DOES GASTRIC RESTRICTION SURGERY REDUCE THE RISKS OF METABOLIC DISEASES

Background: Certain risk factors for arteriosclerosis are associated w ith obesity, e.g. hypertension, insulin resistance, the high triglycer ide - low HDL pattern. One aim in treating morbid obesity is to reduce these risk factors. This study was designed to follow metabolic risk factors after weight loss in 165 morbidly obese patients who underwent a gastric restriction operation. Methods and Patients: Lipid and horm one levels were analyzed before surgery and after 25, 50, 75 and 100% loss of excess weight. Mean cholesterol and triglyceride levels were n ormal or slightly elevated. HDL cholesterol was also normal (41 mg/dl) . Thirty eight percent of the patients had elevated cholesterol and tr iglyceride levels. Insulin levels were measured as an indicator of pot ential insulin resistance, and with a mean of 21 mu U/ml it was at the upper normal level. Results: After reaching 75% reduction of overweig ht in a mean time of 10 months, serum cholesterol levels were unchange d. Serum triglycerides, however, decreased by 35% (P < 0.0001) and HDL cholesterol increased by 24% (P < 0.0001). Insulin levels decreased t o 8 mu U/ml (P < 0.0001). Conclusion: We found an amelioration in the metabolic parameters in 75% of the patients. Nevertheless morbidly obe se patients were found to have fewer abnormalities in lipid and glucos e metabolism than expected from data of overweight patients with metab olic syndrome. Further long-term studies with careful evaluation of th e metabolic parameters as risk factors in patients with morbid obesity need to be performed. (C) 1998 Rapid Science Ltd.