The duodenal switch for morbid obesity: modification of cardiovascular risk markers compared with standard bariatric surgeries

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• 作者：Daniel Nelson ; D.O. ; Rees Porta ; M.D. ; Kelly Blair ; M.D. ; Preston Carter ; M.D. ; Matthew Martin ; M.D. ; ^{matthew.martin1@us.army.mil}
• 关键词：Biliopancreatic diversion ; Duodenal switch ; Laparoscopic ; Morbid obesity ; Weight loss ; Cardiovascular risk ; C-reactive protein
• 刊名：The American Journal of Surgery
• 出版年：2012
• 期刊代码：9_00029610
• 类别：med
• 出版时间：May, 2012
• 卷：203
• 期：5
• 页码：603-608
• 文件大小：226 K

摘要

<h4 class="h4">Backgroundh4>Obesity is associated with cardiovascular risk factors such as lipid levels and increased levels of C-reactive peptide (CRP). We hypothesized that duodenal switch (DS) would show equivalent or superior risk reduction compared with standard bariatric surgeries.<h4 class="h4">Methodsh4>

Patients underwent DS, sleeve gastrectomy (SG), or gastric bypass (GB) over a 2-year period. Body mass index (BMI), lipid panel, and CRP were measured preoperatively and then 3, 6, and 12 months postoperatively.<h4 class="h4">Resultsh4>

A total of 130 patients were identified; 42 underwent DS, 40 underwent SG, and 48 underwent GB. All groups had similar sex and comorbidity profiles, but the mean preoperative BMI was greatest in the DS group (mean = 52). At all intervals weight loss was greater in the DS group (P < .01), with a final BMI of 31 for the DS group, 31 for the SG group, and 28 for the GB group. Cholesterol and low-density lipoprotein showed significantly greater improvement at all time points with DS compared with SG and GB (P < .01). Baseline CRP levels among DS patients were double that of SG and GB, but rapidly declined to equivalent levels by 3 months and normalized in 79%.<h4 class="h4">Conclusionsh4>

The DS procedure resulted in a superior reduction in cardiovascular and proinflammatory risk markers compared with GB and SG.