Longitudinal analysis of cardiovascular parameters after gastric bypass surgery
Longitudinal analysis of cardiovascular parameters after gastric bypass surgery
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DOI：
10.1016/j.soard.2011.09.020
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发表时间：
2012-11-01
影响因子：
3.1
通讯作者：
Chernoff, Arthur
中科院分区：
文献类型：
--
作者：
Dallal, Ramsey M.;Hatalski, Amanda;Chernoff, Arthur
Background: Identifying the predictors of co-morbidity improvement after gastric bypass surgery (Roux-en-Y gastric bypass) might give insight into disease pathophysiology.Methods: We performed an observational study of 949 patients undergoing primary RYGB from 2005 to 2010. Multivariate mixed models were used to determine the predictors of change in hemoglobin Ale (HbA1c), lipids, systemic blood pressure, and C-reactive protein.Results: Greater weight loss, decreased severity of initial disease, and a greater initial body mass index predicted a significantly greater likelihood of improvement in nearly all measured parameters. Male gender predicted greater improvement in diastolic blood pressure and low-density lipoprotein and triglyceride levels. Younger patients had a greater improvement in blood pressure. Improvement in the lipid profile was independent of weight loss, and improved glycemic control was strongly dependent on weight loss. Of the 949 patients, 33% had diabetes before RYGB. A mean of 388 days after RYGB, 66% of these patients had an HbA1c of = 200 mg/dL before RYGB and only 1.1% did so afterward. The mean C-reactive protein level decreased from 5.0 to 1.6 mg/dL. We measured a 20% reduction in patients with measured hypertension after RYGB.Conclusion: RYGB resulted in dramatic improvement in cardiovascular risk factors, with several significant predictors of outcome. (Surg Obes Relat Dis 2012;8:703-709.) (C) 2012 American Society for Metabolic and Bariatric Surgery. All rights reserved.
