Introduction
Materials and Methods
Study Design, Ethics, and Participants
Procedures and Data Collection
Assessment of Weight Change
Definition of Cardiometabolic Comorbidities
Definition of Cardiometabolic Comorbidity Resolution
Surgical Technique
Nutritional Deficiency Management Protocol
Statistical Analysis
Results
Changes of Anthropometric Parameters
Parameter | Preop
M (SD) | Postopa
M (SD) |
P
| Difference
M (SD) |
---|---|---|---|---|
Weight | 126.15 (22.76) | 78.5 (13.17) | < 0.0001 | 51.82 (28.05) |
BMI (kg/m2) | 46.04 (5.99) | 28.30 (6.07) | < 0.0001 | 17 (6.24) |
EW (kg) | 66 (19.54) | 21 (14.9) | < 0.0001 | 47.94 (19.84) |
EWL (%) | – | 81.08 (19.65) | – | – |
Changes of Nutritional Parameters
Parameter | Normal values (unit) | Preop | Postopa
| Difference
M ± SD |
P
|
---|---|---|---|---|---|
M ± SD |
M ± SD | ||||
Hemoglobin | |||||
Male | 13.8–16 (mg/dL) | 14.10 ± 1.25 | 14.43 ± 2.01 | 0.28 ± 1.9 | 0.40 |
Female | 12.1–16 (mg/dL) | 12.52 ± 1.15 | 12.29 ± 1.34 | 0.22 ± 1.1 | 0.17 |
Hematocrit | |||||
Male | 34.8–43.9 (%) | 43.3 ± 2.93 | 44.79 ± 2.42 | 1.3 ± 2.8 | 0.01 |
Female | 34–40.7 (%) | 38.73 ± 2.89 | 38.01 ± 3.68 | − 0.74 ± 3.74 | 0.21 |
MCV | 83–101 (f/L) | 81.16 ± 6.03 | 83.45 ± 6.68 | 2.29 ± 4.12 | < 0.0001 |
Iron | 5.4–28.6 (μmol/L) | 10.31 ± 4.87 | 15.11 ± 7.87 | 4.80 ± 4.89 | < 0.0001 |
Ferritin | 11–304 (mcg/L) | 29.50 ± 25.19 | 34.72 ± 37.79 | 5.22 ± 25.62 | 0.64 |
Total protein | 64–83 (g/L) | 73 ± 4.16 | 69.88 ± 4.63 | − 3.13 ± 5.36 | < 0.0001 |
Albumin | 40–150 (mg/L) | 41.14 ± 4.06 | 40.38 ± 4.67 | − 0.77 ± 4.16 | 0.13 |
Calcium | 2.1–2.5 (mmol/L) | 2.28 ± 0.12 | 2.55 ± 1.79 | 0.28 ± 1.81 | 0.32 |
Magnesium | 0.72–1.04 (mmol/L) | 0.81 ± 0.04 | 0.81 ± 0.04 | 0.00 ± 0.06 | 0.91 |
Phosphate | 0.89–1.66 (mmol/L) | 1.55 ± 0.22 | 1.50 ± 0.19 | − 0.05 ± 0.15 | 0.40 |
Zinc | 10.1–16.8 (μmol/L) | 12.75 ± 1.25 | 11.98 ± 1.22 | − 0.77 ± 1.84 | 0.28 |
Copper | 11–22 (μmol/L) | 21.32 ± 2.26 | 16.87 ± 3.45 | − 4.45 ± 3.91 | 0.04 |
Vitamin D | 30–50 (ng/mL) | 11.73 ± 6.06 | 17.73 ± 9.33 | 6.00 ± 11.11 | < 0.0001 |
Vitamin B12 | 133–675 (pmol/L) | 256.51 ± 106.71 | 271.22 ± 227.64 | − 14.71 ± 229.17 | 0.036 |
Folic acid | 4–45 (nmol/L) | 20.41 ± 11.30 | 14.40 ± 10.74 | − 6.01 ± 12.42 | 0.07 |
Parameter | Preop
N (%) | Postopa
N (%) |
P
b
| De novo
N (%) |
---|---|---|---|---|
Hemoglobin | ||||
Male | 13 (39.4) | 5 (15.2) | 0.02 | 1 (3.0) |
Female | 13 (31.7) | 12 (29.3) | 0.99 | 4 (9.8) |
Hematocrit | ||||
Male | 0 (0) | 2 (5.9) | NA | 5 (5.9) |
Female | 2 (4.9) | 4 (9.8) | 0.69 | 4 (9.8) |
MCV (micro def.)d
| ||||
Male | 7 (20.6) | 2 (5.9) | 0.06 | 0 (0) |
Female | 11 (27.5) | 8 (20) | 0.45 | 2 (5) |
Iron | 5 (20.8) | 4 (16.7) | 0.99 | 1 (4.2) |
Ferritin | 2 (33.3) | 2 (33.3) | 0.99 | 1 (16.7) |
Total protein | 0 (0) | 3 (4.6) | NA | 3 (4.6) |
Albumin | 21 (29.6) | 27 (38) | 0.29 | 14 (19.7) |
Calcium | 2 (4.7) | 2 (4.7) | 0.99 | 1 (2.3) |
Magnesium | 0 (0) | 0 (0) | NA | 0 (0) |
Phosphate | 0 (0) | 0 (0) | NA | 0 (0) |
Zinc | 0 (0) | 0 (0) | NA | 0 (0) |
Copper | 0 (0) | 1 (16.7) | NA | 1 (16.7) |
Vitamin D | 54 (96.4) | 50 (89.3) | 0.29 | 2 (3.6) |
Vitamin B12 | 3 (6.7) | 6 (15.3) | 0.38 | 4 (8.9) |
Folic acid | 0 (0) | 0 (0) | NA | 0 (0) |
Evolution of Nutritional Deficiencies (De Novo Cases)
Changes of Cardiometabolic Parameters
Parameter | Normal value (unit) | Preop
M ± SD | Postopa
M ± SD | Difference
M ± SD |
P
|
---|---|---|---|---|---|
TC | < 5.17 (mmol/L) | 4.57 ± 0.74 | 4.28 ± 0.61 | 0.29 ± 0.78 | 0.02 |
LDL | < 3.36 (mmol/L) | 2.92 ± 0.78 | 2.67 ± 0.66 | 0.26 ± 0.73 | 0.04 |
HDL | > 1 (mmol/L) | 1.14 ± 0.26 | 1.29 ± 0.33 | − 0.14 ± 0.27 | 0.003 |
TG | < 1.7 (mmol/L) | 1.13 ± 0.47 | 0.83 ± 0.41 | 0.30 ± 0.50 | 0.001 |
ALT | 9–24 (U/L) | 31.03 ± 19.54 | 17.68 ± 15.67 | 13.35 ± 19.40 | < 0.0001 |
AST | 13–26 (U/L) | 23.12 ± 9.79 | 18.14 ± 8.85 | 4.98 ± 11.85 | 0.002 |
FBG | 3.5–5.5 (mmol/L) | 5.71 ± 3.14 | 4.85 ± 2.05 | 0.86 ± 2.18 | 0.006 |
HbA1c | 4.8–6 (%) | 6.55 ± 2.61 | 5.48 ± 1.44 | 1.07 ± 1.59 | 0.001 |
PTH | 15–65 (pg/mL) | 56.58 ± 23.23 | 52.83 ± 40.54 | 3.75 ± 42.30 | 0.77 |
Uric Acid | 150–350 (mmol/L) | 355 ± 67.97 | 356 ± 85.52 | − 1.11 ± 38.58 | 0.93 |
Evolution of Cardiometabolic Risk Factors (De Novo Cases)
Parameter | Preop | Postopa
|
P
b
| Remission | De novo |
---|---|---|---|---|---|
N (%) |
N (%) |
N (%) |
N (%) | ||
TC | 10 (20.8) | 3 (6.3) | 0.06 | 13 (29.5) | 4 (9.1) |
LDL | 11 (66.1) | 7 (38.9) | < 0.0001 | 8 (21.1) | 2 (5.37) |
HDL | 12 (32.4) | 7 (18.9 | 0.27 | 37 (100) | 0 (0) |
TG | 4 (10.3) | 1 (2.6) | 0.38 | 35 (83.3) | 0 (0) |
ALT | 29 (45.3) | 7 (10.9) | < 0.0001 | 22 (75.9) | 0 (0) |
AST | 14 (24.1) | 5 (8.6) | 0.03 | 12 (85.7) | 3 (5.2) |
Prediabetes | 17 (12.6) | 4 (5.0) | < 0.0001 | 17 (100.0) | 0 (0) |
T2DM | 10 (12.6) | 6 (7.6) | < 0.0001 | 8 (80.0) | 0 (0) |
Uric acid | 6 (66.7) | 3 (33.3) | 0.25 | 3 (50.0) | 0 (0) |
PTH | 4 (33.3) | 2 (16.7) | 0.63 | 3 (75.0) | 1 (8.3) |