Análise comparativa dos efeitos da Gastrectomia Vertical e Bypass Gástrico em Y de Roux sobre a redução de peso corporal e condições metabólicas em Mulheres e Homens ao longo de cinco anos

Abstract

Bariatric surgery (BS) is an important strategy for weight loss and reestablishment of lipid and glycemic homeostasis, especially in morbidly obese individuals. Brazil is the second in number of BS in the world. The effects of Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) plasma metabolic parameters were available in women and men 1 and 5 years after surgery. This is a retrospective study. All SG and RYGB were performed as a primary procedure between 01/2010 and 12/2013 were included (n = 713). The trained doctors were used to obtain sex, age, body weight, height, Body Mass Index. Blood biochemical levels (glucose and lipids) and systolic and diastolic blood pressure were also recorded. All variables were compared at the beginning, 1 and 5 years after a BS. The unified test was not performed using the Statistic 7.0 software (STATSOFT, 2004) and ANCOVA on the R Core Team, 2018 (p <0.05). The percentage of excess weight loss (%EWL) was calculated and principal component analysis (PCA) at 5 years of follow-up was performed. RYGB was the most common procedure (73%) performed in special women. At the beginning of the study, BMI and body weight were lower in women who perceived SG compared to women in the RYGB group (p <0.05). Hyperglycemia and dyslipidemia were observed in both groups preoperatively. One year after BS there was significant weight loss, BMI, SBP and reductions in DBP in men and women, these effects were similar in the SG and RYGB groups. However, RYGB resulted in a greater % EWL for 1 and 5 years of follow-up, particularly in women. Additionally, the PCA showed that SG and RYGB patients demonstrated reduced body weight, BMI and metabolic parameters at 1 year after BS, but a more accentuated body weight reduction was observed in RYGB patients at 5 years follow up. Glucose and lipid homeostasis were restored in SG and RYGB patients at one year of follow-up; however, these effects tended to disappear at 5 years follow up. Thus, it concludes the SG and RYGB procedures that use body weight, BMI and metabolic parameters with similar effect 1 year after BS in women and men. However, without 5-year follow-up, the RYGB technique was more effective in % EWL, particularly in women. Importantly, in the long term (5 years) SG and RYGB were inefficient in preserving glucose and lipid homeostasis.