Therapeutic effect comparison of laparoscopic sleeve gastrectomy in treatment of obese males and females: a historical cohort analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Haotian ¹ , ZHU Xiaocheng ² , YAO Libin ² , HONG Jian ² ,  SHAO Yong ²

1. Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221004, P. R. China;
2. Department of Gastrointestinal Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P. R. China;

Corresponding author：

SHAO Yong, Email: shaoyutong1975@163.com

Keywords：

obesity; gender; laparoscopic sleeve gastrectomy; clinical therapeutic effect

DOI：

10.7507/1007-9424.202210009

Video：

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Objective To compared weight loss and metabolic improvement effects of laparoscopic sleeve gastrectomy (LSG) in treatment of obese males and females. Methods According to the inclusion and exclusion criteria, the obese patients were retrospectively collected, who underwent LSG from January 2020 to June 2021 in the Affiliated Hospital of Xuzhou Medical University, and there were complete preoperative data and postoperative follow-up data at month 1, 3, 6, and 12. The weight loss and metabolic improvement effects of obese males and females were compared, as well as the remissions of diabetes and hyperlipidemia at the 12th month after surgery were observed. Results A total of 129 eligible obese patients were included, including 44 obese males and 85 obese females. The preoperative body mass index (BMI), fasting blood glucose (FBG) level, and insulin level of the obese males were higher than those of the obese females (P<0.05). ① Weight loss effect after LSG: For both obese males and females, the change value (Δ) of BMI (all change values of the indexes were the difference between preoperative and postoperative value in this study), the percentage of excess body weight loss (EWL%), and percentage of total body weight loss showed continuous upward trends within the observation time range (P<0.05). And it was found that the obese males’ ΔBMI was higher than that of the obese females at the 1st and 3rd month after surgery (P<0.05), and the EWL% of the obese males was lower than that of the obese females at the 3rd, 6th, and 12th month after operation (P<0.05). ② Metabolic improvement effect after LSG: Blood glucose and lipid metabolism indicators in both male and female patients（ΔFBG, ΔINS, ΔHbA1c, ΔTC and ΔTG) changed the fastest at 1 month after operation, and the change became flat after 3 months, except for males ΔTC index (P>0.05), the overall difference between male and female patients at each time point after operation was statistically significant (P<0.05). After operation, the ΔFBG (at the 1st, 3rd, 6th, and 12th month) and Δinsulin (at the 3rd, 6th, and 12th month) in the obese males were higher than those in the obese females (P<0.05). The remission rates of diabetes and hyperlipidemia in the obese males and females at the 12th month after surgery were both higher, but there was no significant difference between the two groups [64.7% (11/17) versus 81.0% (17/21), χ²=0.578, P=0.447; 73.9% (17/23) versus 84.4% (27/32), χ²=0.378, P=0.539]. Conclusions From the results of this study, LSG is an effective method in treatment of obesity and its complications for both males and females. Bariatric surgery should be suggested to perform as soon as possible for obese males with poor metabolic status.

Citation： LI Haotian, ZHU Xiaocheng, YAO Libin, HONG Jian, SHAO Yong. Therapeutic effect comparison of laparoscopic sleeve gastrectomy in treatment of obese males and females: a historical cohort analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(3): 273-278. doi: 10.7507/1007-9424.202210009 Copy

1.	NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1 698 population-based measurement studies with 19.2 million participants. Lancet, 2016, 387(10026): 1377-1396.
2.	Mousapour P, Valizadeh M, Mahdavi M, et al. Trends in the prevalence of severe obesity among Tehranian adults: Tehran Lipid and Glucose Study, 1999–2017. Arch Iran Med, 2020, 23(6): 378-385.
3.	Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol, 2019, 15(5): 288-298.
4.	Bray GA, Kim KK, Wilding JPH, et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev, 2017, 18(7): 715-723.
5.	Ghiassi S, El Chaar M, Aleassa EM, et al. ASMBS position statement on the relationship between obesity and cancer, and the role of bariatric surgery: risk, timing of treatment, effects on disease biology, and qualification for surgery. Surg Obes Relat Dis, 2020, 16(6): 713-724.
6.	Lega IC, Lipscombe LL. Review: diabetes, obesity, and cancer-pathophysiology and clinical implications. Endocr Rev, 2020, 41(1): bnz014. doi: 10.1210/endrev/bnz014.
7.	Ng ACT, Delgado V, Borlaug BA, et al. Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging. Nat Rev Cardiol, 2021, 18(4): 291-304.
8.	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 中国肥胖代谢外科研究协作组. 中国肥胖代谢外科数据库: 2021年度报告. 中华肥胖与代谢病电子杂志, 2022, 8(1): 15-23.
9.	Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg, 2021, 31(5): 1937-1948.
10.	Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg, 2019, 29(3): 782-795.
11.	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 肥胖与代谢病外科疗效报告的标准规范. 中华肥胖与代谢病电子杂志, 2020, 6(2): 73-77.
12.	Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis, 2015, 11(3): 489-506.
13.	王玥, 孟楠. 基于Joinpoint回归分析我国成人超重、肥胖流行趋势的性别差异. 中国卫生统计, 2021, 38(4): 546-548.
14.	Dai H, Alsalhe TA, Chalghaf N, et al. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: an analysis of the Global Burden of Disease Study. PLoS Med, 2020, 17(7): e1003198. doi: 10.1371/journal.pmed.1003198.
15.	Lin X, Li H. Obesity: epidemiology, pathophysiology, and therapeutics. Front Endocrinol (Lausanne), 2021, 12: 706978. doi: 10.3389/fendo.2021.706978.
16.	Oussaada SM, van Galen KA, Cooiman MI, et al. The pathogenesis of obesity. Metabolism, 2019, 92: 26-36.
17.	Bray GA, Frühbeck G, Ryan DH, et al. Management of obesity. Lancet, 2016, 387(10031): 1947-1956.
18.	Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nat Rev Endocrinol, 2018, 14(1): 12-24.
19.	Celik O, Yildiz BO. Obesity and physical exercise. Minerva Endocrinol (Torino), 2021, 46(2): 131-144.
20.	Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults: a review. JAMA, 2020, 324(9): 879-887.
21.	Ghiassi S, Morton JM. Safety and efficacy of bariatric and metabolic surgery. Curr Obes Rep, 2020, 9(2): 159-164.
22.	Cooper AJ, Gupta SR, Moustafa AF, et al. Sex/gender differences in obesity prevalence, comorbidities, and treatment. Curr Obes Rep, 2021, 10(4): 458-466.
23.	Kochkodan J, Telem DA, Ghaferi AA. Physiologic and psychological gender differences in bariatric surgery. Surg Endosc, 2018, 32(3): 1382-1388.
24.	Fallon EA, Harris BS, Johnson P. Prevalence of body dis-satisfaction among a United States adult sample. Eat Behav, 2014, 15: 151-158.
25.	Benaiges D, Más-Lorenzo A, Goday A, et al. Laparoscopic sleeve gastrectomy: more than a restrictive bariatric surgery procedure? World J Gastroenterol, 2015, 21(41): 11804-11814.
26.	Climaco K, Ahnfeldt E. Laparoscopic vertical sleeve gastrectomy. Surg Clin North Am, 2021, 101(2): 177-188.
27.	Zhu C, Zhang Y, Zhang L, et al. Changes in sex hormones after laparoscopic sleeve gastrectomy in Chinese obese men: a 12-month follow-up. Obes Surg, 2019, 29(3): 869-877.
28.	Lopez-Nava G, Negi A, Bautista-Castaño I, et al. Gut and metabolic hormones changes after endoscopic sleeve gastroplasty (ESG) vs. laparoscopic sleeve gastrectomy (LSG). Obes Surg, 2020, 30(7): 2642-2651.
29.	Li M, Liu Y, Jin L, et al. Alterations of gastric emptying features following laparoscopic sleeve gastrectomy in Chinese patients with obesity: a self-controlled observational study. Obes Surg, 2019, 29(2): 617-625.

1. NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1 698 population-based measurement studies with 19.2 million participants. Lancet, 2016, 387(10026): 1377-1396.
2. Mousapour P, Valizadeh M, Mahdavi M, et al. Trends in the prevalence of severe obesity among Tehranian adults: Tehran Lipid and Glucose Study, 1999–2017. Arch Iran Med, 2020, 23(6): 378-385.
3. Blüher M. Obesity: global epidemiology and pathogenesis. Nat Rev Endocrinol, 2019, 15(5): 288-298.
4. Bray GA, Kim KK, Wilding JPH, et al. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation. Obes Rev, 2017, 18(7): 715-723.
5. Ghiassi S, El Chaar M, Aleassa EM, et al. ASMBS position statement on the relationship between obesity and cancer, and the role of bariatric surgery: risk, timing of treatment, effects on disease biology, and qualification for surgery. Surg Obes Relat Dis, 2020, 16(6): 713-724.
6. Lega IC, Lipscombe LL. Review: diabetes, obesity, and cancer-pathophysiology and clinical implications. Endocr Rev, 2020, 41(1): bnz014. doi: 10.1210/endrev/bnz014.
7. Ng ACT, Delgado V, Borlaug BA, et al. Diabesity: the combined burden of obesity and diabetes on heart disease and the role of imaging. Nat Rev Cardiol, 2021, 18(4): 291-304.
8. 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 中国肥胖代谢外科研究协作组. 中国肥胖代谢外科数据库: 2021年度报告. 中华肥胖与代谢病电子杂志, 2022, 8(1): 15-23.
9. Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters. Obes Surg, 2021, 31(5): 1937-1948.
10. Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg, 2019, 29(3): 782-795.
11. 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 肥胖与代谢病外科疗效报告的标准规范. 中华肥胖与代谢病电子杂志, 2020, 6(2): 73-77.
12. Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis, 2015, 11(3): 489-506.
13. 王玥, 孟楠. 基于Joinpoint回归分析我国成人超重、肥胖流行趋势的性别差异. 中国卫生统计, 2021, 38(4): 546-548.
14. Dai H, Alsalhe TA, Chalghaf N, et al. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: an analysis of the Global Burden of Disease Study. PLoS Med, 2020, 17(7): e1003198. doi: 10.1371/journal.pmed.1003198.
15. Lin X, Li H. Obesity: epidemiology, pathophysiology, and therapeutics. Front Endocrinol (Lausanne), 2021, 12: 706978. doi: 10.3389/fendo.2021.706978.
16. Oussaada SM, van Galen KA, Cooiman MI, et al. The pathogenesis of obesity. Metabolism, 2019, 92: 26-36.
17. Bray GA, Frühbeck G, Ryan DH, et al. Management of obesity. Lancet, 2016, 387(10031): 1947-1956.
18. Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nat Rev Endocrinol, 2018, 14(1): 12-24.
19. Celik O, Yildiz BO. Obesity and physical exercise. Minerva Endocrinol (Torino), 2021, 46(2): 131-144.
20. Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults: a review. JAMA, 2020, 324(9): 879-887.
21. Ghiassi S, Morton JM. Safety and efficacy of bariatric and metabolic surgery. Curr Obes Rep, 2020, 9(2): 159-164.
22. Cooper AJ, Gupta SR, Moustafa AF, et al. Sex/gender differences in obesity prevalence, comorbidities, and treatment. Curr Obes Rep, 2021, 10(4): 458-466.
23. Kochkodan J, Telem DA, Ghaferi AA. Physiologic and psychological gender differences in bariatric surgery. Surg Endosc, 2018, 32(3): 1382-1388.
24. Fallon EA, Harris BS, Johnson P. Prevalence of body dis-satisfaction among a United States adult sample. Eat Behav, 2014, 15: 151-158.
25. Benaiges D, Más-Lorenzo A, Goday A, et al. Laparoscopic sleeve gastrectomy: more than a restrictive bariatric surgery procedure? World J Gastroenterol, 2015, 21(41): 11804-11814.
26. Climaco K, Ahnfeldt E. Laparoscopic vertical sleeve gastrectomy. Surg Clin North Am, 2021, 101(2): 177-188.
27. Zhu C, Zhang Y, Zhang L, et al. Changes in sex hormones after laparoscopic sleeve gastrectomy in Chinese obese men: a 12-month follow-up. Obes Surg, 2019, 29(3): 869-877.
28. Lopez-Nava G, Negi A, Bautista-Castaño I, et al. Gut and metabolic hormones changes after endoscopic sleeve gastroplasty (ESG) vs. laparoscopic sleeve gastrectomy (LSG). Obes Surg, 2020, 30(7): 2642-2651.
29. Li M, Liu Y, Jin L, et al. Alterations of gastric emptying features following laparoscopic sleeve gastrectomy in Chinese patients with obesity: a self-controlled observational study. Obes Surg, 2019, 29(2): 617-625.

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Therapeutic effect comparison of laparoscopic sleeve gastrectomy in treatment of obese males and females: a historical cohort analysis

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