Original articleCan bariatric surgery improve cardiovascular risk factors in the metabolically healthy but morbidly obese patient?
Section snippets
Study protocol
A nonrandomized, prospective cohort study was conducted on severely obese patients undergoing bariatric surgery at the Hospital del Mar, Barcelona. Patients were aged between 18 and 55 years and met the 1991 bariatric surgery criteria of the National Institutes of Health [12]. Patients with a BMI of 35–39 kg/m2 were excluded from the present analysis because the criteria for bariatric surgery in these cases include the presence of metabolic abnormalities. Therefore, only patients with BMI >40
Results
Forty-two (18.9%) patients fulfilled the MHMO criteria. Demographic and baseline metabolic characteristics of MHMO and MUMO patients are detailed in Table 1. MHMO patients were younger and more frequently female. No differences between groups were found for weight, BMI, waist and hip circumference, total and LDL-C. At baseline, MHMO patients presented lower levels of systolic and diastolic blood pressure, plasma glucose, insulin and triglycerides, and higher HDL-C levels. In the MUMO group,
Discussion
In the present study, 18.9% of the patient cohort, undergoing bariatric surgery, were MHMO. Besides differences in metabolic profile, MHMO participants were younger and more frequently women than MUMO patients, but similar in anthropometric parameters. Interestingly, MHMO patients, despite having “normal” preoperative blood pressure, glucose and lipid levels, showed a significant improvement in all of these parameters after bariatric surgery.
The common underlying criterion used to identify
Conclusion
Eighteen percent of patients with morbid obesity in a bariatric surgery unit fulfilled the criteria for MHMO. Although cardiovascular risk factors in these patients were in normal range, an improvement in all these factors was observed after bariatric surgery. Thus, from a metabolic point of view, MHMO patients benefited from bariatric surgery. On the other hand, the majority of metabolically unhealthy but morbidly obese patients became metabolically healthy 1 year after surgery.
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
Acknowledgment
We thank Miss Christine O’Hara for review of the English version of the manuscript.
Obemar group members: Department of Anaesthesiology, Hospital del Mar, Barcelona (L. Trillo); Department of Clinical Pharmacology, IMIM (M. Farre, R. de la Torre); Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona (D. Benaiges, J. Flores-Le Roux, A. Goday, A. Mas, A. Parri, J. Pedro Botet, M. Renard, E. Sagarra, M. Villatoro); Department of Psychiatry, Hospital del Mar, Barcelona (S. Ros, J.
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