Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/29336
Title: A Prospective Randomized Controlled Trial of the Metabolic Effects of Sleeve Gastrectomy with Transit Bipartition
Authors: AZEVEDO, Fernanda R.SANTORO, SergioCORREA-GIANNELLA, Maria L.TOYOSHIMA, Marcos T.GIANNELLA-NETO, DanielCALDERARO, DanielaGUALANDRO, Danielle M.YU, Pai C.CARAMELLI, Bruno
Citation: OBESITY SURGERY, v.28, n.10, p.3012-3019, 2018
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/m(2) and < 35 kg/m(2), 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/m(2) versus 30.9 +/- 2.5 kg/m(2); 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.
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