P=0.561), respectively. Episodes of dumping syndrome and marginal ulcer at endoscopy showed rates of 0% and 0% in SADJB-SG and 33.4% and 15.8% in RYGB (P=0.002 and P=0.043), respectively.</p><p><strong>Conclusion: </strong>SADJB-SG is comparable to RYGB in terms of perioperative outcomes, weight loss, and resolution of co-morbidities. It is advantageous in terms of dumping syndrome and marginal ulcer during 1-year follow-up.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Between Liver-to-Spleen Hounsfield Unit Ratio and Metabolic Improvement in Patients With Bariatric Surgery.","authors":"Sin Hye Park, Dong Jin Kim","doi":"10.17476/jmbs.2025.14.1.24","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.24","url":null,"abstract":"<p><strong>Purpose: </strong>Non-alcoholic fatty liver disease (NAFLD) is becoming increasingly common, especially among obese individuals. This study evaluated the liver/spleen Hounsfield unit (HU) ratio (L/S ratio) as an indicator of steatosis and related metabolic diseases using contrast-enhanced computed tomography (CT).</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 34 patients who underwent bariatric surgery at Eunpyeong St. Mary's Hospital between March 2019 and July 2023. All patients underwent CT scans before and 6 months after surgery. The L/S ratio was calculated by dividing the average value of 3 HU of the liver by that of the spleen. The ratio correlated with pre- and post-surgery weight changes, comorbidities, and laboratory findings.</p><p><strong>Results: </strong>The mean preoperative body mass index (BMI) was 40.5. Post-surgery, BMI significantly decreased to 31.5, and the number of patients with diabetes reduced from 18 (52.9%) to 4 (11.8%). Significant reductions were observed in hemoglobin A1c (HbA1c), aspartate transaminase (AST), and alanine transaminase (ALT) levels after surgery. The L/S ratio increased from 0.7±0.2 to 0.9±0.1, correlating with liver function improvements and weight loss (all with P<0.001). Patients with a larger change in L/S ratio demonstrated more significant improvements in AST, ALT, and HbA1c levels and a higher total weight loss percentage.</p><p><strong>Conclusion: </strong>This study demonstrated a strong correlation between changes in the L/S ratio and metabolic improvements, including diabetes remission, following bariatric surgery. The L/S ratio could serve as a valuable index for assessing NAFLD severity and monitoring the outcomes in patients undergoing bariatric surgery.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Non-invasive Methods for Diagnosis of Non-alcoholic Fatty Liver Disease Before Bariatric Surgery and Postoperative Follow-up in Obese Patients.","authors":"Ji-Hyeon Park, Seong Min Kim, Dae Ho Lee","doi":"10.17476/jmbs.2025.14.1.53","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.53","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to identify the most accurate and useful non-invasive method to replace liver biopsy for the diagnosis of non-alcoholic fatty liver disease (NAFLD) before bariatric surgery and postoperative follow-up in morbidly obese patients.</p><p><strong>Materials and methods: </strong>This single-center study is a retrospective analysis of prospectively collected data from 68 morbidly obese patients who underwent laparoscopic sleeve gastrectomy with intraoperative liver biopsy. Preoperative non-invasive diagnostic methods, including fatty liver index, NAFLD fibrosis score, enhanced liver fibrosis score, FibroScan, magnetic resonance imaging-proton density fat fraction (MRI-PDFF), magnetic resonance spectroscopy (MRS)-PDFF, and magnetic resonance elastography (MRE) were compared against liver biopsy results. Diagnostic performance was assessed using Spearman's correlation and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Liver biopsy confirmed the presence of steatosis in 92.7% of patients, Nonalcoholic Steatohepatitis (NASH) in 64.7%, and liver fibrosis (≥F1) in 72.0%. MRI-PDFF and MRS-PDFF demonstrated the highest diagnostic accuracy for NASH, with the strongest correlation with histological findings. For liver fibrosis, MRE showed the strongest correlation with histological fibrosis stage, while FibroScan-Liver Stiffness Measurement (LSM) demonstrated better diagnostic performance in ROC analysis. However, the overall diagnostic quality of non-invasive methods for fibrosis assessment remained modest, with no method achieving a quality value above 0.6.</p><p><strong>Conclusion: </strong>MRI-PDFF and MRS-PDFF were the most accurate noninvasive methods for diagnosing NASH in morbidly obese patients. For liver fibrosis, FibroScan-LSM may be more suitable for detection, while MRE may better reflect fibrosis severity. Further studies are needed to assess the cost-effectiveness and clinical applicability of these methods.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"53-64"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Surgical Outcomes of Metabolic and Bariatric Surgery for Super Obesity in Korean Morbidly Obese Patients.","authors":"Jin-Jo Kim","doi":"10.17476/jmbs.2025.14.1.76","DOIUrl":"https://doi.org/10.17476/jmbs.2025.14.1.76","url":null,"abstract":"<p><strong>Purpose: </strong>To know about the feasibility and effectiveness of metabolic/bariatric surgery (MBS) in Korean super obese patients.</p><p><strong>Materials and methods: </strong>We reviewed the medical records of 18 super obese (body mass index [BMI] ≥50 kg/m²) patients among 131 morbidly obese patients who underwent MBS at Incheon St. Mary's Hospital, the Catholic University of Korea from May 2011 to July 2024 and investigated the early surgical outcomes of these patients.</p><p><strong>Results: </strong>Male/female ratio was 10 to 8, the mean age was 35.4±10.6 year, the mean body weight was 161.6±35.2 (range 112.9-241) kg, and the mean BMI was 58.3±8.2 (range 50.0-78.7) kg/m². Sleeve gastrectomy (SG) was performed in 10 patients, SG plus procedure (SG+) in 5 patients, single anastomosis duodenoileal bypass with SG (SADI-S) in 2 patients and long biliopancreatic limb Roux-en-Y gastric bypass (LBPL RYGB) in 1 patient. The mean operation time was 170.3±64.5 minute and the mean postoperative hospital stay was 9±4.6 day. There was no postoperative morbidity and no mortality. The percentage of total weight loss at 1 year after surgery was 34.3±0.6% in SG, 23.1±3.2% in SG+, 45.8±4.5% in SADI-S and 47% in LBPL RYGB.</p><p><strong>Conclusion: </strong>MBS was feasible and effective in Korean super obese patients. However, SG+ was less effective than expected in these patients.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"14 1","pages":"76-80"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Quality of Morbidly Obese Patients After Bariatric Surgery.","authors":"Yoonhong Kim, Ae Ri Yang, Kwangwook Koh, Kyung Won Seo, Ki Hyun Kim","doi":"10.17476/jmbs.2024.13.2.39","DOIUrl":"10.17476/jmbs.2024.13.2.39","url":null,"abstract":"<p><strong>Purpose: </strong>Obesity is a major risk factor for obstructive sleep apnea (OSA), associated with conditions like type 2 diabetes, hypertension, stroke, cancer, and premature death. OSA involves sleep-breathing interruptions, with over 60% of obese individuals diagnosed through polysomnography. This study explores sleep issues in individuals considering bariatric surgery.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed sleep study records and questionnaires of 137 obese patients undergoing metabolic surgery at Kosin University Gospel Hospital between January 1, 2019, and September 30, 2022. Statistical tests, including Student's t-test and logistic regression, assessed subjective and objective characteristics.</p><p><strong>Results: </strong>Most subjects, predominantly female with comorbidities, exhibited poor sleep quality. Positive correlations between polysomnography and subjective evaluation indicated poor results. Logistic regression revealed increased OSA likelihood with higher Apnea-Hypopnea Index, with associations to sex, age, and body mass index (BMI).</p><p><strong>Conclusion: </strong>Regardless of BMI, most patients with a BMI ≥30 kg/m² undergoing bariatric surgery were diagnosed with OSA, experiencing poor subjective and objective sleep quality. Correlations between subjective and objective evaluations were significant, with sex, advanced age, and high BMI identified as significant OSA risk factors.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"13 2","pages":"39-49"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HbA1c Reductions Following Sleeve Gastrectomy Versus Sleeve Gastrectomy With Proximal Jejunal Bypass: Significant Differences in Diabetic Patients.","authors":"Eunhye Seo, Seung Wan Ryu","doi":"10.17476/jmbs.2024.13.2.71","DOIUrl":"10.17476/jmbs.2024.13.2.71","url":null,"abstract":"<p><p>Sleeve gastrectomy with proximal jejunal bypass (SG with PJB) is often preferred for patients with higher body mass index (BMI) and inadequate glycemic control. This study aimed to compare the outcomes of SG and SG with PJB, focusing on glycemic control and BMI in prediabetic and diabetic patients. Preoperative analysis revealed differences in age and hemoglobin A1c (HbA1c) levels between groups: SG with PJB patients were older (38.72±9.75 vs. 34.93±10.90 years, P=0.002) and had higher HbA1c levels (7.25±1.76 vs. 5.86±0.78%, P<0.001). Patients were stratified into prediabetic and diabetic groups. In the prediabetic group, no preoperative differences were observed between the surgical groups. However, in the diabetic group, patients in the SG with PJB had lower BMI (37.77±5.83 vs. 41.08±8.5 kg/m², P=0.034) and higher HbA1c levels (7.88±1.72 vs. 6.51±1.37%, P<0.001) compared to the SG, despite stratification. Postoperatively, SG with PJB led to significantly lower BMI at 3 months compared to SG, but this difference was not sustained at 6 and 12 months in the prediabetic group. In diabetic patients, SG with PJB resulted in significantly greater reductions in HbA1c levels compared to SG, even when adjusted for BMI as a covariate. At the 12-month follow-up, although SG with PJB still showed higher HbA1c levels than SG (5.79±0.78 vs. 5.59±0.44%, P=0.031), the difference was smaller compared to the preoperative period, where SG with PJB had significantly higher levels (7.88±1.72 vs. 6.51±1.37%, P<0.001). These findings suggest that SG with PJB may offer superior glycemic control in morbidly obese diabetic patients.</p>","PeriodicalId":73828,"journal":{"name":"Journal of metabolic and bariatric surgery","volume":"13 2","pages":"71-77"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}