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- Title
A Prospective Randomized Controlled Trial of the Metabolic Effects of Sleeve Gastrectomy with Transit Bipartition.
- Authors
Azevedo, Fernanda R.; Calderaro, Daniela; Gualandro, Danielle M.; Yu, Pai C.; Caramelli, Bruno; Santoro, Sergio; Correa-Giannella, Maria L.; Giannella-Neto, Daniel; Toyoshima, Marcos T.
- Abstract
Purpose: To compare the effects of the sleeve gastrectomy with transit bipartition (SG + TB) procedure with standard medical therapy (SMT) in mildly obese patients with type II diabetes (T2D).Methods: This is a prospective, randomized, controlled trial. Twenty male adults, ≤ 65 years old, with T2D, body mass index (BMI) > 28 kg/m2 and < 35 kg/m2, and HbA1c level > 8% were randomized to SG + TB or to SMT. Outcomes were the remission in the metabolic and cardiovascular risk variables up to 24 months.Results: At 24 months, SG + TB group showed a significant decrease in HbaA1c values (9.3 ± 2.1 versus 5.5 ± 1.1%, P = < 0.05) whereas SMT group maintained similar levels from baseline (8.0 ± 1.5 versus 8.3 ± 1.1%, P = NS). BMI values were lower in the SG + TB group (25.3 ± 2.8 kg/m2 versus 30.9 ± 2.5 kg/m2; P = < 0.001). At 24 months, none patient in SG + TB group needed medications for hyperlipidemia/hypertension. HDL-cholesterol levels increased in the SG + TB group (33 ± 8 to 45 ± 15 mg/dL, P < 0.001). After 24 months, the area under the curve (AUC) of GLP1 increased and in the SG + TB group and the AUC of the GIP concentrations was lower in the SG + TB group than in the SMT. At 3 months, SG + TB group showed a marked increase in FGF19 levels (74.1 ± 45.8 to 237.3 ± 234 pg/mL; P = 0.001).Conclusions: SG + TB is superior to SMT and was associated with a better metabolic and cardiovascular profile.
- Subjects
OVERWEIGHT persons; TYPE 2 diabetes; ATHEROSCLEROSIS; SLEEVE gastrectomy; BARIATRIC surgery; PHYSIOLOGY
- Publication
Obesity Surgery, 2018, Vol 28, Issue 10, p3012
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-018-3239-3